The U.S. has purchased nearly three million doses at a cost of around US$2,100 each — much higher than a typical dose of COVID-19 vaccine — and is making the treatment available to patients for free, said the manufacturer.
And the World Health Organization endorsed on Friday the medication for some patients at high risk of hospitalization.
But in Canada, this and other drugs, known as monoclonal antibody treatments, are hardly being used — even though doctors say they would be a useful addition to their COVID-fighting arsenal.
“This new antibody cocktail is the one that is probably the most promising for people with mild COVID-19 and also seems to be promising for people who are hospitalized with COVID-19, who are naïve to the virus: so they haven’t been vaccinated or they haven’t been infected before,” said Dr. Amol Verma, a physician and scientist at St. Michael’s Hospital and the University of Toronto.
These drugs are a direct shot of antibodies targeting the virus that causes COVID-19, he said, designed to help people who have already been infected better fight it off, and lessening the chance that they may have to be hospitalized.
Some patients say the treatments made a huge difference in their lives.
Joyce Wachsmuth, of Eau Claire, Wis., and her husband were infected with COVID-19 in January. A breast cancer survivor, she had never felt so much pain.
When doctors at the local Mayo Clinic told the 67-year-old that she and her 70-year-old husband were prime candidates for what was then an experimental drug treatment with monoclonal antibodies, she jumped at the opportunity, she told the Associated Press in August.
Wachsmuth said she felt relief just two hours after the one-hour drip treatment.
“It did wonders. It kept us off the hospital and off the ventilators,” said Wachsmuth, who has since been vaccinated.
“From everything that we know so far, and we have several studies on this, it’s remarkably effective,” said Dr. Andrew Morris, an infectious diseases physician at Sinai Health and University Health Network and professor at the University of Toronto.
But although he thinks it’s useful, Morris said, “In Canada, we just don’t have enough of it.”
According to the Public Health Agency of Canada, Canada has received 6,000 doses of the antibody cocktail, with another 3,000 doses due to come in October — far less than the U.S.’s order of 3 million doses.
Almost every province Global News contacted reported limited supply, with some like New Brunswick saying the treatment wasn’t available at all.
There are a few reasons why these treatments aren’t broadly used in Canada, said Dr. Theresa Tam, chief public health officer of Canada, at a press conference Friday.
“It’s not really fundamentally about cost. There’s access, but also feasibility of delivery,” she said. “For example, one of the antibody combinations used to have to be given intravenously. And there’s new data to show that you can actually give it under the skin now, and that might then increase the viability of the use of these medications in the frontline setting.”
The logistics of actually giving the medication to people are definitely a barrier, said Dr. Donald Vinh, an infectious disease specialist and medical microbiologist at the McGill University Health Centre.
“These antibodies, because they require an intravenous infusion, necessarily required an infusion centre,” he said. “And infusion centres are usually done in a hospital setting where you bring people in and you have dedicated health-care personnel who put an intravenous into that person and they give them the medications and they make sure they don’t have any reactions.”
In the middle of a pandemic, there were issues finding personnel to do this, he said, and with making sure that the antibody patients — who have active COVID-19 — are kept away from other people in the hospital.
“Now you’re bringing these people who are infected into a hospital setting, which is obviously not a good thing because you don’t want them exposing other people with a virus,” he said.
In the U.S., some states have set up dedicated antibody treatment centres for COVID-19 patients.
Vinh is hoping to do something similar in Canada, in a dedicated area of the McGill University Health Centre in Montreal, with negative pressure rooms and specially trained staff to ensure that infections don’t spread.
Like Tam, he thinks that new ways of delivering the drug subcutaneously will help solve logistical problems too.
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Canada should “absolutely” use monoclonal antibody treatments more, Morris said.
“I think it is problematic that we haven’t been using the therapies yet or if we have, it’s been minimal. I see it as a very, very important part of our strategy of keeping people out of hospital and out of ICUs.”
While Vinh said vaccination is still the most important strategy for fighting the pandemic, antibody treatments have their place.
“These monoclonal antibodies are a welcome addition. They are not a silver bullet,” he said. But for people who get vaccinated but still get infected with COVID-19 and are at risk of complications, they are another tool, he added.
“We can’t just sit idly by and let them let them get infected and deteriorate. If they’ve done their part to get the vaccine, we need to do our part to make sure that we still protect them as much as we can.”
— with files from Global News’ Linda Boyle and Jamie Mauracher, and the Associated Press
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