TALLAHASSEE — When the federal government cut back Florida’s supply of monoclonal antibodies in September, Gov. Ron DeSantis went on the offensive.
In social media posts and appearances at news conferences and on television, DeSantis protested what he said was a partisan and “cruel” decision by the federal government meant to penalize Florida. His office forecasted a dire shortage of the promising COVID-19 treatment: Christina Pushaw, a DeSantis spokesperson, said last month the state was looking to be shy as many as 41,000 doses per week because of the policy change.
“There’s going to be a huge disruption, and patients are going to suffer as a result of this,” DeSantis said on Sept. 16 in Fort Lauderdale.
But nearly a month after the federal government cut back Florida’s supply, the state isn’t running low. Data reported by the U.S. Department of Health and Human Services showed that as of Sunday, state hospitals had more than 21,000 doses of monoclonal antibodies on hand. Top state officials said in interviews they’ve heard of no supply issues at the state-run monoclonal antibody sites or other health clinics.
Pushaw said DeSantis’ prediction of shortages did not come true because Florida’s COVID-19 situation has improved in the last month.
“The projection was based on the level of demand for (monoclonal antibodies) at that time, which was significantly higher a month ago than it is today because COVID-19 prevalence in Florida has declined so dramatically since then,” Pushaw said in a statement to the Times/Herald.
In September, when she projected the potential shortage, Pushaw said state health care providers could need as many as 72,000 doses of monoclonal antibodies per week. During the week that ended Sept. 18, the state reported about 76,000 coronavirus cases total. Because not every COVID patient seeks monoclonal antibody therapy, however, the case numbers didn’t align at the time with the governor’s office’s projected treatment figures, according to Thomas Hladish, a research scientist at the University of Florida’s Emerging Pathogens Institute.
“It seems like...they were basing those figures on a much higher case level than what we were seeing in September,” Hladish said, noting that cases had been declining for weeks by the middle of that month.
The Department of Health has said state run monoclonal antibody sites used 35,000 doses per week at peak demand. But despite repeated requests from the Times/Herald since Aug. 23, the governor’s office has not provided data that shows a breakdown of the number of doses Florida’s administered at each of its sites. More detailed figures would help illustrate the extent of the demand for monoclonal antibodies in the state. DeSantis said Monday the state has given out about 130,000 doses at the state run sites, the first of which opened Aug. 12.
Since early August — about one month into Florida’s deadly summer COVID-19 surge — monoclonal antibody treatments have been a main feature of the DeSantis administration’s response to the disease. The treatments have shown promise in preventing the virus’ worst effects if taken early in the disease’s course by vulnerable patients. The medicine may also be used as a preventative measure for extremely frail patients who fear they’ve been exposed.
DeSantis has done much less in that time to emphasize the coronavirus vaccines, which have proven to be a far more cost-effective way to prevent COVID-19 hospitalizations. Since Aug. 1, for instance, DeSantis’ Twitter feed has mentioned the vaccines just three times, including one message cautioning against the dangers of vaccine mandates. Monoclonal antibodies, meanwhile, have been the subject of at least 64 tweets.
In September, after weeks of Florida clinics getting essentially unfettered access to the treatments, the federal government put the state on a monoclonal antibody diet. When it made the decision to cut back the state’s supply of the treatments by more than 50 percent, the Biden administration cited the limited national supply of the treatments: the federal government has ordered about 3 million doses of Regeneron’s monoclonal treatment, for example. The administration also said Florida and other southern states were ordering a disproportionate share of the federal government’s supply even while the region’s case curves were improving.
DeSantis said the move was sprung on Florida without warning. He wasn’t the only official to criticize the Biden administration’s decision. Other Republicans objected. Sen. Marco Rubio tweeted that the move “reeks of partisan payback against states like Florida.” Sen. Rick Scott tweeted that the decision “makes no sense,” and introduced a bill with Rubio to reverse it.
Even some Florida Democrats lamented Biden’s decision. Agriculture Commissioner Nikki Fried, who hopes to challenge DeSantis in the 2022 governor’s race, wrote a letter to Biden asking him to delay the move.
“While we certainly understand the frustration at the inequitable distribution of this treatment to just a handful of states, I would respectfully ask that time be extended before altering our current dose allotments, giving our state time to further reduce COVID-19 from their recent peaks,” Fried wrote.
On Monday, a Fried spokesperson said the commissioner had not gotten any reports of monoclonal antibody shortages.
John Couris, the president and CEO of Tampa General Hospital, slammed Biden’s move at a September meeting with Florida lawmakers. He predicted: “This change is going to hurt people in Florida.”
On Monday, a spokesperson for Tampa General said the hospital has not seen any shortage of monoclonal antibody treatments to date.
Overall, the Trump and Biden administrations bought about 3 million doses of Regeneron’s monoclonal antibody cocktail. Although other monoclonal antibody treatments have also been approved by the U.S. Food and Drug Administration under the agency’s emergency use authorization, the Regeneron treatments comprise most of the federal government’s supply.
After the Biden administration’s September decision to redistribute the doses, DeSantis so feared a shortage that he moved to acquire 3,000 doses of a different FDA-authorized monoclonal antibody: GlaxoSmithKline’s Sotrovimab. Those treatments cost $2,100 per dose, for a total cost of $6.3 million. (The state is offering the drug to patients for free.)
Weesam Khoury, a spokesperson for the Florida Department of Health, did not respond to questions about who would pay for those treatments. Steve Vancore, a spokesperson for CDR Health, the firm Florida contracted to acquire the 3,000 doses, said the company will look to bill private insurance or the federal government before charging the state.
At a news conference Monday in Winter Haven, DeSantis said the treatments had prevented “thousands and thousands and thousands” of hospitalizations from COVID-19 in Florida. During a Sept. 29 Fox News appearance, DeSantis told the network’s Sean Hannity that the push for monoclonal treatments preceded a steep decline in the state’s coronavirus hospitalizations.
DeSantis is correct about the timing. COVID-19 hospitalizations have fallen sharply since a mid-August peak, according to the Florida Hospital Association. And at the worst of the summer virus peak, Florida was reporting nearly 30,000 cases per day. That number has plummeted to about 2,500 per day.
But Derek Cummings, a professor and infectious disease epidemiologist at the University of Florida’s Emerging Pathogens Institute, said the fall in hospitalizations has more to do with state’s declining cases than the monoclonal antibody treatment push. The fall in cases is a reflection of several factors, Cummings said. For example, hundreds of thousands of Floridians gained natural immunity to COVID-19 through infection during the most recent summer surge. Others, fearing the surge, got vaccinated.
“The number of cases and hospitalizations reflect the dynamics of infection mostly,” Cummings said.