Sun Sentinel Palm Beach Edition
With Florida’s monoclonal sites closed, what are your options?
Floridians scramble for alternative FDA-approved treatments
Testing positive for COVID-19 is worrisome for anyone but now Floridians have fewer options for treatment to keep them from being hospitalized.
The Florida Department of Health announced Monday night that all its antibody clinics in the state were closing. The closures came after the FDA revoked emergency authorization for Regeneron and Eli Lilly’s monoclonal antibodies, the therapies being offered at the state-run clinics, stating they aren’t effective against omicron.
The announcement sent thousands of Floridians scrambling for alternate options. Those FDA-approved treatments aimed at reducing the risk of severe illness for those who test positive include oral drugs and alternate monoclonal antibody therapies.
One of those is antiviral pills being prescribed to people who test positive for COVID by physicians and emergency department physicians. Both should be started as soon as possible after a diagnosis of COVID-19 and within five days of the start of symptoms.
Supply, however, is limited.
Only 19 Publix, Walmart, CVS and Walgreens pharmacies in Florida have Pfizer’s Paxlovid and Merck’s Molnupiravir, two drugs that offer protection for people infected by omicron who are at high risk of severe disease.
In South Florida, only one Publix location in each county has supply: 1940 Cordova Road, Fort Lauderdale; 1420 NW North River Drive, Miami; and 2895 N. Military Trail, West Palm Beach.
Paxlovid can be used by anyone 12 or older, and Molnupiravir is restricted to people 18 and older.
It is unclear how much supply of the antivirals are available. However, the state is trying to get more.
“As more Paxlovid and Molnupiravir are made available by the federal government, additional dispensing locations will be added to increase access to these treatments,” Florida health officials said in a statement released to health care providers. The FDA does not recommend Paxlovid for people with severe kidney or liver disease.
Florida doctors already have been prescribing the oral treatment.
“If my patients are really sick with high fever, cough and shortness of breath, but not sick enough to go to the hospital I have prescribed Paxlovid,” said Dr. Daniel Perez of Plantation. “From what I have seen, it works.”
The only antibody therapy that research has shown to be effective against omicron is one made by British drugmaker GlaxoSmithKline, with U.S. partner Vir Biotechnology, called sotrovimab. Florida hospitals, infusion centers, urgent cares and cancer centers also have sotrovimab but because the treatment is more difficult to produce, the company hasn’t made enough of the antibodies to meet demand. Glaxo and Vir said they have taken several steps to increase output.
Now, 600,000 additional doses are being sent to states by the end of March. So far, Florida has received about 3,000 doses per week for the last few weeks, according to federal data.
Dr. Melissa Woo, a hospitalist at Cleveland Clinic Weston, said her hospital is limiting patients who get sotrovimab to people with chronic immune suppression, chronic inflammatory diseases, or people with transplants or cancer
“Right now we do have doses of sotrovimab but a lot will depend on a patient’s medical history,” she said.
At the SIA-Specialty Infusion Center in Boca Raton, Jeff Hertz said he just ran out of sotrovimab doses and demand for it continues. “Hopefully we will get more soon.”
A spokesman for CDR Maguire, which operated 11 of the Department of Health’s monoclonal antibodies clinics, said he doesn’t yet know whether the state will reopen the clinics and offer sotrovimab. “Right now we are in the dark.”
Another option is AstraZeneca’s Evusheld, a preventative monoclonal antibody therapy. It is authorized for people who are moderate to severely immunocompromised and may not mount an adequate immune response to COVID-19 vaccines. Florida received 4,680 doses of Evusheld this week which it distributed to medical providers. Health officials are steering patients to providers via the Department of Health’s online locator.
Vaccination has been recommended as the most effective way to prevent severe illness from COVID.