The majority of U.S. doctors don’t know which coronavirus variant a patient has, and that distinction could make the difference between life or death.
Two monoclonal antibody therapies that have been shown to reduce hospitalizations, and even death, could be of great benefit to high-risk Delta variant patients. Omicron patients, however, would not be able to benefit from those drugs as they are in short supply. Omicron patients will only respond to a third antibody therapy.
While U.S. officials have endorsed using a workaround test that can identify Omicron’s genetic signature, experts say it’s not feasible for large health systems facing a crush of patients to employ in each case.
Maryland is one of the most difficult places to treat patients because Omicron accounts in roughly 58 per cent of all cases. The Delta variant is also strong in the Great Plains, as well as across the West, including California.
While there is no approved test to determine each individual’s variant, a national network of state and other labs use genome-sequencing tests to track variants broadly in communities. The data and regional estimates are then used by the health systems to decide which antibodies to use in their hospitals or clinics.
Many of them concluded, among other things, that a community of largely Delta-patients would be most benefited by the Eli Lilly and Regeneron anti-inflammatories, while Omicron-patient communities would benefit from antibodies from GlaxoSmithKline as well as Vir Biotechnology.
Federal officials have attempted to make the decision on behalf of the nation. After the Centers for Disease Control and Prevention declared that 73% of U.S. Covid cases had been Omicron, they stopped all shipments of Eli Lilly and Regeneron anti-body treatments.
An outcryRepublican political leaders claimed that some people in their states had been infected with Delta. The C.D.C. The C.D.C. lowered its estimate of Omicron cases in the country to 59 percent on Tuesday. Federal officials resumed national shipping for all antibodies treatments on December 31st.
For the next few weeks, as the country grapples with this uneven mix of both variants, tailoring treatments to each patient will be “extraordinarily difficult,” said Dr. Alex Greninger, assistant director of the clinical virology laboratories at the University of Washington Medical Center.
Dr. Greninger is the one who developed the first test to detect the coronavirus virus in the United States. He is not optimistic that the health systems will be able to quickly identify which patients have Omicron or Delta. And although a shortcut test can detect Omicron, there’s no simple way to report the results in bulk, he said.
What’s more, the genome sequencing used by public health officials takes nearly a week — too long to target the early antibody treatments that have been found to reduce the need for hospitalizations. It makes patient care difficult right now, according to Dr. Mark Siedner at Massachusetts General Hospital, an infectious disease specialist and researcher.
Omicron is the most common form of Omicron in Massachusetts, and other nearby states. Dr. Siedner said his health system has stopped using the Regeneron and Eli Lilly antibodies that are not effective against Omicron and are “anxiously awaiting” more doses of the effective treatment by GlaxoSmithKline and Vir Biotechnology.
“We’re in a holding pattern and it’s a terrible time to be in that place,” he said.
Source: NY Times
