Up Close | UCSF Fresno COVID-19 Equity Project Is First in Area to Provide Free, Accessible and Early Treatment for Mild to Moderate COVID-19

UCSF Fresno’s Mobile HeaL COVID-19 Equity Project (CEP) now offers an early treatment for COVID-19. Monoclonal antibody therapy or mAb reduces the need for hospitalization in higher- risk patients with mild to moderate COVID-19 and reduces progression to severe illness by as much as 70%, according to information from the U.S. Department of Health and Human Services.  UCSF Fresno CEP was the first in the San Joaquin Valley to offer the treatment for free without requiring an appointment or referral at its drive-through clinic on Shaw Ave. across from Fashion Fair Mall in Fresno.

Monoclonal antibody therapy has Emergency Use Authorization from the Federal Drug Administration to treat mild to moderate COVID-19 positive patients within the first 10 days of symptom onset and who are at higher risk of severe illness, hospitalization or death due to COVID-19. Currently, there are three mAb treatments available in the United States. The UCSF Fresno COVID-19 Equity Project administers REGEN-COV™ (casirivimab and imdevimab). 

Mayra Arana, lifelong Firebaugh resident and leukemia survivor, was the first person to receive monoclonal antibody therapy at UCSF Fresno CEP. Her husband Michael Rodriguez was the second. Arana is a UCSF patient and was referred to UCSF Fresno CEP by her oncologist in San Francisco.

Arana received the monoclonal antibody therapy on Sept. 17, 2021. “COVID is very bad – headaches, the chills, body aches, and congestion, feeling like I can’t breathe. That’s been the worst for me. I have issues with my lungs since when I had leukemia. It’s like I’m choking,” Arana said.

Arana was diagnosed with leukemia in 2015. She had chemotherapy and a bone marrow transplant in 2016. She is in remission now but is dealing with the aftermath of battling leukemia that includes health problems such as lung issues and Graft versus host disease (GVHD), which can occur after a transplant when donor bone marrow or stem cells attack the recipient. Symptoms vary but in Arana’s case, GVHD caused painful blisters in her mouth and throat.

Because of her immunocompromised condition, despite being fully vaccinated, Arana got sick with COVID-19 and so did her entire family. An ideal candidate for mAb, she was offered the opportunity to receive the treatment at UCSF in San Francisco but there were logistical issues.

“Everyone in my family had it (COVID-19). We would have to take our kids,” she said. “I can’t take them to a safe spot like in a hotel room. I don’t want to expose anyone in the hotel or hotel employees.” And having her children stay in the car in a garage during treatment would not work. A local option was very beneficial. “Forty-five minutes away from my home is better than having to do a three-hour drive and still have to wait at the clinic and then come back at late hours in the night. This is definitely good,” said Arana.

Monoclonal antibodies are synthetic (laboratory-made) antibodies given to patients through intravenous transfusion or under the skin via injections. The synthetic antibodies help patients develop an immune response or a stronger response. At UCSF Fresno’s CEP, four injections are administered, followed by an hour observation period.

“Monoclonal antibody therapy is not a substitute for vaccines. The best way to prevent severe COVID-19 illness is to get vaccinated,” said Kenny Banh, MD, an emergency medicine physician, medical director of the UCSF Fresno Mobile HeaL COVID-19 and assistant dean for Undergraduate Medical Education at UCSF Fresno. “Vaccines are administered when people are well. They help them develop their own immune response to COVID-19. Monoclonal antibodies are given via injections to help prevent people who are already sick from getting worse or who have had a recent exposure.  Vaccines are preventative. Monoclonal antibody therapy is therapeutic. MAb is available for higher-risk patients whether they are vaccinated or unvaccinated.”

Five weeks out from the mAb injections, Arana said she’s feeling great.

“I started feeling better in about 24 hours. I haven’t gotten sick. I haven’t felt weak or any different. I actually feel a little more energetic,” she said. “I kind of feel like the injections may have given me a little boost.”

While the whole family has recovered from COVID-19, her daughter got sick with a cold recently but so far, Arana has remained well.

“If you have a pre-existing condition or your immune system is low, I definitely recommend mAb,” Arana said.

It’s not for everyone, Dr. Banh emphasized. This treatment is for people with significant comorbidities and people who have weakened immune responses that put them at risk for developing severe COVID-19.

Despite having EUA and being recognized as a proven treatment, there isn’t a lot of awareness or availability of monoclonal antibody therapy, according to a CNN report.  

Dr. Banh is hopeful that will change.

“I hope this is a really significant proactive treatment for COVID,” said Dr. Banh. “We are starting small and ramping up as much as possible.”

In addition to mAb therapy, UCSF Fresno’s CEP clinic also administers free COVID-19 vaccines, COVID-19 testing and flu vaccines to the community, especially people from underserved and under-resourced communities. For more information, visit www.fresno.ucsf.edu/cep and follow @UCSFFresno on Facebook, Instagram, LinkedIn and Twitter.