Alaska has so little supply of certain COVID-19 treatments that only the most at-risk people are likely to have access to them — while unprecedented numbers of Alaskans test positive during the current microwave wave.
The state reported 5,508 new cases among residents and non-residents in the past two days on Friday. That equates to 2,598 cases Wednesday and 2,910 on Thursday, crushing again records reported earlier this week.
The number of patients hospitalized with the virus has risen slightly to 87, from 80 as of Wednesday. While that’s a fraction of the record number of hospital admissions reported last fall, hospital administrators this week say facilities are coming under pressure again due to rising patient numbers and staff shortages.
Two more virus-related deaths were reported on Friday. Since the start of the pandemic, 955 Alaska residents and 32 nonresidents in the state have died from the virus.
September and October 2021 have been the deadliest months of the pandemic so far. While the number of recent cases has surpassed previous records, officials say there are some signs that the omicron surge may not be that serious as the delta wave in terms of hospitalizations or deaths.
However, the ommicron variant poses new challenges.
Monoclonal Antibody Treatments have been important in early treatment of COVID-19 patients, especially those at high risk of serious disease, such as those with weakened immune systems. But two of the three types of monoclonal antibody treatments available are ineffective against omicron, putting pressure on the supply of treatments that are.
Meanwhile, a newer oral antiviral treatment is also scarce, albeit for different reasons, according to state pharmacist Coleman Cutchins. The oral drug was only recently approved as a COVID-19 treatment, and not a large amount has been made yet, he said.
Both the drug’s novelty and high demand amid the rising number of cases have led to scarcity. But that probably won’t be the case for long, Cutchins said: It’s easier to ramp up production of the oral medication compared to monoclonal antibodies, which must be refrigerated when shipped and take longer to produce.
The scarcity of some treatments prompted Alaska’s Crisis Care Commission to recommend therapeutic practitioners prioritize people with certain medical conditions in tiers, with those most at risk of becoming seriously ill from COVID-19 at the top.
dr. Anne Zink, the state’s chief medical officer, said this week there is likely only enough of both the monoclonal antibodies and the newer oral antiviral treatments for first-level people.
That group includes people whose immune systems do not respond adequately to the vaccine or a previous infection because of underlying conditions, as well as people who are unaware of their vaccine and are either 75 years of age or older, 65 years of age and older with risk factors, or pregnant, according to the recommendations.
The shipments of monoclonal antibodies arrive in week-long cycles, with enough to supply 13 therapy sites with six doses each, for a total of 78 doses, Cutchins said. Most states get a small allotment as the treatments are difficult to manufacture and take a while to ramp up production.
He said the situation around the treatment is not entirely negative: it is likely that most vaccinated and boosted people do not need monoclonal antibodies, plus there are two new oral drugs that also work against COVID-19, including the ommicron variant, although data is limited, according to the National Institutes of Health.
“Oral drugs are really a game changer,” he said.
The antibody infusions, which require an IV and a sterile environment, are much less convenient compared to the convenience of taking an oral drug. But oral drugs currently remain in short supply, although Cutchins said he expected to see more of them soon, even in the next two weeks and even more a month from mid-January.
“As the orals become more and more available, we actually have a lot less need for monoclonals,” he said.
Jyll Green, operations manager at a state-contracted monoclonal treatment facility in Anchorage, described the lack of supplies Thursday morning as “a pretty dire situation.”
It started the day after Christmas, when her phone’s voicemail was full at 4 p.m. They did about 50 infusions a day, six days a week. By Thursday, Green had only 24 doses available, six of which had already been processed and only a light shipment was expected for the following week.
“It was a big ship to turn around — people are used to that safety net and something that will help them get better and faster,” Green said.
As the treatment center implemented crisis standards around prioritization, Green said she’s had hundreds of conversations with people letting them know she can’t give them the treatment.
“If we had it, we’d be happy to give it to you,” Green said. “We’re not trying to be rude, we’d love to help everyone, but we still need to protect that highest-risk group right now.”
So far, the facility hasn’t had to turn down anyone in the highest-risk category, Green said.
Daily News reporter Annie Berman contributed to this article.