Doctors know more about COVID-19 treatment, but Florida recording highest case numbers

When doctors first began to respond to the coronavirus, they had a hard time identifying it, let alone treating people who had contracted COVID-19.

“We saw so many hospitals that were absolutely packed and couldn’t even keep up with the number of COVID patients that were coming in,” said Liz Chandler, the pharmacy and clinical specialist for infectious diseases at Lee Health.

The unknowns in the beginning left health care providers with an uncertain path forward, with high hospitalizations and death rates.

“There was just so much we didn’t know about the optimal treatment of patients with severe COVID-19,” Chandler said.

Despite all that was learned throughout 2020, cases are climbing once again.

In December, Florida saw its highest number of positive COVID-19 cases, nearly 324,000 cases, which was the most since July 2020.

January is on track to beat that too. Out of Florida’s top-10 highest days of new cases, nine were in the past three weeks, but new treatment options are making a difference.

“Something that specifically comes to mind is the use of steroids,” Chandler said. “Very early on in the pandemic, steroids, especially dexamethasone, we were not using those therapies because we didn’t know they were effective. There was actually a concern that if you used steroids, it would increase viral replication, which you wouldn’t want to do. Fast forward into later on in 2020, there’s so much more literature and research that’s been done that actually shows dexamethasone specifically is one of the most effective treatments for hospitalized patients with severe COVID-19.”

Add to that list the innovation of antibody cocktails, and researchers aren’t done yet.

“From one single umbilical cord, you can obtain over 10,000 therapeutic cell doses,” said Dr. Camillo Ricordi, a researcher at the UM Miller School of Medicine. “These cells have the characteristics that are anti-inflammatory; they modulate the immune response; they are against the cytokine storm; they have antiviral and antibacterial properties; and they promote tissue regeneration and tissue repair after injuries.”

Ricordi uses stem cells from umbilical cords to treat COVID-19 patients and calls the results unprecedented.

“One hundred percent of the subjects of age less than 85 years old survived one month, versus less than 50 percent in the control group that received only the solution without the cells,” Ricordi said.

While not FDA approved, this treatment has been used on compassionate care patients – and has helped.

“We’ve been already distributing doses all the way to San Antonio, Texas and Florida. But what we can do now thanks to the NABTU support, the North American Building Trades Union, is create a rapid response repository of cry-preserved frozen cell therapeutic doses that can be distributed to hospitals in North America,” Ricordi said.

Regarding data on results for anyone given this treatment under compassionate use (outside of the study where data results were documented), Ricordi said it depends on when the treatment is offered.

“In a majority of cases, it has worked within two to three days from admission in the ICU or when put on a ventilator,” he said. “If doctors wait too long to request this type of treatment after everything else has failed, we get into the ‘miracle zone,’ not a treatment zone.”

According to UM Miller School of Medicine, compassionate use is something that can be requested by the attending physician before the FDA has approved a treatment, but it means a therapeutic dose can be distributed. The physician must be the one to determine if the patient could benefit from this procedure. The request must go through the review process by the FDA, the hospital and the University of Miami Diabetes Research Institute (who supply the stem cells).