PSA: Much of the Internet Is Wrong About Monoclonal Antibodies
A pervasive and potent myth says that only the rich can afford the best COVID therapies — but this couldn’t be further from the truth.
Note: regular readers should be aware that some content in this article is reprinted from my recent “Newsletter Update” post. I intend to retell and expand my story about monoclonal antibody treatment in hopes of amplifying a specific, time-sensitive message.
There is a national hotline to help COVID patients find and use monoclonal antibodies. Dial 1-877-332-6585 (English Language) or 1-877-366-0310 (Spanish Language).
A pervasive and pernicious myth about therapies for COVID-19 appears to have reached much of the internet, potentially robbing people of the chance to keep themselves and their loved ones from experiencing the worst outcomes of a dangerous disease. This myth has to do with cost and accessibility, the ability of everyday Americans to receive the best COVID treatments, including monoclonal antibodies.
Some of us believe that certain therapies, which have spared wealthy celebrities from devastating COVID outcomes, belong to a rarefied set of treatments out of ordinary reach — like young-blood transfusions engineered to serve a COVID-suffering elite. This story jives with our experience of an ultra-stratified society. However, it just isn’t true.
Many of the very best treatments for COVID-19 aren’t just affordable and accessible; they are free of charge and plentiful. This applies to perhaps the best remedy for COVID currently available: monoclonal antibody infusion. The antibodies make for a powerful therapeutic that COVID patients of all backgrounds can receive right now. It’s just that many of us don’t realize it.
Infusion confusion may have begun with the COVID case of then-president Donald Trump. In late 2020, it was announced that Trump had caught the deadly coronavirus — and many observers believed he might die as a result. Video clips of the president barely suppressing coughs while trying to instill confidence in a stunned American public went viral. The pundit class offered its usual set of takes about the stupidity of Trump and the horrendous insensitivity of those reveling in that stupidity, since it had now become life-threatening.
Then, one day, the situation seemed miraculously to reverse. The high-BMI, septuagenarian president was no longer suffering but turned in a sprightly debate performance, all things considered.
“I can tell you from personal experience,” Trump said,
that I was in the hospital. I had it, and I got better. And I will tell you that I had something that they gave me — a therapeutic, I guess they would call it. Some would say it is a cure.
Trump’s treatment cocktail included several drugs, in fact. In October 2020, many of the entries on this drug list had not been FDA-cleared for most COVID patients. But the story changed rapidly, and now most of the treatments Trump took are broadly available. This goes especially for monoclonal antibodies, which Trump received in a formula produced by Regeneron Pharmaceuticals.
It seems, however, that the exclusive nature of Trump’s treatment regimen at the time he received it created a lingering perception of scarcity and costliness toward COVID therapies in general. And this is a perception that most of the media has been curiously loath to extinguish.
Since last fall, evidence has emerged that blood infusion with monoclonal antibodies may be the very best treatment for COVID-19.
“The government-supplied monoclonal antibodies . . . have been shown to significantly shorten patients’ symptoms and reduce their risk of being hospitalized — by 70 percent, in the case of Regeneron’s antibody cocktail,” says The New York Times.
Robert Carnahan, associate director of the Vanderbilt Vaccine Center in Tennessee, described antibody treatment as providing COVID mitigation “within minutes to hours.” Another famous doctor made antibodies his top treatment recommendation for the immunocompromised:
And yet in late summer of 2021 — in the midst of a recent and massive spike in COVID hospitalizations due to the coronavirus Delta variant — there came a mainstream news report that very few patients had been taking the free and widely available monoclonal antibody treatments.
“Monoclonal antibodies are free and effective against covid-19, but few people are getting them,” declared a Washington Post headline. “The drugs often prevent severe disease,” the article body elaborates. “Monoclonal antibodies are free to patients and there have been almost no side effects.”
It’s difficult, however, to find other outlets that picked up this story and headline. To the contrary, The New York Times ignored this news and later ran a story called “They Shunned Covid Vaccines but Embraced Antibody Treatment.”
