Alaska is so low on its supply of certain COVID-19 treatments that only the most severely at-risk people will likely have access to them — all while unprecedented numbers of Alaskans are testing positive during the current omicron surge.
The state on Friday reported 5,508 new cases among residents and nonresidents over the previous two days. That breaks down to 2,598 cases Wednesday and 2,910 on Thursday, once again shattering records reported earlier this week.
The number of patients hospitalized with the virus rose slightly to 87, up from 80 as of Wednesday. While that’s a fraction of the record hospitalizations reported last fall, hospital administrators this week say facilities are again feeling strained by rising patient counts and staffing shortages.
[Alaska shatters COVID-19 case record as omicron adds to growing strain on hospitals]
In Anchorage, Alaska’s largest city, the case rate has more than doubled since last week, and municipal residents accounted for more than half of the new cases reported by the state health department. The Anchorage School District was reporting 1,171 currently active cases as of Friday afternoon among more than 49,000 students and employees, though the district’s dashboard doesn’t include every case tracked by the state.
Alaska reported two additional virus-related deaths Friday, involving two Anchorage residents in their 60s. Since the start of the pandemic, 955 Alaskans and 32 nonresidents in the state have died from the virus.
September and October 2021 were the deadliest months of the pandemic so far. While recent case counts have exceeded prior records, officials say there are some signs that the omicron surge may not be as severe as the delta wave in terms of hospitalizations or deaths.
Still, the omicron variant is bringing with it new challenges.
Monoclonal antibody treatments have been important in treating COVID-19 patients early, particularly those who are at high risk of severe illness, like people who are immunocompromised. But two of the three types of monoclonal antibody treatments available aren’t effective against omicron, which is putting pressure on the supply of treatments that are.
Meanwhile, a newer oral antiviral treatment is also scarce, though for different reasons, according to state pharmacist Coleman Cutchins. The oral medicine was only recently authorized as a COVID-19 treatment and there isn’t a large amount manufactured yet, he said.
Both the newness of the drug and the high demand amid surging case counts has led to its scarcity. But that likely 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 more time to produce.
The scarcity of some treatments prompted Alaska’s crisis care committee to recommend that therapeutic treatment providers prioritize people with certain medical conditions into tiers, with those who are most at risk for getting severely ill from COVID-19 at the top.
The state’s chief medical officer, Dr. Anne Zink, said this week that it’s likely there’s only enough of both the monoclonal antibodies and the newer oral antiviral treatments for people in the first tier.
That group includes those whose immune systems won’t respond adequately to the vaccine or past infection because of underlying conditions, as well as people who aren’t current on their vaccine and are either age 75 and older, age 65 and older with risk factors or pregnant, according to the recommendations.
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The monoclonal antibody shipments arrive in one-week cycles, with enough to supply 13 therapy sites with six doses each, a total of 78 doses, Cutchins said. Most states are getting a small allocation, given that the treatments are hard to manufacture and take a while to ramp up production.
He said the situation around treatment isn’t entirely negative: It’s likely that most vaccinated and boosted people do not need monoclonal antibodies, plus there are two new oral drugs that work against COVID-19 as well, including the omicron variant, though 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 far less convenient compared with the ease of taking an oral drug. But oral drugs currently remain scarce, though Cutchins said he expected to see more of them quickly, 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, characterized the lack of supply Thursday morning as “a pretty dire situation.”
It started the day after Christmas, when her phone’s voicemail was full by 4 p.m. They were back doing roughly 50 infusions each day, six days a week. By Thursday, Green only had 24 doses available, with six already accounted for and only a light shipment expected for the following week.
“It’s been a big ship to turn — people are used to having that safety net and something that will help them to get better and more quickly,” 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 would gladly give it to you,” Green said. “We’re not trying to be rude, we’d love to help everybody, but we still have to protect that highest-risk group right now.”
So far, the facility has not had to turn anyone away in the highest-risk category yet, Green said.
Daily News reporter Annie Berman contributed to this article.