The latest version of the coronaviruses does not appear to affect the effectiveness of two of the three monoclonal antibody treatments that doctors have depended on to keep Covid-19 patients from becoming seriously ill.
Many doctors and hospitals have already run out of supplies because of the scarcity of the one treatment that is still likely to work against Omicron.
High-risk patients can be kept out of the hospital with the use ofonoclonal antibodies. As infections surge and Omicron becomes the dominant form of new cases in the United States, some hospitals have begun scaling back treatments, fearing they have become useless.
The administrators at New York-Presbyterian, N.Y.U. Langone, and Mount Sinai all said in recent days that they would stop giving patients the two most commonly used antibody treatments, made by Eli Lilly and Regeneron, according to memos obtained by The Times.
The change in the last week or so is dramatic, said Dr. Daniel Griffin, an infectious disease specialist at Columbia University in New York. I think it makes sense.
The Omicron variant accounted for 73 percent of new cases in the United States last week, according to the Centers for Disease Control and Prevention. It was over 13 percent the week before.
Some researchers think the percentage is not that high, but they also find Omicron infections doubling every two or three days.
A senior administration official who spoke on condition of anonymity said that the federal health officials would decide at the end of this week whether to stop shipments of the Eli Lilly and Regeneron products to individual states based on how dominant Omicron becomes in different regions of the country.
Sotrovimab, made by Glaxosmithkline and Vir Biotechnology, was cleared in May and has performed well against Omicron in laboratory experiments.
The supply of sotrovimab is limited because of high demand. The situation is likely to improve in the coming weeks. An administration official said that the Biden administration is in talks with Glaxo about getting more doses to be delivered by early next year.
The first two products in a new class of Covid treatments are expected to be approved this week.
High-risk patients who might have received antibody treatments can now take both pills to stave off illness. Paxlovid, Pfizer's treatment, has been found to be highly effective and likely to work against Omicron.
Even modest amounts of these antivirals may help ease the strain on doctors who have been relying on monoclonal antibodies to treat Covid patients.
The chairman of the Department of Medicine at the University of California, San Francisco warned that patients might be surprised by the limited availability of antibody treatments.
If you choose to be less safe because of your choice of vaccines or masking, it is riskier than it would have been a few weeks ago, said Dr. Wachter.
The image is.
There is an urgent care center in Florida that has a vial of Regeneron's monoclonal antibody treatment.
The authorizations for the treatments were given late last year by Eli Lilly and Regeneron.
Each patient produced a lot of different things. The companies zeroed in on a few that were the most potent at stopping earlier versions of the coronaviruses.
Clinical trials show that these antibodies are effective at preventing hospitalization if given to people early in the course of their illness. President Trump received a piece of technology during his fight with Covid.
Doctors were struggling to get scarce doses. The drugs were usually given at hospitals or clinics, with sessions lasting several hours. Monoclonal antibodies were used for treating Covid.
Hospitals set up drive-through clinics to make them more accessible. The drugs were given to people who were exposed to the coronaviruses as a way of preventing them from getting sick.
According to the Department of Health and Human Services, nearly 68,000 doses of monoclonal antibodies were given nationwide last week. Most of the patients received treatment from Eli Lilly.
Researchers found that some coronaviruses had gained resistance to the monoclonal antibodies. A change to their surface proteins prevented the antibodies from sticking to the viruses.
The government paused distribution of Eli Lilly's treatment nationwide because it was not effective against variant such as Gamma, which spread to many countries last spring.
Fortunately, doctors were able to give out Regeneron's treatment, which was in plentiful supply. Delta dominated the United States this summer.
Delta was susceptible to all of the authorized treatments. The Biden administration ordered a hundred of thousands of Eli Lilly's treatments.
Everything has changed because of Omicron.
The new variant was found in southern Africa and researchers began testing the monoclonal antibodies against it. Scientists found that both Lilly and Regeneron did a poor job of blocking the variant virus from invading cells. Sotrovimab remained potent.
The resilience of sotrovimab was attributed to the strategy the researchers used to find it. The blood of Covid survivors was not looked at by researchers, instead they looked at the blood of people who had survived the 2003 SARS epidemic.
They found a survivor's antibodies that protected against the coronaviruses that caused Covid. The sotrovimab antibody attached itself to a part of the virus that has not changed much over the course of its evolution. It would not change in new variations.
Dr. Scangos said that they got here by a thoughtful process.
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A patient in Alaska received an injection of a drug.
At New York Community Hospital in Brooklyn, clinicians have been giving the treatments to patients. The hospital ran out of the treatment a few weeks ago.
The hospital's co-chief medical officer said he would give GSK if he had a choice.
The federal government ordered about 450,000 doses of sotrovimab. In the fall, shipments began. As Omicron emerged, officials halted shipments of the still effective sotrovimab to the states in an effort to preserve the supply as scientists determined how much of a threat the new variant would be.
The government allocated 55,000 sotrovimab doses to states when it became clear that Omicron was gaining a foothold. The United States is expected to get 300,000 more doses from GSK in January.
We are doing everything we can to increase the supply in January and February and March, according to Dr. Scangos.
The companies are working to expand their capacity, adding another production facility and speeding up their production plans, according to a spokeswoman for the company.
The upper Midwest may not be able to get enough monoclonal antibodies soon because of the expansion plans.
The president of the Henry Ford Health System in Michigan said that the health system and state officials are bracing for a cutback on the two drugs.
Dr. Muma said that demand for the treatment is out of supply. He expects frontline staff to get angry.
He said that they were going to be dealing with a group of patients who were not able to get what they wanted.
Dr. Muma said that with Omicron that looks like what's coming.
The doctor who sees patients in New York City said he expects difficult conversations now that major health systems have stopped their use until the more effective treatment arrives.
He said that vaccinated patients should do well. Patients who don't want to get vaccine but think they can trust the monoclonals are the most likely to be upset. They will be there for me if I need them.
The Food and Drug Administration is trying to figure out how to regulate the production of monoclonal antibodies in this new chapter of the Pandemic.
The agency is working with sponsors of all currently authorized therapies to assess the activity against any global variant of the disease and is committed to communicating with the public as we learn more.
Dr. Lindsay Petty, an infectious disease specialist at the University of Michigan School of Medicine, said that she and her colleagues were debating when and if to switch from the abundant monoclonal antibodies to the scarcer sotrovimab.
She said that they anticipate running out of drug supply each week once they decide to change.
It will be months before Omicron will be ready for use, according to both Eli Lilly and Regeneron.
Noah gave reporting.
