DeSantis wants more monoclonal antibodies as COVID-19 cases surge. Some may not work against omicron

WUSF | By Stephanie Colombini

Published January 7, 2022 at 9:38 AM EST

The at-home service offers an alternative to the monoclonal antibody treatment sites in the community, some of which have closed, including the one in Hillsborough County near the Florida State Fairgrounds.

Gov. Ron DeSantis has criticized the Biden administration for not sending Florida more monoclonal antibody treatments to reduce the risk of severe COVID-19. But experts say most of these experimental treatments aren't effective against the omicron variant, and the one that does work is in short supply nationwide.

After proving helpful during Florida's delta surge, early data now suggests the monoclonal antibody treatment made by Regeneron doesn't work well against omicron. Neither does one made by Eli Lilly, which is why the federal government temporarily paused its distribution in December.

The only antibody therapy that does appear to be effective against omicron is one made by British drugmaker GlaxoSmithKline, with U.S. partner Vir Biotechnology, called sotrovimab.

Dr. Manuel Gordillo, infectious disease specialist with Sarasota Memorial Hospital, said the problem is the company hasn't produced enough of the antibodies to meet demand.

“So now they are the only ones that work and there’s a very short supply nationally of that,” he said in a recorded interview the hospital shared with the media.

“These are difficult antibodies to produce, so it’s not like we can tell them, ‘Oh go to your plant in England and start making more.’ You know they can't, it’s a difficult production,” he said. “So whatever we have is a small production and we have to distribute it equitably.”

Gordillo said the federal government considers population size when determining how many doses of sotrovimab to distribute to each state, so he said Florida gets more than most.

“But Florida has a raging number of cases and exponential growth, so definitely there’s not going to be enough for everyone. So we need to select who are the most likely to benefit,” he said.

Federal data shows of the nearly 12,000 doses of monoclonals distributed to Florida this week, fewer than 3,000 were sotrovimab.

DeSantis has questioned whether the other monoclonal antibodies are indeed ineffective against omicron, but said he still thinks they should be easily accessible in the state for people who get infected with other variants.

"Omicron is not the only variant that's out there," he said during a press conference in Broward County earlier this week. “We feel there's no need for it to be sitting on the shelves."

This week the federal government notified the state that it was preparing to send more antibody doses to Florida, which the governor said will be used to open treatment sites in South Florida and the Orlando area.

“After pressure from Florida, the federal government has begun planning to send 30,000 additional doses to our state, so we can stand up new sites and expand capacity at existing sites,” DeSantis said in a release. “We expect the Biden Administration to follow through so Floridians will have access to these life-saving treatments.”

Federal officials reversed course on their temporary pause on distributing monoclonal antibodies on Dec. 31, citing the prevalence of other variants in different regions of the United States.

While parts of the country like the Midwest are still fighting off surges of the delta variant, omicron appears to have quickly taken over as the dominant strain in Florida.

Gordillo said the latest genomic sequencing data out of Tampa and Miami suggests omicron accounts for about 95% of cases in those areas.

He said a more promising treatment against omicron infection are the antiviral pills recently authorized for use, particularly paxlovid, which is produced by Pfizer. It appears to work against the variant and is nearly 90% effective at preventing hospitalizations. It’s also easier to administer than the monoclonal antibodies, which require IV infusions or multiple injections.

That too will be in short supply as states begin receiving shipments. Gordillo expects, at least in the near future, that only highest-risk patients will be able to access the medication. Another pill called Molnupiravir from Merck is more readily available but is significantly less effective.