Antibody treatment now available in Sask. no substitute for the COVID-19 vaccination, say experts
Another tool is now available to health workers in Saskatchewan to treat some COVID-19 patients, but health professionals and officials are reminding the public that therapy is not a substitute for vaccination.
Monoclonal antibody treatment is said to help keep COVID-19 patients who are not vaccinated or severely immunocompromised out of Saskatchewan’s hospitals, according to a provincial press release on Monday.
The Saskatchewan Health Authority is already rolling out monoclonal antibody injections at provincial test sites in Saskatoon and Regina.
However, this treatment of COVID-19 patients who are considered at risk of becoming seriously ill has limitations.
Monoclonal antibody treatments only work in patients who have no or very low antibody levels – which means most people who are vaccinated are out of the question.
The Chief Medical Health Officer Dr. Saqib Shahab compared COVID-19 to an icy road and vaccines to a seat belt – while monoclonal antibody treatment is like an ambulance. “Just because you may have an ambulance that could arrive on time doesn’t mean you shouldn’t buckle up,” he said. (Michael Bell / The Canadian Press)
Dr. Saskatchewan’s chief medical health officer Saqib Shahab, comparing high COVID-19 transmissions to an icy road, said monoclonal antibodies are like an ambulance that may or may not arrive on time after an accident.
“Vaccines are like a seat belt, so in an accident they reduce the risk of serious illness or death,” he said on Monday.
“Just because you may have an ambulance that could arrive on time doesn’t mean you shouldn’t buckle up.”
The province also says treatment should only be used in the early stages of mild to moderate COVID-19 infection and within five days of symptoms appear.
The province has provided information on the newly available treatment through social media and other channels.
However, a health policy advisor believes this could send the wrong message.
“I’m surprised … our government is getting into the business of recommending a particular line of treatment,” said Dennis Kendel, a retired doctor and health policy advisor from Saskatoon.
Why did @SKGov started promoting a specific selective therapy option for COVID? It ignores the expertise of the Saskatchewan doctors and now appears to be running medical care. https://t.co/yakAqAnXiE
– @ DennisKendel
Treatment “is a very limited option in medically indicated circumstances … it is not something that everyone can get.”
There is a risk that promoting treatment may make some people feel like they don’t need to get vaccinated, Kendel said.
“It doesn’t help vaccination efforts. If anything, it probably makes people more complacent about vaccinations.”
Treatment with laboratory-made antibodies is also restricted by certain age criteria.
According to the province, treating clinicians could prescribe monoclonal antibodies to COVID-19 patients 55 years of age or older who have not been vaccinated.
The same applies to patients of the same age group who are immunosuppressed or immunosuppressed, regardless of their vaccination status.
In some cases, patients over the age of 18 can receive treatment if they meet certain high-risk criteria.
People who might be eligible for treatment include COVID-19 patients with diabetes, transplants, chronic kidney disease, or moderate to severe asthma, said Dr. Satchan Takaya, the lead physician for the monoclonal antibody project and an infectious disease specialist.
“It works best when you don’t already have underlying immunity, that is, unvaccinated people,” Takaya said. “But it is also for those who initially failed to respond to this vaccine.”
While treatment is new in Saskatchewan, antibody drugs have been used in other provinces such as Ontario as well as outside of Canada.
The best-known example was probably the now former US President Donald Trump, who fought against COVID-19 in October 2020.
In Saskatchewan, treatment is currently only available in Saskatoon and Regina at existing health agency testing and treatment sites, the province said.
“It’s important to remember that you cannot go to an assessment agency yourself for monoclonal antibody treatment,” said Marlo Pritchard, head of the government’s emergency response center, on Monday.
“The SHA will continue to evaluate demand and adequacy of treatment to determine if treatment will be rolled out to other regions of the province.”
Beginning November 1, people with COVID-19 will be able to self-assess their suitability for treatment online, the province said, but clinicians will make the final decision on whether to prescribe monoclonal antibodies.
1,200 cans allotted for Sask.
Sotrovimab – one of three monoclonal antibody treatments approved for use in Canada – is the product currently available in Saskatchewan, Takaya said.
Department of Health Deputy Assistant Secretary Mark Wyatt said 1,200 doses had been allocated to Saskatchewan. The province has received 476 so far.
The federal government bears the costs for the Product, said Wyatt.
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Matthew Miller, Associate Professor at the Institute for Infectious Disease Research at McMaster University in Hamilton, estimates that monoclonal antibodies are about 1,000 times more expensive than a vaccine.
The product requires a one-time treatment, which the Saskatchewan government says will be given intravenously.
“The reality is that there are still many unvaccinated people out there,” Takaya said.
“If we can stop the disease from progressing, keep it out of the hospital, and have our hospital capacity save a patient or two, then we really want to try.”