The subhead of the article laments that “conservative radio hosts” are among those who champion monoclonal antibodies. The body of the story implies that the therapies are indeed rare and costly, suffering from a national shortage — or at least one soon to come. The author makes no real mention that the treatment is free to patients. Instead, the text describes patients seeking “costly antibody treatment” and “chasing down lengthy infusions after rejecting vaccines that cost one-hundredth as much.”
But this is patently ridiculous. I just received antibodies for breakthrough COVID-19, so I can say from personal experience that the length of infusion for Regeneron monoclonal antibody treatment is exactly 20 minutes (followed by 45 minutes of hanging out to see if any rare side effects emerge). The cost of my treatment? Zero dollars and zero cents out of pocket. The clinic didn’t even ask for my insurance card.
Dubious and nonquantitative information appears later in the Times article, framing a discussion of infusion shortages in specific areas. Such shortages may exist, to be sure — but the article gives us no information to assess the scale of the problem. How big are the areas short on infusions? How many patients are in the backlogs? How can patients in affected areas find infusion sites? No information is given. Even stranger, the main quantitative point in the article shows that over 50% of the nationally shipped doses of antibodies have gone unused: “Of the 2.4 million monoclonal antibody doses shipped nationally, at least 1.1 million have been used.” (Interesting use of “at least.”)
The Times also reports that the federal government has placed orders for an additional 1.8 million doses, which should start to arrive in “fall.” It’s unclear, then, how a potential shortage of antibodies differs from the normal distribution problems for any drug experiencing growth in demand. I have vivid memories of my frantic, weeks-long search for COVID vaccine appointments, and I’m sure many others do, too. That should not have stopped anyone from getting the vaccine.
Most concerning is how effective the sparse and slanted coverage of therapeutics, such as antibody infusions, has been. Around the time of the Post article about sparsely used antibodies, U.S. News actually ran a very similar story about another therapeutic used on Trump, dexamethasone: “Dexamethasone Can Help the Sickest COVID Patients Survive. So Why Are Too Few Getting It?” asks the headline.
The overarching effect of the (lack of) coverage has been to reinforce a sticky and pervasive assumption that certain COVID drugs, the ones I mentioned, occupy an “A-list” tier, locked somehow behind an extremely expensive paywall.
Just a few weeks ago, an angry commenter on Reddit responded to my article about media attacks on Joe Rogan with the following:
Joe [Rogan], Tucker Carlson . . . and their ilk all laugh at people who think COVID is serious, insist wearing a mask makes you a pussy and the vaccine isn’t necessary or even dangerous, and then they run to their doctors screaming for the experimental lice medication and a barrage of other treatments that the rubes they’ve convinced to not care about COVID can’t afford. [Emphasis added.]
I now know to ask the following question: what treatments can “the rubes” not afford? Does the poster mean monoclonal antibodies, which are free for patients and nationally ubiquitous? Or is the reference to dexamethasone, which the journal Nature calls a “cheap and widely available steroid?”
Even indie left media has parroted the assumption that monoclonal antibody infusions fall within a supposedly costly class of treatment. News host Kyle Kulinski says in one video, about Joe Rogan’s COVID recovery, “The issue is this: there’s not gonna be many people who have access to the monoclonal antibody stuff, and that’s a shame because that’s really, really helpful.”
Co-hosts of leftist podcast The Vanguard reacted to Kulinski’s video to ask that he hammer home the point even further: “only absolutely opulent people can get access to this stuff.”
Meanwhile, in reality, most antibody treatments are currently free, and the map of likely infusion sites looks like this (barring specific shortages):
After experiencing breakthrough COVID and receiving monoclonal antibody treatment, I can say that I highly recommend the latter. I also cannot emphasize enough that the common media line about antibodies is effectively fake news. A treatment is not exactly costly when patients get it for free and it’s purchased by a government with a sovereign and freely printed currency. An article from Healthline breaks down the cost situation further:
The [initial] cost of Regeneron’s two-drug cocktail is $1,250 per infusion, according to Kaiser Health News. The federal government currently covers this.
