Ron DeSantis is talking up a costly treatment as an alternative to free vaccines, and it won't work
In the midst of a record-breaking surge of COVID-19 cases in Florida, 30-year-old Kristen McMullen gave birth to her daughter Summer Reign. As USA Today reports, Kristen had just enough energy left to hold her daughter for a few moments, long enough for a few quick pictures to be taken. Then McMullen fell into the final stages of a severe COVID-19 infection. She was sent to the ICU, intubated, and died. Two pictures is all Summer Reign will ever have of her time with her mom.
That unthinkable tragedy is just one of many being repeated across Florida. As the head of the hospital where Kristen McMullen died made clear, “We’re seeing people of all age ranges being affected. This is not just people dying who are old and elderly anymore. We’re seeing young people and old people alike being affected – including people dying.”
At a Thursday White House press conference, pandemic response coordinator Jeff Zients noted that 40% of all COVID-19-related hospitalizations were in just two states: Florida and Texas. By absolutely no coincidence, those would be the two states where governors haven’t just failed to impose mask mandates, but actively persecuted anyone attempting to protect people in businesses, schools or government offices. Also on Thursday, the Orlando Sentinel reported that 30 kids were currently hospitalized for COVID-19 at children’s hospitals just in the central part of the state. That’s just a fraction of the record 11,515 COVID patients hospitalized across Florida, but it’s an example of how this current wave is far from something that can be waved off as affecting only the elderly.
Meanwhile, as the Associated Press reports, DeSantis continues to downplay the whole pandemic. More than a year after Donald Trump insisted that the virus would “magically” go away, DeSantis is insisting that the huge surge of cases in Florida—which reached a new record on Thursday—will simply … end. All on their own. The current surge in cases, says DeSantis, are just because it’s hot outside, which is causing Floridians to spend a lot of time indoors. That alone makes a fantastic ad for “the Sunshine State.” Come to Florida, where everyone sits inside and gets sick.
“These waves,” said DeSantis, “are just something you have to deal with.” In other words, Florida, just hurry up and die. Because DeSantis is never going to take action.
When it comes to the data from Florida, there’s something very, very peculiar going on. As the delta variant wave began, Florida reported a rising number of deaths. Over the month between the start of July and the beginning of August, the seven-day running average of deaths in Florida went from around 25 to right at 100. In the weeks after that, the number of cases has continued to climb, rising another 30% in the last two weeks. However, deaths began to tumble on Aug. 6, dropping from 88 down to just 18 on Thursday, the same day that the state hit a record high number of cases.
Looked at another way, the seven-day average case mortality was about 0.6% on Aug. 3, and 0.01% on Aug. 12. There are a number of reasons why calculating CFR over such a short period is essentially worthless, but in this case there is a strong signal that something has abruptly changed. Starting in just the past week, Florida’s cases have continued to go up, while Florida’s reported deaths are plunging.
Over such a brief period, it’s possible that this could simply be statistical noise. Many states and countries have had dates on which they reported sharp changes in deaths that don’t reflect actual change in the course of the pandemic so much as the system catching up to reports that had slipped through the cracks. Texas, for example, reported 708 deaths on July 30, 2020 after bundling in almost 400 deaths that had somehow evaded inclusion until that date.
But Florida hasn’t actually had any such make-up days in the past, and the current decline has persisted, with numbers coming down every day for a solid week. That really only leaves two possibilities. One is that Florida is actually taking steps to address the number of deaths. The other is that state officials are lying.
DeSantis is certainly trying to play things off as if the answer is the former. As The Washington Post reports, the Florida governor has been giving a hard push to the monoclonal antibody “cocktail” from Regeneron Pharmaceuticals. DeSantis has been ringing the Regeneron bell at every press conference for several days, and announcing that he has created a “rapid response unit” with more to follow, specifically to deliver Regeneron’s treatment. In addition, DeSantis said he is building “strike teams” to bring the treatment to the most vulnerable.
There is no doubt that the antibodies, which Forbes noted as costing “somewhere between $1,500 and $6,500 per treatment” can be effective. A study published in Science in November 2020 showed that the antibodies reduced the viral load and markers of respiratory system damage. In March 2021, the company announced its first round of data out of Phase 3 trials, saying that treatment “reduced hospitalization or death by 70% in non-hospitalized COVID-19 patients.” So, if DeSantis is getting the pricy drug to those Floridians most in danger of death, then maybe that’s why the numbers are dropping so fast.
