Episode 17. Case Rates and Monoclonal Antibody Therapy

Sep 24, 03:00 PM

Additional Resources

COVID-19 Case Rates by Race

Q1: We’ve been talking a lot about children’s health and safety now that the school year has started. Can you tell us about how COVID-19 cases are increasing among children?

A1: COVID-19 case counts among children aged have increased dramatically since July 2021. 
  • The case rate for Black children is three times the rate of white or Asian children.
  • The case rate for Pacific Islander and American Indian/Alaska Native children is even higher.

These counts are for children who have tested positive for COVID-19, or are presumed to have COVID-19 because they had COVID-like symptoms and had close contact with someone who tested positive for COVID-19. 

Statewide, there have been 36,080 pediatric cases of COVID-19. 1,104 of those cases have been among Black children. Of the total cases statewide:
  • Over half reported symptomatic COVID-19.
  • One percent (349) required hospitalization.
  • Over a third were due to close contact with other household members who had COVID-19.

Q2: How does that compare to the case rates among individuals overallBlack adults?

A2: We don’t have a report that shows the case rates for just adults, but if we look at the statewide data across age groups, we find that statewide:
  • There have been over 290,000 cases of COVID-19.
  • The case rate for Black adults and children is twice the case rate for white adults and children.
  • The case rates for Pacific Islander and American Indian/Alaska Native adults and children are close to three times the case rate for white adults and children.

Of the total cases for Black adults and children (7,012), 8% (536) have been hospitalized. Meanwhile, 7% of the cases for white adults and children were hospitalized.

Q3: What is being done to address the disparities you talked about?

A3: OHA is partnering with community-based organizations, local public health authorities, coordinated care organizations, and community health clinics to promote vaccination in communities experiencing health disparities.
  • Some of the community based organizations already involved in Oregon’s COVID-19 response received funding to support vaccination.
  • OHA’s vaccine planning unit addresses vaccine equity including partnership with pre-existing Community Partner Outreach Program (CPOP)
  • Supporting outreach to farmworkers as described in the Protecting our Farmworkers Resource Guide. OHA is also collaborating with federal partners who are coordinating regional interstate efforts to support migrant seasonal farmworkers with H-2A visas.
  • FEMA Mobile Vaccine Unit

State planning and resources

If people are having problems with vaccine access or have other vaccine complaints, they can also call 211.

Monoclonal Antibody Therapy

Q4: Are there treatments that can reduce the risk of being hospitalized for COVID-19?

A4: Yes. Monoclonal antibody therapies can help prevent severe illness and save lives. 

Monoclonal antibodies are antibodies developed in a lab. The antibodies work by attaching to the COVID-19 virus. This prevents the virus from entering your cells.

It helps in two ways:
  • This is an effective treatment for people ages 12 and older at high risk of developing severe COVID-19. 
  • This is also an effective form of prevention for high-risk individuals who have been exposed to cannot gain immunity from the COVID-19 vaccines.

Monoclonal antibody therapy can help mitigate the disproportionate rates of hospitalization seen within Oregon’s Black, Latina/o/x, and Tribal communities. 
  • Can reduce the risk of hospitalization when used in those with mild to moderate disease by 70%.
  • When used as post exposure prophylaxis can reduce the risk of symptomatic disease by 81%.

Studies also show that it is most effective within 10 days of testing positive for COVID-19.

Q5: Are these communities accessing this treatment now?

A5: OHA is now working on making sure monoclonal antibody therapy is provided equitably throughout the state. Right now, that isn’t the case. For example, OHSU treated 90 patients since May 2021. Of those patients:
  • 64 were white.
  • 3 were Black/African American (currently experiencing highest rates of hospitalization)
  • 2 were American Indian/Alaskan Native
  • 1 was Asian
  • 20 were other/not specified.

Q6: How does it work?

A6: You can get monoclonal antibody treatment two ways: 
  • Intravenous infusion puts the antibodies into your vein.
  • Subcutaneous injection puts the antibodies into the fatty layer of your skin.

Monoclonal antibodies are antibodies developed in a lab. The antibodies work by attaching to the COVID-19 virus. This prevents the virus from entering your cells.

Q7: Who qualifies for this treatment?

A7: This treatment is recommended for people who have an increased risk of developing severe COVID-19. Factors that contribute to developing severe COVID-19 include but are not limited to:
  • Age
  • Obesity
  • Diabetes
  • Chronic lung disease
  • Chronic kidney disease
  • Cardiovascular disease 
  • Pregnancy 
  • Sickle cell disease 
  • Neurodevelopmental disease 
  • Dependence on medical-related technologies, such as tracheostomy 

Race and ethnicity can also be associated with increased risk for progression to severe COVID-19. For example, data show that patients of color or from Tribal communities are most harmed by health inequities, and the risks of hospitalization and death for these groups are greater than those of white patients. 

These patients may face higher risk than white patients due to longstanding societal injustices such as racism, discrimination and colonization, which have and continue to negatively impact health outcomes. 

Q8: How can we make sure everyone, including the Black community, is aware of this treatment?

Q8: It used to be that this treatment could only be provided at infusion centers. But now that there is a product that providers can deliver by injection, the product should become more widely available. For example:
  • Pharmacists can now complete education and training to provide a specific monoclonal antibody product at the pharmacy or any other location that is appropriate. 
  • More traditional hHealth care providers can provide this treatment in the office setting.

But the most urgent need is sharing this information with the communities who need this information, including the Black community. 

Q9: Would it also help to share this information with our providers?

A9: Definitely. The injectable form is new, and nNot all providers may know they can order and use this treatment. If you think you may qualify, Aask your provider if they offer this treatment, or if they plan to order it for use in their clinic.