Compare this to the cost of a single dose of the COVID-19 vaccine — about $20 — which is also covered right now by the federal government.
The cost of GSK’s and Vir’s monoclonal antibody costs about $2,100 per infusion. This is covered by a combination of government payments, reimbursements, and GSK’s copay program, reports USA Today.
However, some infusion centers may charge treatment fees. These are covered by Medicare, Medicaid, and most private health insurances, although some plans may charge a copay.
It’s also true in some places — probably most places but definitely in the city of Chicago — that CARES Act funding will take care of any stray fees for the uninsured. A medical group called Innovative Care reports, “If you do not have any medical insurance, your treatment will be covered under the federal CARES Act.”
Even if antibodies were not free for most people right now, costliness is still somewhat relative. Most patients receive a single infusion of antibodies. $1250 is not chump change, but I imagine the typical family could come up with means to fund this treatment, up front or over time, if doing so might mean sparing one of its members from death or long COVID.
After receiving my own no-cost dose of the Regen-COV formula, my COVID symptoms quickly and substantially abated. By the day after treatment, I felt far less symptomatic and fatigued, and I began to regain my sense of smell, which has almost completely returned from a state of near-total anosmia. I now have little fear of the “long COVID” symptoms that can persist for far longer than a typical case length.
There are a few things to keep in mind when evaluating whether antibody treatment might help you or someone you know. Importantly, antibody treatment has to be given early to be effective — it’s widely acknowledged that antibodies should be given within 10 days of symptom onset, or within 10 days of a positive test, if that comes sooner. Anyone who suspects they may have COVID, or who tests positive, should be prepared to reach out to a healthcare provider as quickly as possible. This goes doubly if there are risk factors or a compromised immune system involved.
Folks should also, in advance, investigate the health qualifications that might be necessary to receive antibody treatment in their area. At Innovative Care in Chicago, the list of qualifying criteria is extensive: patients can qualify for treatment due to hypertension, current or former use of tobacco and other substances, and BMI in the overweight category or higher, among other things. However, when I went in for my own treatment, the doctors didn’t actually ask if I met the criteria. So, it could be the case that patients who want to reduce COVID symptoms or to avoid the worst of them can actually receive antibodies even if they are quite healthy. If someone is very healthy and mostly asymptomatic, they should probably abstain from treatment. However, many areas do seem to have extra doses. Some judgment is needed here.
Shortages seem unlikely for most of the country. The therapeutics are now being distributed regionally by the federal government, and a fairly recent Reuters story shows that only 25-30% of patients eligible for one of the top antibody treatments in the country actually receive it. These numbers might have gone up, but more doses are now on order, as mentioned.
The answer to how and why there is such widespread ignorance about antibodies and other therapies appears to be a potent combination of naïveté and bias in media. I was urged to check out antibodies not by the media I consume but by my own brother and sister-in-law, who live in a much more conservative part of the country. I consume news avidly, especially to find topics for the articles I write, and I’ve had a lot of interest in the COVID pandemic in particular. But none of that helped me here.
Right now, it appears that parts of the media lack information on therapies because the better funded and more biased parts have insisted on a monomaniacal, vaccine-only focus for pandemic coverage. This approach, shown in the New York Times article above, is what some folks believe to be the best way to ensure public safety (and/or pharma profits, depending on the booster situation). In actuality, such monomania likely fuels speculation that dubious treatments such as ivermectin are maligned only to suppress their potential economic effects. But still, the media has effectively buried discussion of the best COVID therapies beneath their slant and beneath mountains of other content.
Many people have primary care providers who can sift through the bullshit and give correct advice for early COVID, but many people don’t. For those people, for those reluctant to seek medical advice as soon as they’re sick, and for those who might get COVID even with their vaccines — look into the therapies, and especially the antibodies. It just might save your lungs, or your life.
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