Only … there are a couple of big problems with that.
First off, the cocktail, which is now officially named REGEN-COV, was authorized for use by an Emergency Use Authorization last November. So anyone who wants to (falsely) call the vaccines “experimental” because they’re being delivered with an EUA should certainly level that same charge against the treatment that DeSantis is using. It’s also worth noting that this technology is considerably newer than the mRNA techniques used in Pfizer and Moderna vaccines.
What’s more, there are limits on that EUA—limits that are reflected directly in the text of Regeneron’s Phase 3 announcement:
REGEN-COV (casirivimab with imdevimab) is not authorized for use in patients
who are hospitalized due to COVID-19, OR
who require oxygen therapy due to COVID-19, OR
who require an increase in baseline oxygen flow rate due to COVID-19 in those on chronic oxygen therapy due to underlying non-COVID-19 related comorbidity
Benefit of treatment with REGEN-COV has not been observed in patients hospitalized due to COVID-19. Monoclonal antibodies, such as REGEN-COV, may be associated with worse clinical outcomes when administered to hospitalized patients with COVID-19 requiring high flow oxygen or mechanical ventilation.
REGEN-COV was never intended for those in the ICU, or even those already hospitalized for illness due to COVID-19. Even giving Trump the treatment (four times over) when he was infected was debatable, given the seriousness of his illness. REGEN-COV is designed for people who have a mild or moderate symptoms, to help them from ever developing serious illness.
It’s exactly that intended use of the antibodies which made Donald Trump’s promise to make the treatment available “for free” for every American so ridiculous at the outset—Regeneron could not even begin to produce enough of the antibodies to treat the millions of Americans who have tested. Not only is this a new form of treatment, it’s one that is not yet in wide production. Ron DeSantis certainly doesn’t have enough to treat the 24,000 Floridians who tested positive on Thursday alone. Even if the volume of treatment was available, actually instituting a program where everyone who tested positive got a $1,500 dose of antibodies rather than insisting that they get a free vaccine or wear a $1 mask would be right up there in the annals of the most foolish policies ever.
REGEN-COV is a valuable treatment. If any doses are actually going out to the people who are intended to get it—those who are displaying symptoms but not yet seriously ill—that’s a good thing. What REGEN-COV is not is a replacement for vaccines and masks.
Because that’s what DeSantis is really doing here. He’s pushing REGEN-COV because it’s associated with Donald Trump, as a distraction from his continued refusal to allow schools and local authorities to issue mask mandates, his lackadaisical-at-best approach to vaccination, and his overt hostility to companies or schools mandating vaccination.
For Ron DeSantis, REGEN-COV is how he intends to have his Trump-extremist cake, sacrificing his state on the altar of “no masks, no vaccines,” while eating up the pretense that he’s doing something about it. And though it would be nice to believe that the number of COVID-19 deaths are really falling in the state, that’s very hard. It’s been hard for a long time.
Believing those declining number is even harder in the face of stories like this one from NBC News. In a period of less than a day, four teachers from Broward County died. At least three of those teachers were unvaccinated. The status of the fourth is unknown. “Florida is the epicenter for the COVID-19 virus,” said Broward County School Board Chair Rosalind Osgood. “In Broward County, hospitals are now close to being filled with capacity. We’re in a very, very difficult moment in time with losing people to COVID.”
Broward County is one of the largest school districts in the country, with nearly 261,000 students. The first day of school is currently scheduled for Aug. 18. That school district has voted to make wearing masks mandatory for both students and teachers. As The Miami Herald reported, DeSantis immediately responded by threatening to fine the district and cut off pay to officials. On Thursday, his office “softened” that threat to make it clear they wouldn’t stop funding to the district; just to the officials who voted to protect the kids.
“I guess I’ll go to my community to set up a GoFundMe or work at McDonald’s,” said Osgood. “At least I’ll be able to have a moral conscience and know I didn’t put someone’s life at risk,”
It’s strange that, with the rate of deaths falling so quickly, four teachers in a single district died in the space of 24 hours. That is, unless what DeSantis has really done to push down those figures is to extend what’s happening in Missouri. As The Kansas City Star reported last week, at least one Missouri coroner has been leaving COVID-19 off death certificates because, “A lot of families were upset. They didn’t want COVID on the death certificates.”
Those teachers were one week away from being in front of students. Had they been required to be fully vaccinated before the start of classes, they would not have died. There’s nothing a strike team can do to help them now.