SAN FRANCISCO (KCBS RADIO) – More than two years into the pandemic, researchers and health experts have learned more about the COVID-19 virus, and how to improve and change ways to treat it.
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Initially, monoclonal antibody therapy like regen-cov was the best way to combat the virus once people were infected, like former President Donald Trump, who despite being high risk was able to bounce back fairly quickly after treatment.
"That was then and this is now," said Dr. Peter Chin-Hong, Professor of Medicine and Associate Dean for Regional Campuses at UCSF on KCBS Radio's "Ask an Expert" with Melissa Culross and Jason Brooks on Friday.
"A lot has changed from the virus perspective," he said, and a lot has changed with treatment options as well.
The biggest change with monoclonal antibody treatments, is that the virus has evolved, and that spike protein on the surface of the virus has changed, rendering many monoclonal antibodies ineffective now.
"The monoclonal antibodies are great because they provide ready-made soldiers," said Chin-Hong. "But those soldiers are only trained to target a specific enemy."
As a result of the ever-changing virus, the treatment has waned in effectiveness over the last year or so, he said.
A new treatment, evusheld, combines two different antibodies to combat the virus, particularly the most recent variants that have emerged, BA.4 and BA.5.
But despite this, the therapy hasn't gained much traction yet as an effective treatment. "It hasn't really penetrated into the community as much as we’d love it to be," he said.
Part of that is due to that initially, there wasn't enough staff available to administer evusheld, because it works more as a preventative measure. But now that there are more resources available, Chin-Hong's staff is better able to dispense the treatment.
"I hope that more people would contact their healthcare professionals to get it," he said.
The main difference with this new treatment is that it's long-acting, and is particularly useful against subvariants of omicron.
It acts mainly as a substitute for vaccination, for those who may not be able to, and helps prevent them from getting COVID-19.
"It's good for people who are very immune compromised in the beginning, when the vaccines may not work because you don’t have a robust immune system," said Chin-Hong.
It prevents hospitalization and severe illness by as much as 70%, he said.
Other treatments, like paxlovid, are used after an infection has already occurred. But Paxlovid does have the potential to be used in the future also as a preventative treatment.
It’s likely that all these treatments will become widely available in the future, but right now they are still under emergency-use authorization, so it’s authorized only for those with at least one risk factor.
"But that category is very, very broad," he said, which includes factors like obesity or ADHD, meaning many people are eligible but just don’t know it.
In a perfect world, everyone would be able to access paxlovid, said Chin-Hong. "The other secret silver lining about paxlovid is that it drops viral load very quickly."
So it could not only be used effectively as a treatment for the virus, it could also help reduce transmission.
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