Monoclonal antibody treatment for COVID-19 touted by public health in shortage in Manitoba

What Atwal didn’t say is that Manitoba only has 268 doses of Sotrovimab – the only monoclonal antibodies recommended by the province for use against Omicron – plus an undisclosed allocation available to First Nations communities. Nations.

“Unfortunately, that won’t have a huge impact in terms of the number of cases we can avoid. But of course every case we avoid is a good thing, ”said Dr. Philippe Lagacé-Wiens, assistant professor in the Department of Medical Microbiology and Infectious Diseases at the University of Manitoba.

“We have a very, very limited supply of the effective product, Sotrovimab, because it’s just not available globally,” Lagacé-Wiens said.

Rescue treatment

A total of 122 doses of Sotrovimab have been administered since it became available on December 20, according to a spokesperson for Shared Health.

“This is the first true outpatient treatment option we have,” said Dr. Sylvain Lother, who sits on the Manitoba Science Advisory Board for COVID Therapy. Lother says monoclonal antibody treatments should always be seen as a rescue treatment, not a replacement for vaccination.

The number of patients eligible for Sotrovimab is extremely limited and it must be administered within seven days of symptom onset to be effective.

Manitoba Shared Health has identified three specific groups of people who may be offered treatment in a note to health care providers from November 20 and published on its website:

• People 40 years of age and older who have no history of COVID-19 infection and are not fully immunized.
• Unvaccinated or partially vaccinated people between the ages of 18 and 40 who have health problems such as diabetes, smoking, obesity, heart disease, kidney disease, lung disease or cancer.
• Immunocompromised adults, including those receiving active treatment for solid tumors, some organ transplant patients, and patients receiving a number of medicines that suppress their immune system.

Eligible patients could either have a positive PCR test or a positive rapid test administered by a healthcare professional.

Jane Kraut received one of 122 doses of Sotrovimab between Christmas and New Years. She is triple vaccinated but is taking immunosuppressive drugs for her psoriatic arthritis.

She feels lucky to have discovered the monoclonal antibodies from her rheumatologist who referred her for treatment.

“It was by chance that I spoke to my rheumatologist because it was more about my meds,” Kraut said.

She avoided boredom as she sat with two other patients in a four-person IV room by tweeting her experience live.

“Most of the people who reached out were not people who weren’t vaccinated. They were people like me who had an autoimmune disease or an underlying health problem,” he said. said Kraut.

More than 2k unnecessary doses

Sotrovimab was a small fraction of the monoclonal antibody treatments made available to the province by the federal government.

Manitoba originally had about six times as many monoclonal antibody treatments, but most of the doses were Casirivimab-Imdevimab from Regeneron Pharmaceuticals, a drug combination that is not effective against Omicron, according to Lagacé- Wiens and the province.

“Manitoba did not use up its supply of Casirivimab-Imdevimab (approximately 2,200 doses) because there were not enough people seeking treatment at the time. Treatment with monoclonal antibodies is preferable for specific patients who meet the stated criteria. of people eligible for treatment, ”wrote a spokesperson for Shared Health.

“Casirivimab-Imdevimab is unnecessary [against] Omicron and has little or no use in current epidemiology, ”wrote Lagacé-Wiens.

Casirivimab and imdevimab were originally recommended for the treatment of COVID-19 because they have been shown to be effective against the Delta variant, which is no longer the dominant strain in the province.

Undisclosed number of doses attributed to First Nations

The 268 doses of Sotrovimab remaining on Tuesday evening do not include the Manitoba allocation of Sotrovimab available for use in First Nations communities.

The province is currently negotiating with the Public Health Agency of Canada for an additional supply of Sotrovimab.

“The Government of Canada continues to work with provincial and territorial partners to equitably allocate supply, including responding to requests for additional supply,” a Health Canada spokesperson wrote in an email.

On January 6, pharmaceutical giant GlaxoSmithKline announced that it had signed an agreement with the Government of Canada to provide 20,000 doses of Sotrovimab in addition to the 10,000 doses acquired by the federal government last fall.

Health Canada authorized Sotrovimab for injection July 30 for treatment of mild to moderate COVID-19.

Kraut’s advice to eligible people is to stand up for themselves.

“If people test positive and they are candidates, don’t give up because the window is short,” she said.

She says she is grateful to have been vaccinated, boosted and treated with monoclonal antibodies.

“I don’t know how things would have been if all of these things hadn’t happened,” Kraut said. “I’m recovering, almost recovered and it’s okay. But it wasn’t fun.”

Atwal said the government’s risk mitigation strategy will also focus on accelerating immunization through appointments and additional staff.

Manitoba is also preparing to use antiviral pills as a COVID-19 treatment once they are approved by Health Canada.