Omicron is driving test and treatment shortages — what this means for the Triad

The omicron variant of COVID-19 has driven a massive surge in case numbers that has Triad health care providers desperate for relief. In unusual joint press conferences this week, leaders described a health care system pushed to the brink, with available treatments in short supply. At-home testing kits are also scarce, and lines at some testing centers are hours-long.

WFDD's April Laissle talked with health system officials about the omicron-induced shortages, and how frontline workers are managing the crisis. She spoke with Assistant News Director Bethany Chafin. 

Anyone who's been to a drug store lately knows that omicron has caused a spike in demand for the at-home testing kits. What are leaders saying about how people can access tests?

They're acknowledging that finding a test right now is tough. And that makes logical sense when you think about these numbers. On Friday, over 100,000 tests were completed in North Carolina, about double the number a month ago. And that's just counting those performed at testing sites — at-home tests aren't included in that number. Demand has risen to the point where the system is being stretched to the max. 

Dr. Christopher Ohl of Atrium Health Wake Forest Baptist, did offer a solution to this problem that I was somewhat surprised by. He basically said unless you are severely ill, have underlying health issues, live with an immunocompromised person, or are an essential worker, you don't need a test. 

“If you have cold and flu symptoms, take some days off of work and enjoy being inside during the cold January time. Just set up for five days,” Ohl said. “That's the quarantine and isolation time now for COVID. You don't necessarily need a test to do that.”

I spoke to Dr. Brent McQuaid with Cone Health about this, and he agreed with Dr. Ohl — if you can't find a test, just stay at home.  

“I wish I didn't have to say that,” said McQuaid. “That's what I've been telling people is that if you've got a cold, and you can't get a test, and you just need to assume you have it, you need to self-isolate. If you can get a test, great. But because the resources are so thin, you know, you should just self-isolate.”

Tests are available at community sites and at various health care providers throughout the state, you can find those on the state health department's website. But you may have to wait in line for a while to get the test, and results may also be delayed due to the spike in cases. 

So, let's say you find a test, the results come back positive and you're worried because you're at high risk for severe illness. We've heard a lot about these groundbreaking new treatments. Are they available in the Triad, and if so, how can patients qualify for them?

Yes, many of the treatments that have been in the news recently are available in the Triad, but in extremely limited quantities. Let's start with monoclonal antibody treatments. They're given as an infusion or an injection and have been shown to reduce hospitalizations significantly in high-risk populations. Back in the fall, there were several brands that worked on the circulating COVID variants. 

Cone Health officials tell me they were really churning them out then, administering as many as 60 treatments per day. Recently, that number has been closer to seven. And that's because only one brand has proven effective on omicron. 

Two antiviral drugs have been approved for use in COVID patients, one by Merck and another by Pfizer. They've both been shown to reduce hospitalizations, with the Pfizer pill being more effective than the Merck option. Triad hospital systems have been given allocations of these drugs, but again there's just not enough to go around. 

Then, there's intravenous remdesivir, an antiviral drug that has been used for hospitalized COVID patients since relatively early in the pandemic. Recent studies have shown that it can also reduce deaths and hospitalizations when given to patients early on in their illnesses. 

Dr. McQuaid, with Cone Health, says they're now using the drug this way, but they're only able to give it to about 10 people each day. That's really the case with all of these treatments, there's only so much to go around and doctors have to figure out who needs these drugs the most. 

How are doctors deciding which patients get these treatments?

McQuaid says this is something that's incredibly frustrating to health care workers. 

“I would love to be in the business of something other than allocating a precious resource in a careful manner to make sure that it goes to the highest risk patients,” said McQuaid. “It's not exactly what I signed up for when I went to medical school.”

McQuaid says they're following federal guidance in order to make these decisions, but in general, the more high-risk conditions you have, the more likely you are to get these treatments. 

If you think you may qualify, talk to your doctor after you test positive. You'll be put on the list if you're at high risk of severe illness. If you don't have a doctor, it's trickier. If you're extremely ill, you can go to an urgent care center and McQuaid says you can make it onto the lists that way. The thing is, these treatments are most effective early on in the course of the illness. So by the time you're severely ill, they may not work for you. But health officials are in a difficult position here because they don't want to encourage people to overwhelm these care centers. 

“So, if you're high risk, if you have symptoms of COVID that are worrisome, you know, ‘I'm short of breath, I feel like I can barely move and I'm clearly worsening today compared to yesterday,' yeah, okay, we, we need to see you in our acute care center,” said McQuaid. “However, if you're 25 years old and you have no underlying medical problems, and you have a runny nose, I cannot advocate for you coming into an urgent care or worse yet an emergency room right now, because those centers are just so overwhelmed.”

It seems like these health care workers are in a really tough spot right now. How are they reacting to this latest wave?

Well, McQuaid told me that they're getting through this just as they have during other surges, but people are definitely fearful about what could be coming around the corner. 

“The rising numbers that are predicted right now are scary looking, there's no question about it. I mean, these are big numbers that are coming our way,” said McQuaid. “And we will manage, we will get through this as we have managed the other waves. But this is intense.”

He did say one silver lining here is that they do have confidence in the treatments that they can deliver. They know what the protocols are for COVID patients at this point — that wasn't the case early in the pandemic.