My 62-year-old relatively healthy husband was vaccinated in March 2021. Nine days ago, he became symptomatic for COVID-19 and tested positive. His symptoms included a mild fever, cough, watery eyes, runny nose, congested sinuses, chest tightness, fatigue, grumpiness, very swollen glands, light-headedness, foggy cognition, and body aches. On his seventh day of symptoms, his daily report was reminiscent of the movie Groundhog Day: “Good morning. The patient is not feeling better, but he’s not feeling worse.”
On day seven of the illness, I was speaking with a colleague from Everyday Health’s professional publication, MedPage Today. When he inquired as to how my husband was doing, I told him, “He’s not worse, but he’s not getting better.” I was concerned about what to do: I had been doing everything as best as I could at home and had all my CDC printouts taped to my workboard in the kitchen to show for it — but with no improvement.
According to the American Medical Association, breakthrough COVID-19 infections are not common, but breakthrough infections in general are not a new phenomenon: It's still possible to become infected with a disease after getting a vaccine that was intended to protect you. No vaccine is perfect, and the efficacy depends on the individual. Fortunately, most cases of breakthrough COVID-19 are mild.
My work colleague and I live in the same New York county. We are in relatively similar age groups, which means we share relatively similar health risks. He mentioned that he knew about the availability of a monoclonal antibody treatment for COVID-19 at our local hospital, recalling that you first have to get a doctor’s prescription or authorization. If you qualify, you can get an IV infusion that takes about an hour. I thanked him, ended our Zoom call, and immediately searched online for more information.
Doing My Own Research
Personal recommendations, even from people I trust, require me to do my own digging — often through trusted sites like CDC.gov or FDA.gov. So I went online, but I couldn’t find what I was looking for about our local resources versus general information on the treatment and its FDA status for emergency use. Most of the articles I did find were written before vaccines were widely available, and most did not specifically address breakthrough COVID-19 in vaccinated patients.
In cases like these, it’s important to talk to your doctor first. And especially with COVID-19, where the information is changing so rapidly, you have to be careful. An article about monoclonal antibody therapy from June 2021 is probably out-of-date.
In addition, the availability of such new treatments varies by location. Resources can be limited in communities that don’t have access to the medicines or the clinical trials that can provide the medicines, and access may be dependent on local prevalence of viral variants and their potential for resistance.
While I was learning a lot about all this, my husband was doing some digging of his own and found criteria from the CDC for getting REGEN-COV, one of the monoclonal antibody treatments currently available. The following are some of the medical conditions or other factors that can put a patient at higher risk of progression to severe COVID-19, and therefore make them eligible:
- Older age (for example, age ≥ 65)
- Obesity or being overweight (for example, BMI > 25 kg/m2; or, for ages 12–17, a BMI ≥ 85th percentile for their age and gender based on CDC growth charts)
- Chronic kidney disease
- Immunosuppressive disease or immunosuppressive treatment
- Cardiovascular disease, including congenital heart disease and hypertension
- Chronic lung diseases, such as chronic obstructive pulmonary disease, asthma (moderate to severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension
- Sickle cell disease
- Neurodevelopmental disorders
- Other medical conditions or factors, such as race or ethnicity, may also place individual patients at high risk of progression to severe COVID-19
We were fortunate that my husband has a doctor at the local hospital that provides the treatment. (Note to self: Get a doctor and go for a checkup. It’s always good to have someone familiar to call when you get sick.)
We called the doctor at 8:45 a.m. on day eight and, lo and behold, someone in the office picked up right away. Within three hours, my husband got a call back and was screened for the criteria over the phone. The screener had access to my husband’s medical records, which expedited things exponentially — very important in this case because the treatment works best within the first 10 days of the onset of symptoms. Because he was at day eight, my husband was a priority. The hospital just happened to have had a cancelation, so my husband was scheduled for the IV infusion in their designated COVID-19 wing just one hour later.
We hightailed it to the car. Got to the hospital. As instructed, my husband called from outside the entrance to the hospital. He was quickly greeted and taken in for the infusion. A nurse guided my husband through the procedure, which included: an interview with the doctor, my husband’s signature giving consent for the emergency use of the as-yet-FDA-unapproved treatment, then the saline drip, and then the IV infusion. All of it took less than one hour. My husband walked to where I was parked and waiting outside the hospital, and I asked, “How do you feel?”
“Optimistic for the first time in days,” he answered.
A Cautionary Tale
Everyone in our home is vaccinated. We were practicing conscious hygiene (masks, disinfectant, and physical distancing under one roof as best as we could). But our 31-year-old daughter had just attended an event at which, although everyone was vaccinated, masks came off and social distancing became nonexistent by the end of the night.
My family aims to follow what we call the Seven Immunity Empowering Practices every day: get physical activity, eat healthy (fruits, veggies, lean proteins), get adequate sleep (seven to nine hours a night), practice healthy hygiene (disinfecting, masking in closed populated places, quarantining to designated areas if sick), keep stress and anxiety to a minimum (self-care, meditation, hobbies, breathing), be immunized (current on all vaccines that are relevant to one’s personal health), and detoxify (avoid adding toxins to your body, like excessive alcohol or drug abuse, smoking, vaping, chemical irritants, and even toxic relationships).
When our daughter — “COVID Mary,” as we were calling her — got home from the event, she was worn out. We assumed it was from a busy weekend and thought she needed rest, hydration, detoxification, and TLC. She got a COVID-19 home test on her first day back just to be safe, and both tests included in the packet were negative. But when her symptoms worsened on day two, my husband took her to a local urgent care facility for a PCR test. It came back positive. She quarantined herself in a room in our house, but my husband still came down with symptoms, and his home test turned positive — immediately and boldly.
Because we thought he just had to ride out the symptoms, it initially did not occur to us to call our doctor. We amped up home remedies and lifestyle treatments for them both, including lots of soup, tea, garlic, turmeric, fresh squeezed and pressed juices, naps, blankets, hot showers, outdoor walks (with masks!), coughing up mucus, and alone time.
Our daughter turned a corner on day six, but my husband was getting worse, not better. He had that glassy-eyed look, light-headedness, no appetite, and a tight chest. Nothing made him feel better, including sleep. He got “sick grumpy.” But he kept going through his daily routines, adamant about moving and outwitting his breakthrough COVID-19.
Now, not long after his IV infusion, our home has returned to its comforting smells of my husband’s cooking. He has turned a corner, and I am grateful for my work colleague — and that my husband agreed to the treatment even in his COVID-foggy, cranky state.
My family tends toward home remedies and lifestyle modifications first, but we should have called the doctor sooner. We were fortunate to hear about this treatment from a friend, to qualify for it, and to get quick access. And I’m grateful that my husband is feeling better now.
If you or someone you know may benefit from COVID-19 treatment like monoclonal antibody therapy, see if you or they qualify, get a recommendation from a doctor, and find a location that provides treatment. The U.S. Department of Health and Human Services provides information that can be of more help.