UPDATE: Eli Lilly’s Bamlanivimab is now granted FDA EUA.
This video discusses updates with the COVID surge here, controlling the COVID Pandemic, Immunity to the Covid, possible Covid treatments on the horizon, and more.
And as if COVID by itself is not bad enough, it has a domino effect on the rest of our society. It’s not just the economy that suffers. It’s also the rest of healthcare in general that suffers. Not to mention increased rates of depression and suicide deaths during these times. If hospitals are overwhelmed, guess what happens to the care of other patients who don’t have COVID?
Elective surgeries are being put off for things like heart surgery, hip replacement, and more. Also, who wants to go to a doctor’s office or an ER during these times and possibly get COVID? It’s not like we don’t know how to get this pandemic under control. It can be done. Look at how well other countries handled it and how well they are doing. And how well their economies are doing. Australia. New Zealand. South Korea. Taiwan. What do all of these countries have in common? Testing, contact tracing, quarantine, distancing, and masks.
Bamlanivimab for COVID
This pandemic will only worsen in the next couple of months, and more and more hospitals will be overwhelmed. The difference between what’s happening now and what happened during the previous spike in cases is that the entire country is a hotspot. And because it is so widespread, we will soon reach a breaking point in our hospitals and the number of healthcare workers.
In all likelihood, one of three things is going to happen. There will be a federal mask mandate because not enough people are wearing masks when they should be. If this does not occur, there will likely be a shutdown of most of the country.
Now some people say doctors are inflating the numbers. So this is not true. Part of my job as an ICU physician is to complete a death certificate, and I have to write the primary cause of death and secondary causes of death. There is usually a chain of events that causes someone to die. Multiple contributing factors often lead to someone’s death, but we typically know the primary cause of death. And with COVID, it’s usually pretty straightforward. Also, regarding the claim that doctors get paid more based on the diagnosis? It’s a lie, plain and simple.
Are people immune to the virus after they are infected? The body makes antibodies in response to a given infection or a vaccine. Usually, antibodies protect someone from future infection, and so they are called “neutralizing antibodies.” Researchers at Mount Sinai’s Health System between March and October looked at the antibody responses of more than 30,000 people who tested positive for Covid. These people who had Covid had either mild or moderate illnesses.
In the study, they described their antibody responses as either low, moderate, or high. More than 90% had moderate to high levels of neutralizing antibodies to the spike protein of the virus, and the response was maintained for at least 5 months. So can you get infected with Covid twice? Based on this, probably not. If it does occur, it’s the exception, not the rule. And this study also has implications when it comes to immunity from a vaccine. A vaccine will likely provide immunity, but for how long is another question. Based on this study, the answer is most likely at least 5 months.
There are over 70 monoclonal antibody treatments for COVID in various stages of development. The two that have the most potential right now are the ones made by Eli Lilly and Regeneron. Both of these companies have already applied for FDA emergency use authorizations. Eli Lilly recently signed a $375 million deal with the government for 300,000 vials of this monoclonal antibody, called Bamlanivimab. A recent study in NEJM looked at Bamlanivimab. It seemed to decrease the risk of hospitalization and ease some symptoms in this phase 2 trial that involved over 400 patients with either mild to moderate COVID.
In this RCT, less than 2% of patients who received Bamlanivimab had symptoms progress enough to the point of requiring hospitalization or a trip to the ER. For those who received a placebo, it was 6%. For patients in higher-risk categories – defined as those who were obese or older than 65 years – 4% who got the treatment were hospitalized, compared to 15% in the placebo group. The study’s primary goal was to see if the treatment eliminated the virus by day 11, which it did for most patients.
Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine