What COVID-19 treatments are being used in Michigan?

The state of Michigan is expanding access to COVID-19 therapeutics in Michigan as it battles a massive surge in COVID-19 cases and hospitalization. But what are these antibodies and how do they work?

When Gov. Gretchen Whitmer asked for more COVID-19 vaccines while resisting pressure to issue new orders to close businesses and schools, she also urged people to seek treatment from doctors if they test positive, especially if they're high risk.

During a press briefing on Wednesday, Whitmer announced the state was expanding access to Regeneron's monoclonal antibodies (mAb), which has been shown to reduce hospitalizations and help people get better, faster.

What is monoclonal antibody therapy?

Monoclonal antibodies are created in labs and are engineered to serve as a substitute for antibodies. They can restore, enhance, or mimic the immune system's response to the virus and help you feel better faster.

The mAb does this by blocking viral attachment and entry into human cells which then neutralizes the virus. It's designed to limit the viral replication of the virus inside your body.

There are currently three different mAb therapy options available: 

  • Bamlanivimab, which is made by Eli Lilly
  • Casirivimab + Imdevimab, which is made by Regeneron
  • Bamlanivimab + Etesivimab, which is also made by Eli Lilly

All three are administered through an IV and are for non-hospitalized patients with mild to moderate symptoms who are at-risk for severe symptoms and hospitalization.

Do antibody treatments work?

According to the state of Michigan, as of April 14, almost 7,000 treatments have been used since it was first deployed in the state in December. Of those 7,000 treatments, Michigan reports 65% of those treated felt better within two days and fewer than 5% required hospitalization following treatment.

"When administered to non-hospitalized patients within 10 days of symptom onset, monoclonal antibodies may reduce symptoms and the risk of hospitalizations and emergency room visits associated with the virus," said Dr. Joneigh Khaldun, chief medical executive and chief deputy for health. "Michiganders who contract COVID-19 should ask their health care providers about receiving this treatment and I urge providers to assess if their patients qualify. We have seen successful use of this therapy in long-term care facilities and even in home use by EMS providers. This therapy can help save the lives of more Michigan residents as we work to vaccinate 70% of Michiganders age 16 and older with the safe and effective COVID-19 vaccine as quickly as possible." 

The state also reported the mAb has seen success in nursing homes and long-term treatment facilities. This has included a 33-patient nursing home in Wayland in January, a senior care facility in Cass County in December and a veteran’s home in Grand Rapids in December. In seven long-term care facility outbreaks, 120 vulnerable patients with high mortality rates were treated with mAb.

Only three of those patients needed to be hospitalized with one death was reported.

When should mAb therapy be used?

The treatment is best used on people who are not hospitalized but are considered high-risk. It should be used within 10 days of symptoms and before the virus so severe that you have to be hospitalized for treatment.

When used early enough, they can reduce the viral load, symptoms, and reduce hospitalizations and emergency room visits. 

Who can receive mAb?

Anyone over the age of 12 can receive monoclonal antibodies if they have mild to moderate symptoms, they weigh more than 89 pounds and have one of the following risk factors:

  • Have a body mass index (BMI) ≥35
  • Have chronic kidney disease
  • Have diabetes
  • Have immunosuppressive disease
  • Are currently receiving immunosuppressive treatment
  • Are 65 years of age and older
  • Adults 55 years of age or older AND have cardiovascular disease, hypertension, or chronic obstructive pulmonary disease/other chronic respiratory disease.

Between the ages of 12 and 17 there are additional risk factors:

  • Body mass index greater than 85th percentile for their age and gender based on CDC growth charts
  • Sickle cell disease
  • Congenital or acquired heart disease
  • Neurodevelopmental disorders, for example - cerebral palsy
  • A medical-related technological dependence, for example, tracheostomy, gastrostomy, or positive pressure ventilation (not related to COVID-19), 
  • Asthma, reactive airway, or other chronic respiratory disease that requires daily medication for control.

Who cannot receive mAb?

Anyone under the age of 12 or weighs less than 89 pounds cannot receive the treatment.

Additionally, it's only for people who are not hospitalized due to COVID-19 or do  not require oxygen therapy due to the virus.

Should you get a COVID-19 vaccine after having antibody treatment?

While the vaccines are still being rolled out, it's not known how long they will be effective in the human body. However, if you've had COVID-19, it's unlikely to be reinfected within three months so the state advises not to get a vaccine for three months as a precaution.