After vaccines, monoclonal antibodies are probably the second-best weapon doctors have against COVID-19.
But some patients are reporting trouble getting access to the drugs, even though supply appears to be plentiful.
During a Monday news conference, Gov. Pete Ricketts said he had heard anecdotal stories about people whose doctors would not prescribe monoclonal antibodies.
"I've had many people tell me their doctors just didn't want to do it," Ricketts said.
"It is incredibly frustrating to me that doctors would do that," he added.
Monoclonal antibodies are drugs that use synthetic antibodies that mimic the immune system's response to a virus. In the case of COVID-19, the drugs stop the virus from attaching to cells, making it harder for it to reproduce, which reduces the risk of a severe illness.
Dr. Jim Nora, Bryan Health's medical director for infection prevention, said he's seen people at the hospital who could have benefited from monoclonal antibody treatment but weren't offered the option by their doctor.
In some of those cases, he said, treatment with the drugs likely would have kept the patient out of intensive care or off a ventilator.
Nora said with many doctors, it may be an education issue. Some may not be aware of the benefits, while others may not know the eligibility requirements, which have changed significantly in the past year.
He also said, however, that instances of people not getting the treatment aren't all tied to doctors. In some cases, people have waited too long to seek treatment and are past the 10-day window. In others, they may not meet the criteria.
When monoclonal antibodies were first approved for use as a COVID-19 treatment, they were only available to people with very high risk factors, such as those over age 65 and pregnant women.
Now, anyone over age 12 is eligible if they meet some other criteria, such as being overweight or having a chronic illness.
The requirements have been "very liberalized," said Dr. Gary Anthone, the state's chief medical officer.
In fact, he said, patients don't even necessarily have to test positive for COVID-19 to get the treatment. Anthone said high-risk people who have been exposed to someone with a confirmed case can qualify, and the treatment also is available as a preventative measure to some immunocompromised people and those who can't get vaccinated because of a medical condition.
The supply and availability of monoclonal antibodies is higher than it was just a few months ago, when Anthone said the state was averaging only about 300 treatments per week. Now, it's doing about 1,400, he said.
He said one reason doctors may not be prescribing monoclonal antibodies is that primary care physicians are busy, and they may not feel like they have the time to deal with getting their patients a treatment, which isn't as easy as prescribing a pill they can pick up at the pharmacy.
Most monoclonal antibody treatments are done by infusion, and Anthone said there are now 86 infusion centers offering the treatment across Nebraska, including many at rural hospitals. He encouraged people seeking the treatment to get a second opinion if necessary or to go to the state's COVID-19 website to seek help.
In Lincoln, both hospital systems are regularly giving monoclonal antibody infusions to patients who qualify.
Bryan Health said it has given more than 1,300 treatments since it opened an infusion center at Bryan West Campus in September.
CHI Health said it has given more than 4,300 infusions to date at its hospitals across the state, including more than 1,000 at St. Elizabeth in Lincoln. That includes more than 100 this month in Lincoln.
"We can tell you we are seeing a growing demand for the antibodies as the months go on," CHI Health spokeswoman Taylor Miller said in an email.
Unfortunately, the effectiveness of the treatments may be fading. Early evidence shows most of the monoclonal antibody drugs on the market are not as effective against the new omicron variant.
Only one treatment currently in use in the U.S., sotrovimab, retains some effectiveness against omicron, and U.S. health officials have said they will likely direct supplies of that drug to states where omicron case numbers are the highest. As of Tuesday, Nebraska had 18 confirmed cases of omicron, including one in Lancaster County.
Nora said it may only be two or three more weeksÌýbefore the treatments stop working in Nebraska,Ìýdepending on how fast omicron spreads.
But the treatments continue to work on people who have cases linked to the delta variant.
"So I would encourage people to still seek out monoclonal antibodies," he said.