The world is constantly trying to keep up with the latest COVID-19 variant – from Alpha to Omicron and now Omicron’s cousin BA.2, we have seen how contagious and virulent these variants can be. Viruses are wily adversaries, and they mutate both to avoid detection and to defeat the body’s immune responses from vaccines and previous infections.
Even if vaccines continue to be effective at preventing severe illness and death from the COVID strains in most cases, about 30 percent percent of Americans still are not vaccinated, and “breakthrough” infections do still occur. Also, there are large numbers of immunosuppressed individuals, who do not respond to vaccines. While some antibody therapies have made their way to the market, most of these have already failed against Omicron. The world urgently needs a future-proofed COVID treatment, one that will continue to fight off future variants, even before we know they exist. More effective and efficient treatments will curb hospitalization rates and mortality when combined with periodic vaccine updates and a global effort at vaccinating greater numbers of people worldwide.
Monoclonal antibody therapies as a COVID solution
Existing monoclonal antibody COVID treatments, which generally have not been future-proofed, have limited effectiveness against the new variants and must be administered intravenously, hence are generally inconvenient. New treatments, anti-virals, in pill form promise some greater efficacy and ease of treatment but are not appropriate for all people due to serious interactions with other medication and hence more toxicity. Antibody therapies are an important solution to the pandemic, providing a neutralizing force that can heal as well as protect, as long as they have been designed to work against variants yet to come.
What makes future-proofed monoclonal antibody therapy possible is that these target parts of the virus spike protein which remain virtually the same even when the COVID virus mutates. The future of antibody drugs works by attaching to these epitopes. Think of them as the foundation upon which the virus is built. The foundation does not generally change over time but everything else above it will change. By targeting the foundation, we can be sure that new variants can be handled ahead of time and have therapies ready before the next variants even arrive.
Effective treatments for new COVID-19 variants will significantly lessen the impact of the disease on individuals and reduce the burden on the healthcare system. Neutralizing monoclonal antibody therapies have proven to be highly effective when applied properly with efficacy rates at 80 percent or above. These even have the potential to be used prophylactically to prevent infection among the 15 to 25 million immuno-comprised Americans.
Antibody treatments in the U.S.
Now, the Biden Administration must focus on the development of new therapeutics that are future-proofed, in addition to continuing vaccination efforts to fully control COVID-19. Massachusetts, for example, has led the way in establishing sites for COVID-positive individuals to receive currently available therapeutic treatments – it is time for more states to follow suit.
With government and industry working hand in hand, we can develop and stockpile monoclonal antibody therapeutics in anticipation of variants to come. We need to be thinking several moves ahead to keep ahead of variants so that stockpiles of therapies do not become obsolete as they have now. Our government needs to ensure the proper funding to support the development and manufacturing of such therapies, and we need to begin demanding they do so.
These are highly complex and time and resource-intensive endeavors. However, the technology exists today through modern antibody platforms to address these needs, and countless lives can be saved with such an approach. The more action we take now, the more we can be ready for future variants from threatening our nation’s health.
Ian Chan is a health care executive.
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