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Government officials are trying to figure out how to make better use of drugs that can keep people with COVID-19 out of the hospital. That is an urgent question in Michigan, where hospitals are struggling to keep up with a surge in new cases. And as NPR's Richard Harris reports, it's a daunting challenge.
RICHARD HARRIS, BYLINE: Drugs called monoclonal antibodies can hold the coronavirus in check. And there's increasingly good evidence that they help people with mild to moderate symptoms of COVID-19. The Food and Drug Administration authorized them for emergency use in older people and others with certain underlying health conditions back in November. Yesterday, Michigan Governor Gretchen Whitmer said she's trying to expand access to these drugs.
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GRETCHEN WHITMER: We know that as awareness increases, more people will take it. And we want to make sure we have the capacity to keep up with demand.
HARRIS: About 30% of the people in Michigan newly diagnosed with COVID-19 could potentially benefit, she says. That's currently more than 2,000 people a day. Lindsay Petty, an infectious disease doctor at the University of Michigan says her program does more antibody treatment than anybody else in the state, and right now, it maxes out at about 16 patients a day. Petty says the infusions are time-consuming, and many nurses who do them are already working nights and weekends.
LINDSAY PETTY: We can only expand to a certain amount before it definitely begins to impact our non-COVID patient care. So we are limited within the capacity of what we can do, and other sites are certainly limited in the same way.
HARRIS: The treatment could be given in emergency rooms, she says, but the current surge makes that unrealistic.
PETTY: All of our emergency departments in the state are overwhelmed.
HARRIS: The best option would be to set up whole new sites to infuse these drugs. At least there's plenty of the drug to go around. That's because many hospitals and clinics around the country have not been aggressive in using monoclonal antibodies, and many people freshly diagnosed with COVID-19 haven't sought them out. Dr. Peter Newcomer in neighboring Wisconsin, said UW Health treats only a patient or two a day because of logistics.
PETER NEWCOMER: If you show up in a clinic in the county, first, we need you to be aware that there is a treatment - or your provider. We need that provider to call. We need that call to go to the pharmacist who then reviews it. That pharmacist calls the patient back, convinces them to come in for an infusion. They got to do that at the end of the day. It's just complicated, right?
HARRIS: To get over that recruitment hurdle, the University of Michigan actively seeks out people who would qualify based on their COVID test results and their medical records, which identify age or other qualifying health conditions. But Dr. Petty says that process has bogged down during the surge, starting with a testing system that's overwhelmed and running behind.
PETTY: The more patients that are positive, the slower each of these steps in the process to get them their treatment happens and the more impacted we are.
HARRIS: And doctors need to treat 10 to 20 patients to keep one out of the hospital. Even so, there is potentially a growing role for this treatment. Regeneron, which - along with Eli Lilly - makes these drugs, reported this week that they are effective in preventing COVID in people at high risk. The drug also worked in infected people with no symptoms. The FDA hasn't authorized these uses yet. Leah Lipsich is an executive at Regeneron.
LEAH LIPSICH: I wish I could tell you, Richard, that the need for treatment in the outpatient setting is going to go away sometime soon, but I - sadly, I do not believe that.
HARRIS: Vaccines should reduce the need for treatment, but not eliminate it. And in Michigan, where cases are surging, Dr. Petty agrees with public health officials who say the most critical response is more mask-wearing and social distancing. Richard Harris, NPR News.
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