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COVID treatment not used enough for most at-risk individuals in San Diego

The county is shifting its focus on COVID-19 case investigations to help San Diegans most at risk. KPBS Health Reporter Matt Hoffman says the move comes as the immunocompromised are finally getting the help they’ve been waiting for.

Those who are immunocompromised may get little to no protection from COVID-19 vaccines, that is where the antibody Evusheld comes in.

It is a combination of two monoclonal antibodies drugs used to prevent serious illness.

"It’s really been approved by the FDA to be used as a preventive for people that are high risk or people that may not have responded to vaccines," said Dr. Christian Ramers, an infectious disease specialist and Chief of Population Health at Family Health Centers of San Diego.

COVID treatment not used enough for most at-risk individuals in San Diego

Evusheld has been out since December, but supply issues and the omicron surge complicated its rollout. County officials report they currently have plenty of supply, but are not seeing high demand.

"There’s definitely increasing demand [for Evusheld] but not at the rate at which we would like to see it," said Seema Shah, San Diego County's Medical Director for Epidemiology and Immunizations. "And that’s really why getting that message out that if you’re immune compromised talk to your doctor and get referred, get your Evusheld."

A 2013 study estimated about 3% of people are moderately or severely immunocompromised. That suggests there are some 100,000 San Diegans fitting into the category. The treatment could help those most-at risk ease into the “new normal.”

"These people have been kind of hung out to dry and they are feeling very anxious and vulnerable as the mask mandates come off," Ramers said. "It’s one thing to not have to wear a mask because you don’t want to, but there’s people around you that are really high risk and worried about severe consequences of COVID."


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At Family Health Centers, Ramers estimates about 100 doses of Evusheld have been given out and are recommending at least 600 other patience to receive the antibodies. He said there have been no reported cases among patients who have taken it and there have not been any allergic reactions.

"It's an injection not an infusion," Ramers said."[Evusheld] is thought to last about six months and thought to give about 80% protection from COVID. We've had a really big response with people coming out of the woodwork and really wanting this treatment."

Ramers said people from outside San Diego County and California have been asking if they can get Evusheld.

UC San Diego Health started administering the medication to patients in their hospitals and now are making it more accessible.

"Started off with inpatient, then moved it into clinics and now realized that there is more drug and we want to make it more broadly available and have it operationalized in our drive-up locations," said Dr. Shira Abeles who's head of COVID-19 therapeutics at UCSD Health.

Recently the dosage for Evusheld increased, so officials have been bringing patients back for second injections.

The immunocompromised can include people with organ transplants, cancer, leukemia, lymphoma and autoimmune diseases like lupus. Some medications including those for ulcerative colitis can make someone immunocompromised.

"There were some patients who received organ transplants — who knew they didn’t mount an antibody to the vaccine — who were missing kids' weddings and just now feel an added measure of security," Abeles said.

Evusheld can also provide protection for those who are allergic to COVID-19 vaccines. It does not work for everyone and has to be prescribed after a consultation.

Over the last two months about 150 patients have received the preventative treatment with recent increases in numbers.

"We are fortunate that demand has not exceeded our supply," said Sharp spokeperson John Cihomsky.

Scripps Health said patients needing Evusheld are prioritized through their COVID-19 care team.

"Scripps Health is currently administering Evusheld to our immunocompromised patients, and both supply and demand have been consistent," said Scripps spokesperson Steve Carpowich.

Kaiser Permanente San Diego is also offering the treatment and reports demand is not high.

"This medication is delivered by two injections every 6 months and is believed to work against COVID-19, including the omicron variant," said Kaiser spokesperson Jennifer Dailard. "We are in the process of identifying and reaching out to eligible patients to determine if they are interested in receiving this treatment."

Since the omicron surge earlier this year, supplies of treatments to fight infections have also stabilized. The county reports monoclonal antibodies and antivirals are available for those with symptoms who have recently tested positive.

“The time of short supply is kind of behind us,” Ramers said. “We really have plenty of medicines to treat people that need it and we’re sort of moving toward a more normal phase where this is a disease that has a treatment and you can get diagnosed with it and we’re beyond the time when we had to really triage and use a limited resource.”

The county has a webpage showing exactly where and how COVID-19 treatments can be accessed.

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