The University of Arkansas for Medical Sciences administered its first monoclonal antibody drug for COVID-19, Eli Lilly’s bamlanivimab, to qualifying COVID-19 patients today, medical center CEO Dr. Steppe Mette said.
Arkansas has been allocated 1,930 doses of the Lilly drug and 384 doses of casirivimab/imdevimab (Regeneron). The Arkansas Department of Health is distributing the drugs to 41 sites across Arkansas where patients may receive the drug; in Little Rock, along with UAMS, sites include CHI St. Vincent, Baptist Health and Arkansas Children’s Hospital.
To qualify, patients must have mild to moderate disease and carry one of the risk factors that could worsen outcomes from COVID-19, such as lung disease, diabetes, chronic kidney disease or weakened immune systems. It is given outpatient only.
Bamlanivimab and other monoclonal antibody therapies deliver man-made antibodies that the body’s immune system would produce when exposed to the novel coronavirus. The body’s machinery to produce antibodies to the virus antigen takes a bit of time; introducing man-made antibodies to the body is faster. The drug is not a cure, but is designed to lessen the time and severity of illness.
UAMS has received 60 doses of bamlanivimab, which is administered by infusion. The medical center has set up a special infusion site so that patients are kept separate from admitted patients. Infusions take about an hour and the patient is kept for another half-hour to hour to make sure there are no serious reactions to the drug. Mette said UAMS has capacity to deliver the drug to 40 a week; its allocation of more drug will be tied to the number of patients it sees. Three people were infused today.
Mette said a hospital committee has determined priority within the hospital to receive vaccine, which could come as early as Dec. 12. Health care workers treating COVID-19 patients in ICU will be at the head of the line, but who will follow is hard to say “because we don’t know much” about how the number of doses that will go to UAMS. The Centers for Disease Control and Prevention has issued guidelines for triage. Secretary of Health Dr. Jose Romero has said he expects the state to get 25,000 doses, a number based on the number of Arkansans over the age of 18.
Handling the vaccine, likely to be Pfizer’s, will not be a problem, Mette said; the hospital has experience with the required ultra-cold storage, but the administration is going to be “tricky,” he said, because once thawed, the vaccine must be given within six hours or so and each thawed vial contains five doses, requiring five available patients at once.
With the state’s new COVID-19 patients at a new high today — 2,827 testing positive in PCR and antigen testing — and more than 1,000 Arkansans in the hospital (50 at UAMS), the medical center has entered phase one of its surge plan. Medical surgical patients have been moved off the 9th floor of the hospital to make room for COVID-19 patients. The ICU is full, Mette said; along with other critical patients there are 14 with COVID-19. The ICU has added 12 beds for step-down patients. The hospital has postponed a number of elective procedures that would require overnight stays to free up rooms for COVID-19 patients, and has worked out an agreement with Arkansas Children’s Hospital to accept adult trauma patients up to age 30.
Mette said if the trajectory of new cases does not change, “I fear that we will need to put a temporary halt to elective procedures.” He also said that health care leaders “need to step forward and provide honest appraisals of the public health crisis and articulate solution.” Some of those leaders are surely on the governor’s COVID-19 winter task force.