Minnesota COVID-19 patients face a lottery for monoclonal treatment that works against omicron

Christopher Magan, Pioneer Press, St. Paul, Minn.
·3 min read

Jan. 24—Minnesotans who get a serious case of COVID-19 may face long odds of getting one of the life-saving treatments that can fight off the omicron variant because they are in such short supply.

State health officials had steadily increased the availability of monoclonal antibodies — a type of antibody infusion — to help high-risk patients avoid severe COVID-19 infections. Unfortunately, now only one monoclonal antibody formula, Sotrovimab, works against omicron.

"That is in very low supply nationally and in Minnesota," Jan Malcolm, health commissioner, recently told members of the Minnesota House health committee.

The state has moved to a random selection process to decide who gets what monoclonal antibodies the state has on hand. This week it got just under 600 doses of Sotrovimab, a slight increase from the week before.

The state received larger allocations of the two new antiviral pills — Molnupiravir and Paxlovid — getting about 12,000 total doses of those newly approved pills since they became available in December.

The random selection process the state uses is a weighted system that identifies patients who would most benefit from monoclonal treatments. When treatments are scarce, patients who receive the medicines are picked through a lottery.

In some instances, the process could give consideration to front-line health workers who were sickened while caring for COVID patients. Many Minnesota health systems, but not all, follow the state's guidance for distributing scarce treatments.

The guidelines do not take into account whether someone has been vaccinated.

The state stopped using race as a factor in that weighted system for allocating monoclonal treatments Jan. 12 after America First Legal threatened a lawsuit against the Minnesota Department of Health alleging racial and ethnic discrimination.

"These racist policies decide questions of life and death based on skin color and must be rescinded immediately," Stephen Miller, the group's president and a former adviser to President Trump, said in a statement. "No right is safe if the government can award or deny medical care based on race. End this horrid injustice."

America First Legal filed a lawsuit Jan. 16 against the New York State Department of Health for a similar policy.

Throughout the pandemic, Minnesota Department of Health data has shown Black, Native American, Hispanic, Asian and multiracial residents have had higher rates of COVID-19 hospitalization and death than white residents.

When asked about the rationale for removing race as a factor, despite it being part of federal guidance, a state Department of Health spokesman said in an emailed statement:

"The State of Minnesota is committed to serving all Minnesotans equitably in its response to the COVID-19 pandemic. Ensuring that communities that have been disproportionately impacted by COVID-19 have the support and resources they need is critical and we are constantly reviewing our policies in order to meet that goal."

Minnesota continues to experience record high caseloads of COVID-19 driven by the highly contagious omicron variant. The state is reporting, on average, more than 11,000 new infections each day and test-positivity is at 27 percent.