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Steve E. Bishop, M.D.

By: Steve E. Bishop, M.D. on December 15th, 2021

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COVID-19 Update: COVID & Flu, Omicron, Monoclonal Antibodies

COVID-19 | Facebook Live Recap

On this COVID-19 update, Dr. Bishop provides an update on COVID case counts and the flu, discusses the Omicron variant, and explains how and when to request monoclonal antibodies if you contract COVID. Watch the update below and read on for the full recap. 

COVID & Flu Update

First things first, some generally good news. Despite the fact that we had Thanksgiving about two weeks ago and that it looks like, yes, we're having a little bit of a bump up in numbers, but overall things are essentially stable. 

Hospitalizations actually are up a smidge, but fatalities in most areas, including in Virginia, are actually down from where they were a couple of weeks ago. That is all good news.

We're going to continue to see little ebbs and flows of COVID over the weeks and months as this continues to be an issue. We're going to keep getting these little peaks and valleys as new populations either get exposed to the first time or new variants come and they expose people for the first time. So keep expecting to see that. It looks like we're at a plateau, and now it's going to come back down, and then we'll probably see another one again around the new year.

That's normal for a lot of these respiratory viruses. We're seeing a lot of flu out there, so don't forget, COVID is not the only thing going on right now. Influenza has come back this year with a vengeance. It's now considered widespread in Virginia.

If you do get sick, make sure you ask to be tested for both COVID and influenza, because you may just have garden variety, run-of-the-mill flu, for which there are effective treatments to reduce the duration of the illness.

There are a couple of different drugs out there. One is called Tamiflu, and the other one is Xofluza. Both of those are excellent medications that can be used early in the course of the flu. Of course, we recommend, in addition, that you get vaccinated prior to getting the flu. Hopefully so that you either won't get it or so that if you do get it, it's a mild illness.

But if you do happen to get the flu, whether you're vaccinated or not, there are two medications that are excellent treatments. I would ask your doctor about them if you do get the flu.

The Omicron Variant

So let's talk about Omicron. Omicron continues to be in the news. Like we told you guys a couple of weeks ago, it's going to continue to spread and probably become the most prominent variant out there as these variants are want to do. Once they appear, if they have a replication advantage, they're going to become the dominant variant.

It's pretty much everywhere now. It's now been reported in Virginia and up to 13% of the cases in the Northeast are essentially Omicron.

Virginia has put out this neat new dashboard that I think you guys will find interesting, and it's actually tracking the variants as they come. They're actually showing you which variants are the most common ones out there around as part of their surveillance screening.

By and large, the vast, vast majority — over 99% of the cases in Virginia right now are still the Delta variant.

Omicron just popped up this week, but you can track that over time. I would expect Omicron to continue to rise and become more noticeable in the numbers and probably Delta will fade off like Alpha faded off in the summer.

COVID Antibody Infusions

So let's talk a little bit again about COVID antibody infusions or monoclonal antibodies infusions. There are a few different ones. They all have worked very well.

So, Diana, you had a question, what's the success rate for monoclonal antibody infusions? Very high. For the vast majority of people who get infusions of monoclonal antibodies, it prevents hospitalization and it prevents fatalities.

I'll have to go back and check the exact number, but it's very high. I will tell you all the patients that I've gotten monoclonal treatment for, none of them have wound up in the hospital or have died after getting the treatment. So they do work very well.

They are sometimes a little tricky to find and get. That's the main thing I want to talk about. The thing is these are very effective therapies. They are available, but what I'm finding is that a lot of people out in the community don't know they exist.

What I would recommend for you guys as patients, just know, first of all, if you get sick, or someone else you know gets sick with COVID, ask about monoclonal antibody treatment.

Not everyone qualifies, but many people do. The drugs work very well. They prevent hospitalizations. They prevent fatalities. They have minimal side effects, and it's essentially like getting a vaccine in a bag or a vaccine in a bottle. You get the antibodies to destroy the virus immediately upon receiving the infusion. Most patients feel better within 24 hours of getting the infusion.

We have a couple of partners in the area where we send our patients. Your doctors may have different ones that they're using, but they are available in most places and I would urge you to ask about it and press your doctor a little bit if they are not forthcoming or don't know where to get access. Challenge them to figure it out, because it is available out in the community, these things are available in the area, especially in large metro areas.

Spread the word, let your friends and loved ones know. If someone gets sick, they should be asking for this treatment, because it can be lifesaving. And this is whether you're vaccinated or unvaccinated, it doesn't matter. You can still get treatment with monoclonal antibodies. You can also get post-exposure prophylaxis with monoclonal antibodies.

So if you are someone that's either not vaccinated, partially vaccinated, or you're at very high risk for doing poorly after getting exposed to COVID, you can get post-exposure prophylaxis.

You can actually go get a dose of this, even if you're not currently sick because you're at high risk for getting COVID and having a bad outcome, so you can get post-exposure prophylaxis. It lasts for six to eight months. So it will protect you for six to eight months, which is excellent.

They've also approved a new monoclonal antibody product called Evusheld, which can actually be used for children and other people who are younger who can not get vaccinated for some reason or another and who have severe immune system problems. And they can use that as pre-exposure prophylaxis actually, which is interesting.

People who are high risk can go ahead and get a dose of this prior to exposure in order to protect them for six to eight months after getting the dose. It's for adults as well, but the primary indication and primary reason it was developed was for people with immune system problems, kids, things like that, that either can't get vaccinated or they have high risk in terms of they've had a bad reaction to one of the first COVID vaccines or what have you.

The Evusheld is not widely available everywhere yet, but the other monoclonal antibodies for either post-exposure prophylaxis for adults or treatment for adults are available. There are certain criteria and I've shared this before, but I'm going to share it again, here's a nice little article about who might qualify.

Again, I think this speaks to the fact that many of us in the U.S. have qualifying things, even if we consider ourselves "healthy", right? Just being overweight is enough to qualify you as high risk. If you are a little bit overweight, 10-15 pounds overweight, you may qualify for monoclonal antibody treatment because that 10 or 15 or 20 extra pounds puts you at increased risk for doing poorly with the virus.