Some COVID-19 treatments will still work, others won’t as omicron becomes dominant variant

Coronavirus

RALEIGH, N.C. (WNCN) – Omicron is expected to be the dominant variant in North Carolina in the coming weeks. Some of the current COVID-19 treatments will work against it, but others won’t, according to experts.

The current monoclonal antibodies used are key to treating people sick with the delta variant. However, they don’t work against omicron. A different monoclonal antibody called sotrovimab does work against omicron, but is in limited supply.

“The tools we have to fight omicron are not available right now, and when they do become available, they’re gonna be in very scarce supply,” said UNC-Chapel Hill infectious disease professor Dr. David Wohl. “So, this is not what we want to see two years into this pandemic.”

The federal government shipped out 55,000 doses of sotrovimab across the country. Of them, 1,380 went to North Carolina. The state Department of Health and Human Services said it’s in addition to 354 doses already on hand.

“Currently, providers are utilizing several different monoclonal antibodies, including REGEN-COV and bamlanivima/etesevimab, and reserving sotrovimab for high-risk patients who are identified to have omicron variant and for when Omicron is more prevalent,” said a spokesperson for NCDHHS.

The U.S. Department of Health and Human Services said additional doses won’t be available until the week of January 3rd. Dr. Thomas Holland, an associate professor of infectious diseases at Duke University, said the just over 1,700 sotrovimab doses won’t go far.

“Yeah, 1,700 doesn’t get us very far when we’re seeing thousands of new cases per day,” Holland said. “That’s a pretty limited supply at the moment. It’s really gonna get prioritized for patients who are really at highest risk of not doing well, so the kinds of patients like those that are immune suppressed and can’t respond to vaccination, for example.”

As for pills, Merck’s and Pfizer’s are awaiting FDA approval. Wohl expects them to work just as well on omicron as they do on delta, but said Pfizer’s future seems more certain.

“I think we’ll see movement on that very soon, but unfortunately I’m hearing too that there’s not a lot of supply of medication,” Wohl said. “So, even if it comes, we may not have enough of it to bridge where we need to to get more people treated until we get other therapies.”

Holland said Pfizer’s pill, paxlovid, will be a really important part of treating patients and is roughly equivalent to monoclonal antibodies

Another COVID-19 treatment currently used is remdesivir, which is an IV. Holland said it should remain effective against omicron, but the tricky part is it’s given over multiple days in a hospital, unlike monoclonal antibodies.

“We’re not totally out of tools or out of weapons here, but it is a moment of transition,” Holland said.

Remdesivir and the pills are expected to work against the new variant because they work on a part of the virus that stays relatively the same from variant to variant, Wohl explained. Monoclonal antibodies, on the other hand, attack the spike proteins, something that does change between variants.

Health officials stress treatments are not a replacement for one of the biggest tools, getting vaccinated.

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