Alberta rolls out its first outpatient COVID-19 treatment as experts warn it's not a vaccine substitute

As Alberta offers a new COVID-19 treatment to unvaccinated seniors and some transplant recipients — in their own homes — experts caution this is not a replacement for vaccination.

Sotrovimab is a monoclonal antibody treatment — administered intravenously and  authorized for use by Health Canada in July — designed to boost the body's immune response with antibodies created in a lab that target the virus. It was developed to treat patients with mild to moderate COVID-19 symptoms

Alberta began a phased roll-out on Tuesday which initially includes people 65 and over who test positive but have not received any doses of the COVD-19 vaccine as well as solid organ transplant and stem cell transplant recipients who are COVID-positive regardless of their vaccination status.

"It is the first treatment to be offered to outpatients in Alberta," said Dr. Deena Hinshaw, Alberta's chief medical officer of health, at a news conference on Tuesday.

Community paramedics administer the IV therapy in patients' homes in regions where these teams are in place. The treatment will be offered in an Alberta Health Services clinic for people living in the Fort McMurray area.

"For maximum effectiveness it must be administered within five days from when the symptoms begin," said Hinshaw.

"The treatment is being rolled out in a phased approach starting with those at the highest risk of severe outcomes like hospitalization."

According to the Alberta Health Services website, Sotrovimab "is reported to have the potential to prevent one hospital admission for every 20 patients who receive treatment."

Not a vaccine alternative

"The early results have been quite encouraging. But this doesn't prevent infection. This simply stops progression to severe disease," said Craig Jenne, associate professor in the department of microbiology, immunology and infectious diseases at the University of Calgary and member of the Snyder Institute for Chronic Diseases.

"The original clinical trial was suggesting that people who became infected and received this therapy had about an 80 per cent reduction in their risk of being admitted to hospital with severe illness."

While the treatment holds promise, Jenne is worried its limited benefits could be misconstrued.

"Absolutely there may be people who are looking at this as an alternative to vaccination. And really it can't be stressed enough that it's not," he warned.

"This is meant to treat people that are at high risk of — once being infected — being admitted to the hospital. So this is really an effort to preserve healthcare capacity. This will not stop new infections. This will not stop individuals from becoming infected and things such as long COVID."

'Another safety net'

University of Alberta infectious disease physician Dr. Ilan Schwartz said this treatment could offer another layer of protection for vulnerable  transplant recipients who can still get very sick and die despite being triple vaccinated.

"For immune compromised patients this is another safety net in a very scary disease," he said. "As a transplant infectious disease physician....I'm grateful that this is now available."

According to Schwartz another monoclonal antibody treatment has been used to treat hospitalized patients in Alberta for about six months.

But he too warned Albertans should not use Sotrovimab as a "crutch in order to avoid getting vaccinated."

"It is not as good as your body producing the antibodies after having been trained against the virus by the vaccine. It is not as effective as vaccination. It is much more expensive to the system compared to vaccination," he said.

"However, if for whatever reason some individuals have not been able to get vaccinated whether its because of misinformation or, rarely, because of allergic reactions to the vaccine, for those individuals this provides at least some sort of safety net."

Schwartz also cautioned  it will be challenging to reach unvaccinated Albertans within the short 5-day window after symptom onset.

"I think that this is probably an intervention that on paper looks really good if you're an anti-vaxxer and you just want your Premier to be doing something to prevent you from dying but you don't want to actually follow the advice and be vaccinated," he said.

While AHS plans to include additional patients in future phases of the rollout, Hinshaw also warned that people still need to get vaccinated.

"While this medication is helpful it does not change the fact that vaccines continue to be our most important tool to protect ourselves and others," she said.

In early October GlaxoSmithKline announced a deal with the federal government to supply 10,000 doses of Sotrovimab to be distributed to the provinces and territories.

The company said the agreement allows the Canadian government to purchase additional doses in 2022.