Ballad doc, TN health commissioner hope more COVID patients opt for antibody treatment

Local Coronavirus Coverage

One-hour infusion therapy greatly reduces hospitalization rates for high-risk patients

JOHNSON CITY, Tenn. (WJHL) – It may not be a miracle treatment, but an antibody therapy has likely kept a few dozen COVID patients out of Ballad Health hospitals over the last several weeks – even though many people are unaware it’s available and won’t cost them anything out of pocket.

Monoclonal antibody treatment is a one-hour infusion available for any COVID positive patient with symptoms who is over 65 or any age and has underlying conditions including heart disease, diabetes, high blood pressure or obesity.

Dr. Mark Wilkinson

“Out of the 180-some that we’ve done in the past month or so, I think there may have only been one or two admissions resulting from that population of patients,” said Dr. Mark Wilkinson, Ballad’s VP of medical staff services and hospital-based programs.

That’s likely kept Ballad’s skyrocketing COVID patient hospital census – it’s more than quadrupled in three weeks to 201 – from rising even faster.

“It makes a huge difference,” Wilkinson told News Channel 11 Tuesday. “We are stretched thin with our resources and our bed capacity is pushed to the limits and so every patient we can keep out of the hospital is a great win for the health system and the region as a whole.”

Tennessee Health Commissioner Dr. Lisa Piercey made note of that when she touted the treatment in a Monday news conference.

“So not only that’s what you can do for your own health, that’s also what you can do to reduce the demand on hospitals,” Piercey said.

It’s free, but timing is everything

But the treatment, first introduced by Lilly under the name Regeneron, has to be administered within a 10-day window after symptoms appear.

Patients must have at least some symptoms, though those can be mild, and not be in need of oxygen (or additional oxygen if they already use it).

Wilkinson said he thinks clinicians across the region “are well versed in monoclonal antibody availability and the effectiveness of that.” He’s confident doctors, nurse practitioners and others are steering eligible patients in that direction, citing what he called “exponential growth” in use of the treatment over the past six weeks.

“We administered five or six infusions the week following the July Fourth weekend,” Wilkinson said. “Last week we had 67 infusions. There’s a nice curve up the slope, and we expect to have more requests for infusions coming up by the end of the week.”

Wilkinson said the treatment lasts about an hour, followed by a one-hour wait.

He said no patient who receives the therapy from Ballad will owe any money out of pocket, either for the antibody itself, or the infusion and other administration costs. The drug itself was purchased by the federal government and is given to eligible providers.

“Third-party payors, all insurance companies are paying for that (infusion and admin costs) currently, in full quite honestly,” Wilkinson said.

“For those folks that have any concerns about insurance coverage or if they don’t have health insurance for example, Health Resources and Services Administration (a federal agency) will pay for their infusion – so they will never get a bill for the infusion.”

Anyone who wants to recover more quickly and stay out of the hospital is almost certain to benefit, Wilkinson said.

Tennessee Health Commissioner Dr. Lisa Piercey, right, talks about the continuing battle against the coronavirus pandemic during a news conference Wednesday, July 1, 2020, in Nashville, Tenn. At left is Gov. Bill Lee. (AP Photo/Mark Humphrey)

Piercey said in Monday’s news conference there is plenty of availability statewide.

“I promise you, if you are high risk and you get infected there is no better two hours that you can spend (than) getting that infusion because it is so highly effective of keeping you from progressing to need of hospitalization or even more severe disease,” she said.

Treatment was proving its worth regionally during winter surge

In February, News Channel 11 reported on the use of monoclonal antibody therapy for long term care residents and other high-risk COVID patients.

Dr. B.J. Smith, who runs Renuven Health Partners and works inside multiple long-term care facilities, had recently begun prescribing the treatment the U.S. Food and Drug Administration (FDA) had given an emergency use authorization for in November.

Studies then showed the single infusion of the synthetic antibody — bamlanivimab — decreased hospitalizations among people over 65 and other high-risk patients by 70%.

At that time, Centers for Disease Control and Prevention (CDC) data showed patients in that age category are hospitalized at rates 5 to 13 times higher than 18 to 29-year-olds, according to the Centers for Disease Control and Prevention (CDC).

One of Smith’s nurses, Brooke Price, fell ill just before Christmas. Renuven had already started using the therapy, and she qualified for the treatment due to some other high-risk factors.

Price already had a high fever, lung changes that showed up on an x-ray and lower-than-average oxygen saturation when she entered the Johnson City Medical Center ER.

Four hours later, Price had waited on COVID test results, been hooked up to an infusion machine, received 700 mg of “bam,” as the providers call bamlanivimab, been observed for a bit and headed home.

“I had the antibodies and within three days was starting to feel better,” Price said. “I really feel like I would have been much sicker had I not gotten them.”

Help yourself, help others

Wilkinson said monoclonal antibody treatment is such a difference-maker that Ballad is working right now to get some additional providers certified. A new option involving four injections is available, though Piercey said the infusion remains the preferred method.

“You want to get better sooner rather than later from your COVID infection. This has been proven to decrease the duration of symptoms, minimize the severity of symptoms and prevent hospitalization,” he said.

It also reduces the risk of what Wilkinson called sequelae — a medical term for longer-term symptoms, generally termed “long COVID” — that’s affected a significant number of people.

And right now, while hospital resources are strained, Wilkinson said there’s plenty of antibody treatment currently available.

“The other things are in short supply that you may need to have on the inpatient side, but the monoclonal antibodies that we currently have, the Regeneron COV combination therapy, we have plenty on hand of that.”

While he stressed the preference for vaccination, as well as masking and other social distancing during outbreaks, Wilkinson said he’d encourage anyone who might be eligible to check into the option if they do test positive and develop symptoms.

Piercey was even blunter.

“If someone is in an eligible category,” Piercey said, “Your very first call should be to your doctor or to a facility that has monoclonal antibodies to go ahead and get on the schedule.”

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