Over the past 18+ months many new words have entered the vocabulary of the public, such as pandemic, PPE, community spread, “herd immunity”, droplet transmission, asymptomatic, isolation, quarantine, and antibody. When listed together, these words can seem big, and threatening, so it is important to educate ourselves on what they really mean and understand them. Medical professionals and scientists use these words often as part of their language to communicate to each other, but when these words are broadcast across the news, social media, and cover newspaper headlines they can be scary to the rest of us.
So let’s recap what we know…
Pandemic: By now, most of us know what a pandemic is; we have been making history living through one after all. The CDC defines a pandemic as an epidemic, or increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area, that has spread over several countries and continents, usually affecting a large number of people. Hence the current global state of our COVID-19 pandemic.
PPE: PPE is an acronym used every day in the medical field, which is short for personal protective equipment. Doctors and nurses have been using PPE for years to protect themselves from bodily fluids while treating patients. Standard supplies include gloves, masks, gowns, hair covers, face shields or eye protection, and shoe covers. The pandemic now requires that more extreme precautions are taken, at all times, by all, medical staff. Often the use of N-95 masks or respirators will be worn with full cap and gown garb to protect caregivers from infected patients.
Herd Immunity: Community spread and herd immunity are often mentioned in news stories sharing the latest reports on infection or vaccination numbers. Community spread is the circulation of a disease among people in a certain area with no clear explanation of how they were infected – they did not travel to an affected area and had no close link to another confirmed case. This means they may have contracted it while running errands or being in a large group of people. Herd immunity, or community immunity, is our protection against community spread. This happens when a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely.
Droplet Transmission / Asymptomatic: We also know that COVID-19 is spread through droplet transmission, meaning the virus is passed from one person to another through a spray containing large, short-range aerosols (tiny particles suspended in air) produced by sneezing, coughing, or talking. And we know some people can have COVID-19 and be asymptomatic, or be a carrier of the illness but not show any symptoms.
Isolation/Quarantine: That brings us to isolation vs. quarantine. Isolation helps keep the healthy people from the sick people. For those who may not feel sick or have symptoms but have been infected with the virus they are encouraged to stay home and “isolate” themselves from others. Those who may have been in close contact with another are required to quarantine by many state and federal laws, unless they have been vaccinated.
So we have learned a lot since 2020 began about pandemics, how they spread, and what we should do to prevent spread. One other vocabulary word that you may be hearing a lot about is antibodies, and specifically monoclonal antibodies. What are they? How do they help treat patients? What are the benefits? And who should get them? Let's answer some of these questions.
What are monoclonal antibodies?
An antibody is a Y-shaped protein produced by B cells, which are part of the immune system. There are several different kinds of antibodies, and typically vaccines are designed to produce the antibodies that recognize and “tag” viruses as foreign invaders by binding to unique parts of a virus.
Antibodies that bind to the surface of a virus and block entry into a person’s cells can actually prevent infection or disease: this is called neutralization. These antibodies, which occur naturally in some people after vaccination or infection, can be copied in the lab and then given to people as a prevention option or treatment. The term “monoclonal” refers to these laboratory-made antibodies.
Patients with COVID-19 can receive infusion treatments to help their bodies better fight the disease. These infusions include medications that act like human antibodies in the immune system to fight off harmful pathogens such as viruses. Monoclonal antibodies help by disrupting disease pathology by blocking receptors or interfering with cell-to-cell transmission.
What are the benefits?
The use of dual monoclonal antibodies can benefit patients who have contracted COVID-19 and have co-morbidities, or pre-existing health conditions, that weaken their immune system. These patients have the potential to be at an increased risk for complications from the virus. The treatment may decrease the opportunity for advancement of COVID-19 in higher risk patients and it may shorten the length of time a patient will have symptoms.
Monoclonal antibodies are also able to provide immediate protection or treatment for those who are exposed and not yet vaccinated. Reducing the amount of virus load for patients can decrease the affects the virus has within the body.
Who should use this treatment?
Patients who are 12 years old/older, have a positive COVID test, are not hospitalized and do not require an increase in supplemental oxygen or do not routinely wear oxygen. Also those with pre-existing conditions including Pregnancy, Chronic Kidney Disease, Diabetes, on Immunosuppressive Disease or Treatment, Cardiovascular Disease including HTN and CHF, Chronic Lung Disease including Asthma and COPD, Sickle Cell Disease, Neurodevelopmental Disorders or have a Tracheostomy are at higher risk and should get antibodies.
What does treatment include?
Monoclonal antibodies are administered through an IV infusion therapy. It requires the patient to have one dose (over 1 hour) by IV while monitored in the hospital setting. Patients are then monitored for an additional hour to observe for any possible allergic reactions. Patients remain on quarantine for the remainder of their time; Memorial Hospital’s nursing staff reaches out to follow up with the patients at 24-48 hours and then again as needed. Patients are also monitored at two weeks, for conclusion of symptoms.
Where can I get Monoclonal Antibody Infusions?
Memorial Hospital provides infusion therapy Monday-Friday from 7:00am-7:00pm in our Infusion Center. Sparta Hospital and SIH of Carbondale are also offering this treatment. To schedule an infusion, a doctor’s order is required. Patient’s should contact their primary physician and discuss the need for this treatment. Providers will order therapy and forward the information to the infusion department and nursing will coordinate the treatment with the patient, There is a time window to be treated. Patients should start treatment 10 days from the development of symptoms or a positive COVID test.
What is the cost?
Insurances are asking for precertification, patients are not currently billed for the medication, only the equipment for administration and the nursing staff time.
To learn more about the fight and treatments for COVID-19, visit: https://coronaviruspreventionnetwork.org/