Skip to main contentSkip to main content
You have permission to edit this article.
Edit
Nebraska health care workers warn of COVID treatment shortages amid omicron surge
0 Comments
editor's pick

Nebraska health care workers warn of COVID treatment shortages amid omicron surge

  • 0
{{featured_button_text}}

Nebraska doctors are warning that treatments effective against the omicron variant of COVID-19 are in such short supply that not all of the high-risk patients who qualify for them are getting them.

The upshot: The treatments, some of which are new and promising, won't be an option in the near future for the vast majority of Nebraskans.

That means vaccination and boosters remain the best way to prevent serious illness, hospitalization and death.

While efforts are underway to bolster production of the treatments, ramping up to the point where they will make a difference during the omicron wave "is logistically just not going to be possible," said Dr. Mark Rupp, chief of the University of Nebraska Medical Center’s infectious diseases division.

"I don't want folks to have the wrong idea that, 'Oh, they've got all these medicines that they can now treat people and either prevent them from getting more seriously ill, or if they are seriously ill we can rescue them in the hospital," Rupp said. "That's just not reality, unfortunately."

The warning comes as cases of COVID-19 in Nebraska jumped to 14,799 for the week ending Wednesday, more than double the 7,176 cases recorded during the previous seven-day stretch. The tally was the second-highest weekly total of the entire pandemic, just below the 15,348 cases recorded during the second week of October 2020. 

COVID-19 hospitalizations, which lag infections by about two weeks, continued to tick up after a brief dip over the Christmas holiday, reaching 568 statewide Thursday. That included 352 in metro Omaha hospitals.

The state recorded 78 additional deaths during the past seven days, the highest weekly figure in exactly a year. It's not clear, however, whether those deaths, which also lag infections by weeks, are attributable to the delta variant or to omicron.

Dr. Barbie Young Gutshall, a physician in O'Neill, wrote in a social media post that the hospital there now has an entire wing of COVID-19 patients and that its family room had been turned into an infusion center.

She, too, stressed that health care providers soon would have next-to-nothing to offer patients because of the limited supply of therapies that can target omicron. 

Rupp said some of the monoclonal antibodies that providers used successfully during prior waves to keep people with COVID-19 from become seriously ill are not effective against the omicron variant. That includes the infusion that became commonly known as the BAM drug.

The monoclonal therapy that is effective against omicron, called sotrovimab, is in short supply across the country. The state receives an allotment and parcels it out to providers across the state.

Nebraska Medicine, UNMC's clinical partner, posted Friday on Facebook that the health system currently receives enough of the therapy for about five people a day. But the hospital has 75 to 100 outpatients a day who meet federal criteria to receive intravenous infusions of the drug. 

"We way outstrip the number of people who would meet the criteria for use," Rupp said.

CHI Health officials said their hospitals, too, have limited supplies of the treatment. The health system randomizes who will receive the infusions based on extensive criteria and a review by a multidisciplinary team.

"The best current treatment we have to recommend is that patients get vaccinated, and get a booster if previously vaccinated," CHI Health officials said in a statement.

Rupp said Nebraska Medicine also has enough of another long-acting therapy called evusheld to infuse between 50 and 100 high-risk people a week. That drug, a preventative, gives people about six months of antibody protection. The health system has about 10,000 patients who would qualify, with 1,000 in the highest-risk group. That group includes people who probably haven't mounted an immune response despite vaccination, a group that typically consists of transplant and high-risk cancer patients.

The health system also is starting to administer three days of intravenous remdesivir to outpatients. A recent study showing that the drug, which previously has been used in seriously ill patients who require oxygen support, could substantially decrease the risk of progression in high-risk patients. It's best used within five to seven days of infection.

But administering it is not easy. "We will be maxing out the number of infusion chairs in our infusion centers to give that," Rupp said.

Two new oral treatments also are available. The first, molnupiravir, prevents progression in about 30% of patients. Nebraska Medicine currently gets about 40 courses a week. "But by no means is it a game-changer," Rupp said.

Data suggests that the more promising of the two, paxlovid, is up to 90% effective in keeping people from becoming seriously ill and requiring hospitalization. Rupp said the hospital, to the best of his knowledge, has not received any doses of the drug.

The first doses of the drug apparently have been directed to clinics that serve those with limited access to health care, such as Omaha's OneWorld Community Health Centers and Charles Drew Health Center. 

Andrea Skolkin, OneWorld's CEO, said the health center has received enough for four patients a day. More is coming, but officials don't know how much or when. The health center has to prioritize who receives it. 

President Joe Biden said Tuesday that he had doubled the nation's order of the drug to at least 20 million courses and is accelerating delivery. The first 10 million courses are to be available by June and the rest by the end of September.

Meanwhile, health systems are bracing for more patients and urging Nebraskans to help head off a surge, namely by getting vaccinated and boosted, wearing quality, well-fitting masks in public and avoiding large crowds. 

Jeremy Nordquist, president of the Nebraska Hospital Association, tweeted Tuesday that hospitalizations due to COVID-19 may double in Nebraska over the next two or three weeks. 

"At the same time, hospital staffs will be limited due to COVID spread," wrote Nordquist, a former state senator. "This very well may be the worst of the pandemic. Nebraskans, you know how to help our hospitals & #HealthcareHeroes. Please do!"

Said Rupp, "There's a popular belief out there that omicron is very mild and that people don't have to worry about it. But the issue is there's just such a vast wave of folks who are sick that even if a much lower proportion of them get seriously ill and require hospitalization, it's going to still result in a very high crest of hospitalizations and a high stress level on the medical system."

World-Herald Staff Writer Henry J. Cordes contributed to this report.

0 Comments

Locations

Concerned about COVID-19?

* I understand and agree that registration on or use of this site constitutes agreement to its user agreement and privacy policy.

Related to this story

Most Popular

Get up-to-the-minute news sent straight to your device.

Topics