COVID-19 treatment options in short supply

CEDAR RAPIDS — A nationwide shortage of available COVID-19 therapies has forced local health care providers to adjust their treatment protocols to prioritize the highest risk patients.

UnityPoint Health issued a warning this week that its Eastern Iowa hospitals are experiencing a shortage of monoclonal antibody therapy, an infusion of that uses antibodies to prevent patients exposed to the coronavirus from developing a serious illness.

As a result, local health care providers are unable to provide the therapy to everyone who may need it currently, said Dr. Dustin Arnold, chief medical officer at UnityPoint Health-St. Luke’s Hospital in Cedar Rapids.

“If you’re high risk, it’s fair to be concerned,” Arnold said. “If you’re unvaccinated, you should be concerned. That’s why it’s important they get the vaccine with a booster to get that protection from the virus.”

Experts have found some monoclonal antibody therapies are not effective against omicron, the new highly transmissible coronavirus variant. The one therapy that is effective against the variant is Sotrovimab, which was developed by Vir Biotechnology in California. However, health system officials say the supply of that treatment is very limited, and should be prioritized “for patients at highest risk for hospitalization.”

“If this treatment is prescribed by a provider, there is no guarantee that infusion centers will have supply on hand,” UnityPoint Health officials said this week in a statement.

The therapies are distributed to hospitals across the country through a federal allocation system. State public health departments are tasked with distributing the state’s allocation to individual hospitals and health care facilities.

St. Luke’s received only five doses of Sotrovimab last week, which have been administered to patients. Arnold said. This week, St. Luke’s has not received any allocation of Sotrovimab.

Arnold said they don’t know when they will receive their next allocation, but officials expect the limited supply will be an ongoing challenge for some time.

Mercy Medical Center in Cedar Rapids, which also receives a Sotrovimab allocation from the Iowa Department of Public Health, also confirmed it is facing a shortage of the therapy.

Among patients who qualify for the treatment, Arnold said St. Luke’s providers are prioritizing those who are pregnant, women and children first. From there, Arnold said they determine who is most at risk based on preexisting conditions and whether they are fully vaccinated. Those who are unvaccinated would also be prioritized, since they don’t have the benefit of being protected from the vaccines, Arnold said.

New coronavirus infections have surged statewide in recent weeks, driven by the arrival of the omicron variant.

On Monday, 32,732 positive tests were reported in the state in the past seven days, driving the 14-day positivity up to nearly 20 percent, according to the latest coronavirus data from the Iowa Department of Public Health. This past Monday, the 14-day positivity rate was 13.5 percent, state data shows.

Antiviral medicine also in short supply

UnityPoint Health officials also warned patients there’s a limited supply of new oral antiviral medications that have recently hit the markets as a new treatment option for patients with mild to moderate COVID-19 infections.

Last month, the U.S. Food and Drug Administration authorized two types of COVID-19 pills that officials say reduces the risk of hospitalization and death. The agency’s federal use authorization approves use for only those who are at highest risk for developing severe disease.

Those medications will be distributed through the same federal allocation, which means drugs will be sent to retail pharmacies and health care facilities by the state public health department. Arnold said its unclear to hospital providers how many doses will be available locally.

As a result, health system officials warn that even if the medication is prescribed to a patient, there’s no guarantee pharmacies will be able to supply the pills to patients.

At a time when supplies of available COVID-19 treatments are limited, hospital officials stressed the importance of COVID-19 vaccines, which are highly effective in preventing serious illness and death. Anyone aged 5 and older are encouraged to be fully vaccinated against COVID-19 as soon as possible. Those aged 12 and older, and who are eligible, also should get a booster shot as soon as possible.

“This can help reduce the current burden on our health care workers and ensure care is available for those who need it most,” UnityPoint Health officials say.

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