Some hospitals prioritizing who gets it; others not participating
Texas has received only 5,800 doses of a newly approved coronavirus treatment heralded by Gov. Greg Abbott and will receive even less this week, underscoring the massive challenge that remains as the state scrambles to tamp down its latest outbreak.
While the medication, made by Eli Lilly, is welcome news to many in the state’s health care community, its supplies are so limited that some hospitals are weighing how to ethically prioritize eligible patients, and others have opted out altogether.
“We recognize that this therapy could provide some modest benefit, but it requires space, staff and additional training around infusions that are hard to come by right now, as we
are currently strained just taking care of the patients we have in house,” said Dr. Ann Barnes, the executive vice president and chief medical executive at Harris Health System in Houston.
The hospital network decided last week to decline shipments of the treatment, called bamlanivimab. The medication is designed to neutralize the virus, preventing severe symptoms from developing.
It was unclear if any other hospitals in the state had made similar decisions. Officials at multiple hospitals did not respond to requests for comment.
Abbott held a news conference Thursday to tout the treatment, at one point displaying a poster-size photo of an IV bag and a patient’s arm.
“All it takes is one hour, and then the treatment is complete,” he said. He declined to disclose how many doses were available.
Carrie Williams, a spokeswoman for the Texas Hospital Association, said executives huddled last week with state leaders and “were largely very supportive of having the opportunity to have their hands on this therapeutic.”
“It’s an outpatient infusion therapy and requires significant space and staff time, which obviously is taxed right now,” Williams said in an email. “That said, we welcome all the help we can get to decrease demand on hospitals right now.”
Texas is expected to receive an additional 3,200 doses this week, data from the U.S. Health and Human Services Department shows. That would make it the second-largest state recipient, just behind Illinois.
Still, it’s not keeping pace with Texas’ mounting infections. Health officials reported more than 50,000 new positive cases last week through Friday, and there are 152,000 estimated active cases statewide. More than 8,000 people were hospitalized with the virus as of Friday.
And the drug is not a cure-all; in clinical trials, it was shown to reduce hospitalizations among high-risk patients but not eliminate them. Federal officials have said they expect close to 400,000 doses to be available nationwide through the end of the year; 80,000 of those have already been distributed.
To be effective, the treatment has to be administered early in an infection, before severe symptoms emerge, and it is meant only for people over age 65 who have chronic conditions such as diabetes or high blood pressure. It’s administered intravenously over the course of an hour.
In Lubbock, where cases are surging and the governor visited Thursday, hospitals received 172 doses last week, according to Dr. Drew Payne, a physician and associate program director at Texas Tech University. He said they have scrambled since to determine how best to get the doses out and hoped to begin administering them over the weekend.
“It’s good to say, ‘Hey, everybody needs this medication and we need to give it out,’” Payne said. “But then the logistics of having nursing staff, a place to bring COVID-positive patients into, a way to give that medication, a plan if there’s an adverse reaction to that medication — those are all things we’ve been dealing with.”
Lubbock reported nearly 500 new positive cases Friday, with 5,700 active cases overall.
Payne added that several patients have been reluctant to take it, saying they feel fine or don’t believe they’ll develop symptoms.
“Our job as physicians is to advocate for the science and to advocate for our patients and let them know that this is what’s out there, this is what we have available,” he said. “But ultimately, it comes down to the patient.”
State leaders have declined to say how many doses are going to each region, and several officials in El Paso, another hot spot, did not respond to requests for comment.
Chris Van Deusen, a spokesman for the Texas Department of State Health Services, said this is being determined by how many new positive cases and hospitalizations a region has reported in the last five days, as well as its total number of COVID-19 hospitalizations.
“We may well end up tweaking that going forward, just based on what we’re seeing,” he said. “It sounded like the governor was interested in sending more of it to the hot spots, so we’re still working on what it’s going to look like.”
El Paso County reported just over 1,000 new positive cases Friday and had nearly 1,100 patients hospitalized with the virus. The county has recorded more than 800 COVID deaths, many of them in the past two months.