Delayed shipments of monoclonal antibodies stress supply of time-dependent COVID-19 drug for some in Alaska

Alaska on Tuesday was still awaiting a shipment of COVID-19 treatments meant to arrive last week as supplies of the drug nationwide were tangled up in distribution and shipping woes.

At least 110 people needing the monoclonal antibody treatment had been turned away by midday Tuesday at a facility in Anchorage, according to Jyll Green, operations manager at the treatment center located in Tikahtnu Commons.

“It’s really depressing,” Green said, having sent nurses home for the day with no drugs to treat people and little expectation as to when the treatments would arrive.

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Monoclonal antibodies are a treatment geared toward those who have tested positive for COVID-19 and are at an elevated risk for severe complications from the virus but don’t yet need to be hospitalized for the illness.

If the drug is infused early, it can help keep some people sick with COVID out of the hospital, which is critical right now as the state’s health care system continues to face strain.

But nationwide, the process — from distributor to shipment — for supplying monoclonal antibody treatments to states is overwhelmed right now, said Coleman Cutchins, state pharmacist.

Most facilities in Alaska were not completely out of supplies by Tuesday, he said. Things have become especially stretched during the current COVID-19 surge, with so many people getting sick at once.

“They’re working through it, but it’s just unfortunate,” Cutchins said. “And it’s not just Alaska that this is affecting, it’s most of the U.S.”

The state was supposed to receive approximately 600 doses last Friday, and Cutchins said 1,000 were expected to arrive this Friday. There are also separate allocations that come into Alaska for tribal health care facilities, Veterans Affairs facilities and the Department of Defense.

Once the drugs arrive, playing catch-up and attempting to prioritize those who need the treatment sooner will be yet another hurdle, Green said.

“I don’t want to be the one to decide who gets to come in first,” Green said of the treatment, which is supposed to be administered within the first few days of the illness.

Green said she sent people to two other clinics that had backstock of antibody supply.

She was able to get hold of 10 extra doses and had eight leftovers from no-shows, so Green said she gave those all out on Monday morning. Beyond that, the center is entirely out of the treatment.

“This is impossible for any health care provider who cares, to be honest,” said Green, a family nurse practitioner. “Because you can’t help them. It’s pretty soul crushing.”

People are angry, she said. After changing the clinic’s voicemail to note they were out of supply, she said some swore at her through the voicemail.

At Central Peninsula Hospital in Soldotna, there were still about 40 courses of the drug available by Tuesday, and spokesperson Bruce Richards said he was not aware of any current shipping delays, though a few weeks ago the hospital came close to running out.

Staff with the Tanana Chiefs Conference, a nonprofit that operates the Chief Andrew Isaac Health Center and other facilities in the Interior, shared around 36 antibody treatments with Fairbanks Memorial Hospital recently and has around 70 doses remaining, according to Dr. George Bird, director of clinical services at TCC.

The center gets allotments from both the state and Indian Health Service. Bird said that the 70 doses should last the center around 10 more days. They had expected to get an additional 144 doses Monday that didn’t show up.

“That’s not a very healthy, comfortable cushion,” Bird said.

Dr. Claire Stoltz with Fairbanks Memorial Hospital said that because of the current limited national supply of monoclonal antibodies, “we are narrowing our prescribing of it to the patients who are at greatest risk of severe illness.” The hospital is “providing as many doses as we can” and expecting more allocations to come from the state as supply becomes available, with the hope of being able to expand availability in the future, Stoltz said.

Cutchins, with the state, said the situation further underlines what health officials have been saying for months: Vaccination is critical to avoiding severe consequences from the illness. Most fully vaccinated people don’t need the treatment, he said.

[Alaska coronavirus Q&A: What to know about monoclonal antibody therapy]

The delayed shipments mark yet another twist in the pandemic. A month ago, Alaska had such a large supply of the treatments that state health officials worried some would reach their late 2022 expiration date before getting used.

Now the state’s stockpile has dwindled, according to Cutchins, as the delta variant has spread rapidly across Alaska.

“Your safety net just got removed,” Green said of the lack of treatment available. “It’s hard.”