The President’s address to Congress is an opportunity to highlight Covid-19 treatments

The United States broke records with the swift development and distribution of new Covid-19 vaccines, but after the Trump administration’s hydroxychloroquine debacle, the focus on treatments was pushed to the side.

Photo via New York Times

by Arielle Kane, Director of Health Care

The United States broke records with the swift development and distribution of new Covid-19 vaccines, but after the Trump administration’s hydroxychloroquine debacle, the focus on treatments was pushed to the side. President Biden has acknowledged that even with the new vaccines, the Covid-19 pandemic will likely linger throughout the year. To save lives, we’ll need to increase access to evidence-based treatments by educating the public, restructuring treatment facilities to handle Covid-positive patients, and helping patients navigate the health care system. Federal leadership will be essential to meet these goals.

President Biden has spent the first few weeks of his presidency ramping up Covid-19 response efforts. He signed an executive order requiring mask-wearing in all federal buildings, called for a $1.9 trillion economic recovery package, and pushed to increase vaccinations to 1.5 million per day. But one thing he hasn’t drawn a lot of attention to is treating patients with Covid-19 infections.

Even as new cases have plummeted in recent weeks, more than 1,000 Americans per day are dying from Covid-19. And because the country isn’t likely to return to ‘normal’ until the end of the year, it’s important to not lose sight of the important role effective Covid-19 treatments can play in reducing unnecessary deaths. Two drugmakers — Eli Lilly and Regeneron — have developed monoclonal antibody therapies that lessen the effects of Covid-19 on high-risk patients. Increasing access to these treatments will save lives.

Next week at his State of the Union address, President Biden will emphasize his Covid-19 recovery plan. He should use the bully pulpit of the presidency to emphasize that evidence-based therapies are available to people who get infected.

Recent research from Baylor University Medical Center published in the Journal of the American Medical Association found that monoclonal antibodies reduced hospitalizations among high-risk Covid-19 patients. However, to be effective, it was important that these high-risk patients — those over 65 or with obesity or diabetes or immunocompromised — received the therapy early in the course of their illness. This means that doctors need to be aware of and prescribe the treatment and patients need access to infusion facilities since the drugs are delivered intravenously within the first 10 days of symptoms.

Yet uptake of these effective therapies remains low. There are four main hurdles:

• With ever-changing clinical guidelines for Covid-19, many physicians aren’t aware of the efficacy of these new treatments and thus aren’t prescribing them to patients
• Stand-alone infusion centers require referrals from physicians and may be hesitant to accept Covid-positive patients
• Hospitals are overburdened with critically ill Covid-19 patients and vaccination efforts and haven’t set up out-patient infusion centers where patients can easily be treated
• It’s difficult to identify and treat patients within the 10-day window from the onset of symptoms

There are steps the new administration can take to improve access to these therapies which will in-turn save lives and lessen the impact of the pandemic.

First, the Centers for Disease Control and Prevention (CDC) should work with state licensing boards to ensure the timely dissemination of clinical information to providers on the ground. Because guidelines are evolving as we learn more about Covid-19, it’s important that there are clear communication channels to get information to individual providers across all states. While it makes sense for the CDC to act as a central gathering place of information, providers should not have to be checking the CDC website daily in order to stay up to date.

Second, infusion centers need to adapt to Covid-19. Given the importance of receiving treatments within 10 days of the onset of symptoms, infusion centers need to update their practices to expedite the treatment process. That might mean working to build relationships with individual providers so that they know where to refer Covid-positive patients and changing their protocols to accept walk-ins without appointments. They also need to make sure they have the infrastructure needed to treat Covid positive patients and keep them separate from patients receiving other types of infusions.

Third, as daily cases have dropped, hospitals should shift their focus from treating Covid-19 inpatients patients to helping treat Covid-19 patients in the outpatient setting. Typically, hospital infusion centers are for administering cancer drugs. Restructuring infusion facilities so that they can be safe for Covid-positive patients and cancer patients will be an important step to getting more people treatment.

Finally, contact tracing, testing and diagnosing Covid-19 patients in a timely fashion remains as important as ever. Patients need to know they are Covid-19 positive within a few days in order to be able to benefit from monoclonal antibody therapies. Continued investment in contact tracing and testing will make fast diagnoses possible. But after a patient receives a positive Covid-19 test either from a doctor’s office, public testing site, or a pharmacy, there needs to be a pipeline to a care provider and treatment, if needed. Monoclonal antibody therapies require a prescription and a referral and often patients will have to drive to an infusion site. Making sure the patient is easily transferred between care sites will be vital to timely access to treatment.

There is no question that the pandemic is improving. But with President Biden’s admission that Covid-19 is likely to drag on in the coming months, it is vital that people know more about treatment opportunities. Monoclonal antibody therapies are out there and should be available to everyone — not just the well-informed health care consumer or the elites. The president has made effective use of his bully pulpit to encourage mask wearing and vaccinations. He should do the same with Covid-19 therapies.