Most of you reading this will know my name because of the articles you read on a somewhat regular basis. But I actually have another job. I run special projects for a company that services nursing homes and home-bound patients. For the last few months, my primary project has been the acquisition and distribution of monoclonal antibodies (mAB). Without getting into too much clinical detail, mAB are a treatment for a variety of diseases and conditions, and they have come to the attention of the general public recently for their effectiveness in handling COVID-19.
In fact, they are so effective that the federal government took over their distribution in mid-2021, much like they did the vaccines and they do every year with the flu shots. Up until the takeover, anyone was able to use them to effectively treat their patients. No state did this more effectively than Florida, which was among the first to implement a statewide distribution policy. Once the general public became aware of their vast capabilities, every step of the process is now handled by the federal government, from the time they leave the companies that make them until the time they are given to patients.
Like the vaccines, there are a few companies that produce the mAB supply. Regeneron produced REGEN-COV, the most popular early in the distribution process, as it was the only one that was able to be given subcutaneously (i.e. an injection). The other two, Eli Lilly’s Bamlanivimab (BAM) and Vir Biotech’s Sotromivab (Sotro), had to be given intravenously. It is for this reason that while most doctors’ offices might want to have a stock of REGEN-COV on hand, only facilities such as hospitals had the capabilities to give the IV version. And even though the REGEN-COV was able to be given both as an IV and as an injection, the FDA explained that the IV was preferred and more effective.
Recently, however, the FDA learned that both the BAM and REGEN-COV, while very effective against the Delta variant, were less so against the Omicron variant, and has removed their emergency use authorization. Thus, the only approved mAB available as of writing is the Sotro.
The sudden cancelation of REGEN-COV and BAM opened a world of questions that have yet to be answered. Firstly, how ineffective are these treatments exactly? All we’ve heard so far is that they’re less effective against Omicron, but we have yet to hear just how ineffective they are. The reason this is so important is that if they are even a little effective, perhaps they would be better than nothing. There have been very few major downsides to using these antibodies, and the upside is incredible. Additionally, we have been wearing masks for the last two years, and cloth masks are only about 37% effective, according to an August 2021 study from Yale and Stanford. The EPA released a study that had the cloth masks at a 26% effective rate. The point is that while N95s, KN95s, and surgical masks are more effective, nobody is saying that no mask is as effective as a cloth mask. The same should hold true for monoclonal antibodies. If they are even a little effective, perhaps they should not be sidelined. We will not know until the data is made available.
The other major issue that arises from this is how the federal government chose to utilize their stockpile of mAB. Supply of this life-saving drug was carefully allocated throughout the last several months, despite there being more supply than was distributed. After all, the government did not want providers to waste these drugs. They needed to be given sparingly so only those in dire need would get them. So now the federal government must be sitting on an unfathomable stock of mAB that could have been used at a time when Delta was the dominant variant. Instead, the country now owns countless useless supplies of what could have been life-saving drugs at the time, and instead will now sit unless they prove to work against the next new variant.
Now we do not know how much of the unused stock of the BAM and the REGEN-COV the government has, but I know how much my company has of this stock, and if the rest of the country is anything like that, this country has way too much of what used to be a good thing. We can only hope that the federal government learns its lesson and chooses not to sit on any doses moving forward because as soon as the next variant hits, Sotro can go the same way.
Izzo Zwiren is the host of The Jewish Living Podcast, where he and his guests delve into any and all areas of Orthodox Judaism.