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State stops using some monoclonal antibody treatments after feds find it fails against omicron

Minnesota health systems were administering up to 3,000 monoclonal antibody infusions every week during the delta surge.

MINNEAPOLIS — The Minnesota Health Department announced there were just seven verified cases of omicron in the state last week. On Wednesday, MDH said that has increased more than nine-fold. 

Health officials estimate there are now 65 verified cases, and say omicron is the state's dominant coronavirus strain.

When it comes to treating COVID-19, doctors are being told to stop using two types of monoclonal antibodies after federal research found they don't work against the new variant.

For the last year, monoclonal antibodies have been one of the most promising, mostly outpatient, treatments for moderate COVID — until now.

"Omicron is making response hard," said University of Minnesota Public Health's Center for Public Health Systems Director JP Leider. "It's making prevention hard."

Leider is a public health researcher who helps prioritize what patients get the treatment that, just two months ago, the state had expanded. Most recently, it was providing up to 3,000 infusions every week to combat the delta variant.

But this week, new data from the Centers for Disease Control and Prevention shows two of the three types of treatment can't hold up against omicron. In a memo sent to state health systems on Monday, MDH asked them to re-prioritize the treatment for high-risk patients only.

"Monoclonal antibodies are made to be so specific to COVID and that's one of the reasons they're so effective, that when a new variant emerges and you have new mutations on that variant, that's why you always check and see, does this monoclonal still work," explained Leider. 

Leider calls the news a disappointing development, especially since the treatment left standing —  sotrovimab —  makes up just 10% of the state supply, the smallest amount between the three. 

"I think there's a very good chance that we won't have enough sotrovimab in the state if cases increase because of omicron," said Leider. "This is something essentially every state this week has to deal with because there's not enough to go around."

Minnesota may have to use a lottery system eventually to serve only the highest-risk patients. Even now, they're using a scoring system to limit the treatment for people who would have the poorest outcome if they got the disease. Those include people who are immunocompromised, pregnant or the elderly with chronic disease.

"We have to kind of escalate the level of risk that a patient needs to have coming in to be eligible for this incredibly, incredibly scarce drug," said Leider. 

Despite fewer tools in the tool box, Leider says there are ones in the pipeline, including Pfizer's new pill called Paxlovid. 

The Food and Drug Administration authorized it Wednesday, which makes it the first oral anti-viral treatment for COVID. Clinical trial data shows it prevents hospitalization by 90%.

It could be available in a matter of days, but supplies will be extremely limited and doctors caution that it's not a substitute for vaccination.

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