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Biden’s team tightens grip on state use of Covid antibody treatments

President Joe Biden has sharply criticized DeSantis and others for resisting efforts to encourage mask wear and ramp up vaccinations, swearing in a speech last week that if “the governors don’t help us beat the pandemic , I will use my power as president to get them sidelined.

Yet until recently, the administration had shipped antibody treatments to states on an as-needed basis – senior health officials in early August going so far as to encourage those battling the Delta surge to seek even more supply.

But demand from a handful of southern states has exploded since then, state and federal officials have said, raising concerns that they are consuming a disproportionate amount of the national supply. Seven states – Texas, Florida, Mississippi, Tennessee, Georgia, Louisiana and Alabama – accounted for 70% of all orders in early September.

The imbalance has prompted an effort to bring control of supplies under control, fearing the government did not have enough on hand to respond to outbreaks of Covid-19 elsewhere in the country.

Earlier this month, HHS officials told states they would take a closer look at the amount of treatment actually used – but that the department was not going to limit supply to states.

“The answer is no, we haven’t gone back to an award process,” said John Redd, chief medical officer of the HHS emergency preparedness and response office at the time.

This changed a few days later, when the ministry informed that it was indeed planning to take back control of where the doses were sent, with allowances based on the number of cases and the use of the drugs. of antibodies.

“The HHS will determine how much product each state and territory receives each week,” said an HHS spokesperson. “State and territory health departments will then identify which sites will receive the product and in what quantity. “

The move drew criticism from the Alabama State Medical Association, which warned it would limit access to treatment for hospitals already struggling with an increase in the number of Covid-19 patients.

In Tennessee, Department of Health spokeswoman Sarah Tanksley told POLITICO that the additional review of state orders is already causing delays in getting drugs to providers.

Yet administration officials have bristled in recent weeks over the southern states’ reliance on expensive treatments paid for by the federal government – even as several governors have attacked Biden for his attempts to raise the rate. vaccination and reduce the number of cases.

States like Tennessee and Alabama that have relied heavily on drugs are also among those with the lowest levels of vaccination against Covid-19.

“That’s where the surges are,” said Marcus Plescia, chief medical officer of the Association of State and Territory Health Officials, of the growing demand for drugs based on monoclonal antibodies. “And where they haven’t been successful with the other mitigation efforts.”

The new HHS policy represents a throwback to the early days of the pandemic response, when states had few other options to fight Covid-19 and demand was high for any treatment that could help keep people out. of the hospital.

Once the Covid-19 vaccines were rolled out across the country and the number of cases declined, demand for monoclonal antibody drugs plummeted, allowing the government to distribute them more freely as needed.

Yet as Delta fueled a resurgence across the Southeast, Republican governors have clung to treatment as a preferred alternative to reimposing public health restrictions. In Texas, Governor Greg Abbott has opened a series of antibody infusion centers, even as he sought to ban mandatory masks in schools.

DeSantis also touted efforts to make treatment widely available, while downplaying the threat of the virus and criticizing the Biden administration’s support for vaccine warrants and school mask warrants.

“The people of Florida who are receiving this treatment are people who need it,” said DeSantis spokesperson Christina Pushaw. “We are proud of this deployment and proud of Governor DeSantis for leading the project and raising the profile of this treatment across the country.”

Faced with this growing demand, the Biden administration also rushed to speed up the manufacture of the drugs; the government has already increased its overall weekly shipment from 100,000 to 150,000 doses.

Even so, it will likely take several weeks to expand the pipeline of treatments, with state officials saying they expect the new limits to stay in place at least until October.

“No one really used monoclonal antibodies until a few weeks ago. Then there was just this increase in usage, ”Plescia said. “There is now clearly a shortage.”