REGEN-COV monoclonal antibody therapy delivery will arrive in Singapore next month
According the Lianhe Zaobao, Singapore largest chinese newspaper/media outlet, a spokesman from the National Center for Infectious Diseases of Singapore (NCID) had confirmed to the Associated Press that the monoclonal antibody cocktail, casirivimab and imdevimab, developed by US drugmaker Regeneron and Swiss pharmaceutical company, Roche, will be expected to arrive in the island state next month.
The cocktail, known as REGEN-COV in the USA, was provisionally approved for special use on the 21st September earlier this month, to treat mild to moderate COVID-19 patients, age 18 and above.
According the US FDA guidance on REGEN-COV, the candidate for the therapy must be COVID-19 positive, do not yet required hospitalisation/oxygen supplement, but have the health conditions that will likely allow COVID-19 to develop into a serious illness or even death. Such candidates includes patients with pre-existing conditions like cardiovascular disease, chronic lung / liver / kidney diseases, diabetes, obesity; the elderly (50 and above), people who are not fully vaccinated or did not complete vaccination due to immunocompromised conditions. Although in the USA, this drug cocktail is approved for age 12 and above.
This comes at a important juncture in Singapore’s fight against the pandemic, as Singapore had taken a few step backwards in their plans to reopen the country fully and treat COVID-19 as an endemic disease. However, unexpectedly high transmission rate, with over 2200 cases reported yesterday (29 Sept 2021), has pushed the Lion City to enhance restrictions to just 2 person per social group.
Singapore government had reiterated that this is a difficult decision but however, necessary to protect the healthcare system to ensure that it not overloaded. Singapore is currently still in the preparation stage of treating COVID-19 as an endemic disease – and this delivery of REGEN-COV is coming at the perfect time for Singapore’s conundrum.
Singapore had been betting on high vaccination rate as the solution to allow the country to return back to normal life. However, the data over past 2 months had been discouraging, as fully vaccinated individual starting require oxygen supplement or even ICU, after a good start where only unvaccinated individuals had been the ones required oxygen supplement and ICU. The new wave triggered by the Delta variant had exposed the inadequacy of the vaccination strategy, notwithstanding the fact that vaccination greatly reduce the likelihood of COVID-19 developing into a serious disease, some of the frail and elderly fully vaccinated patients started dying.
In September 2021 (this month), 38 individuals had been killed by COVID-19. This death rate is considered extremely high by Singapore standards, as up till now, there are only 93 COVID-19 related death reported. At August 1st, total death toll was at 37. By end of August, its 55. Thus, there is all the reason for the Singapore Government to reconsider the plans to ease on the restrictions.
The main concern now is the elderly, as 31 of the 38 deceased are able the age of 70. REGEN-COV might be an important weapon to keep the death rate and hospitalisation rate down, in order to handle a bigger wave of infection that will bound to come with further relaxation of restrictions.
Singapore is definitely watching countries that had reopened or relaxed its restriction closely to calibrate their forecast models. Israel is the closest to what Singapore is, with high density population and a high vaccination rate. Followed by United Kingdom with their fully reopened endemic position. However, anyone that studied their data would know that the numbers are not acceptable for Singaporeans and the high standard Singapore set for itself.
REGEN-COV could be the key.