The federal government has resumed sending states all three monoclonal antibody treatments authorized for early-stage coronavirus, even though evidence suggests two might be ineffective against omicron, The Washington Post reported on Monday.
Experts are split over the decision, with some worried that many of the costly treatments will be useless and cause confusion among patients. They are also concerned that treatment decisions will be difficult, because it can be hard for physicians to determine if patients are infected with the omicron or delta variant.
But other doctors are eager to receive treatments, even if they are less effective, because of a severe shortage of sotrovimab, the monoclonal antibody therapy that apparently works best against omicron. These experts say they would rather have some monoclonal antibodies than none, especially since some of their patients may be infected by the delta variant, which is still prevalent is some areas of the country.
David Kessler, the chief scientific officer for the Biden administration’s COVID-19 response, said the government has made clear that the two that don’t work against omicron should be used “only if the delta variant represents a significant proportion of infections in the region, and then only with the explicit understanding that these treatments would be ineffective if the patients are infected with the omicron variant,” according to The Washington Post.
Florida Gov. Ron DeSantis, one of the most vocal proponents of monoclonal antibody treatments who complained that the Biden administration late last month halted shipments of the two other such treatments shown to be less effective against omicron, made by Regeneron Pharmaceuticals and Eli Lilly, took credit in a press release for forcing the administration to resume shipments.
DeSantis and some physicians have said the Regeneron treatments could help in areas where the delta variant is still infecting people, with the governor adding that he is not convinced that these treatments were ineffective against omicron.
The Regeneron and Lilly medications, which are given to outpatients by infusion or injection, are free and have caused few side effects.
But experts are concerned that in the vast majority of cases, physicians making treatment decisions do not know whether their patient is infected by omicron or delta, because little genomic sequencing is being done, with most hospitals not having the capability to do real-time sequencing to determine how to treat individual patients, The Washington Post reported.
Even when tests are sequenced, the results are usually too late for a decision on treatment.