Ada County hopes it can get a community monoclonal antibody treatment center off the ground as Idaho’s hospitals are overloaded with COVID-19 patients.
On Wednesday, the Ada County Commissioners held an emergency meeting with more than a dozen state health officials, representatives from the local health systems and local public safety department heads to discuss the possibility. Commissioners are hoping a central place for the early treatment will help cut down on the number of high-risk patients who later end up in overcrowded ICUs.
This center would be in addition to the 32 hospitals currently using the antibodies statewide, including in the Treasure Valley. Commissioner Rod Beck pointed to a treatment center in North Idaho using the Kootenai County Fairgrounds as a clinic run by Heritage Health as an example this region could follow.
“I think this is a critical element of us getting over this COVID thing is getting these (monoclonal antibodies) up and running, and up and running fast,” Beck said, with agreement from fellow Commissioners Ryan Davidson and Kendra Kenyon. “If we do 250 treatments a week it will cut down on hospitalizations.”
Tight supply from federal government
But, there is not an infinite supply of antibody treatments. Up until last week, hospitals and clinics could place orders with the government to get as many treatments as they needed. This changed on September 13 when President Joe Biden’s administration opted to issue the supply of antibodies based on hospitalizations, case numbers and other factors in a bid to ensure there are enough supplies nationwide.
There are three different types of monoclonal antibody treatments, two of which are controlled by the federal government and free of charge to patients. This includes the popular treatment produced by the company Regeneron. All three antibody treatments are operating under emergency use authorization status from the Federal Drug Administration.
Patients must test positive for COVID-19, have a high risk of hospitalization and be referred for treatment by a physician.
Dr. Marcia Witte with the Idaho Department of Health and Welfare said the antibody clinics in Kootenai County and in Eastern Idaho have gotten off to a strong start in the past two weeks. However, she said that as of now the demand for the treatment outpaces the number of treatments distributed by the federal government. The Gem State received 1,080 treatments the first week of federal distribution and 1,424 the second.
Witte said the state was in the process of hearing proposals for a community site earlier this month but decided to hold off on a direction now that the supply is restricted. She said they received one proposal for a central site in the Treasure Valley, but it came in one day after the distribution rules changed. She did not identify the organization that made the proposal.
“We have paused that decision making until we have a better idea of what our allocation would be and what we can support,” Witte told the group.
Witte hopes that a central treatment clinic could treat at least 45 patients a day, five days a week.
Staff required to administer treatment
There are other complications to setting up an antibody treatment center other than supply.
Only one of the available treatments, the one produced by Regeneron, can be administered in an injection. The other two must be required to be given in an IV, a treatment that requires nursing staff in a time when health systems are strapped for employees. The center would also require a large enough area to accommodate patients who sit for the mandatory hour of observation time after they receive the antibodies.
Although Regeneron’s treatment can be injected, Idaho state epidemiologist Dr. Christine Hahn noted that IV treatment is still the “highly preferred” option by physicians and other public health officials. She requested that if a central site is set up for those that need treatment it accommodate both styles of treatment of the state can be flexible depending on the supply of antibodies.
‘More bang for our buck’ without central site?
Hahn praised the strong partnership of health providers in North Idaho responsible for setting up the treatment center and its “good flow” of patients since it got up and running. She said the Treasure Valley should look for an equally strong partnership to build a treatment center in Southwestern Idaho and ensure it would treat all patients referred from all doctors equally.
She also wondered if it might be more efficient to ensure there was a better process for any patient who qualifies for the treatment to be referred to the existing outpatient clinics operated by Saint Alphonsus Health System and St. Luke’s Health System and treated there.
“Would we get more bang for our buck if we make sure there was a clear path so providers knew how to refer patients in and there was an assurance patients would be treated equally whether they are a Saint Als patient or not or a St. Luke’s patient or not?” she said. “How important is it to set up an independent different site?”