Nate Monroe: In Jacksonville, DeSantis' first Regeneron site off to slow, embarrassing start

Nate Monroe
Florida Times-Union
People wait in line outside the Main Library in downtown Jacksonville on Friday morning for the doors to open for the Regeneron clinic.

COMMENTARY | As hospitalizations in Florida continue to rise, testing remains scarce, and political fights over masks intensify, Gov. Ron DeSantis has pinned all his hopes for statewide recovery — and personal vindication — on opening a series of pop-up sites in several cities that offer an antibody cocktail designed to improve health outcomes for COVID-19 patients.

But the first days of data from the site in Jacksonville — the first one DeSantis announced last week — shows his moonshot strategy to focus state resources on a therapeutic, instead of proactive efforts like more aggressive vaccine distribution and testing, is off to a slow start. And an image that went viral this week from the Jacksonville site of two patients lying on a carpeted floor in agony while waiting for the treatment seemed to encapsulate the last-minute, shoddy effort to stand up the sites.

From Aug. 12-17, the Jacksonville site administered only 229 doses of Regeneron's monoclonal antibody cocktail, with the daily doses given out ranging between a low of 8 on the first day to a high of 97 by Tuesday.

Photo from the Regeneron clinic:Viral photo of people on floor at Jacksonville Regeneron clinic ‘doesn’t convey how much pain they were in’

More on the picture:Yes, this photo of severely ill COVID-19 patients lying on the floor in Jacksonville is real

In that same time, testing has remained scarce but in incredibly high demand — one of the new city-supported testing sites closed by early afternoon twice after depleting its daily tests — and hospitalizations in Jacksonville have continued to remain on a high plateau, with more than 300 in intensive-care units in the city hospitals that release data publicly. Regional school systems have also announced hundreds and hundreds of cases among students and staff.

DeSantis has been defiant in the face of questions about his singular focus on offering the Regeneron therapeutic, and his spokesperson has repeatedly suggested critics simply want to see people suffer for political gain. Conservative TV host Sean Hannity called DeSantis' strategy "innovative," and it's clear the governor himself believes he's due a victory tour.

But more than a month after a remarkable wave of disease has washed over Florida, the sluggish pace of dosages in Jacksonville and the slow rollout of other sites (he was still announcing new sites this week) strongly suggest DeSantis' Regeneron ploy is too little, too late.

Indeed, his administration officials, for more than a week, have said they are anticipating the peak of the latest COVID wave coming, if it hasn't already been hit, and they are hopeful for a rapid decline. That raises an obvious question: Why did it take DeSantis so long to act? Why did he wait until the moment he believes cases may already be in decline to rollout this apparent life-saving strategy?

Why, if this massive surge is due only to seasonality, as his administration has claimed it anticipated, weren't these sites set up at the start of summer, instead of near its end?

It's true that monoclonal antibodies can significantly help some COVID-19 patients  — hospitals have already been administering the therapeutic for months — as long as the infection is caught soon enough. So that is important: Some people will be helped by these pop-up sites.

But it's just one of many tools government officials can deploy. Most medical professionals believe in a layered approach to pandemic management that includes, first and foremost, vaccination, and can be followed by other measures like some indoor masking in areas with high spread. The point is to have many arrows in the quiver, instead of a high-stakes single shot.

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Gimmicks won't work with COVID-19

Florida can't claw its way out of the pandemic with DeSantis' Regeneron-only strategy.

If the state could guarantee every dose was only going to an eligible patient who would stand to benefit the most from the treatment, and if supply were enormous, these sites might start to make a difference, at least on the margins. But that's not how it works.

The state is allowing anyone to access the new pop-up sites, which guarantees some level of waste: Some people who will show up to get it will be vaccinated and already protected; some simply won't have a robust reaction to it; some will not have caught the infection early enough for the antibodies to work — a particularly likely problem when testing remains scarce.

That is important because supply is also limited. Kirby Wilson, a reporter with the Tampa Bay Times, reported this week the state has asked the federal government to supply it with 7,000 doses for its state-run sites — a small number in a state with more than double that amount of currently hospitalized COVID patients.

This strategy relies on patients educating themselves on an experimental treatment, getting to the site — in some cases located an hour or more away — and possessing a willingness and ability to wait for hours to get the antibodies. It took the Jacksonville location nearly a week to hit almost 100 doses administered in a day, while averaging just over 38 doses per day over the first six days it was open. If that is a rough guide, the additional sites popping up across Florida in the coming week won't be fully ramped up and administering significant numbers of doses until two weeks out. That is time enough for many thousands of more infections and hundreds of hospitalizations — it is time no one has.

DeSantis' Regeneron ploy feels as if it were crafted backwards: an after-the-fact justification for his cruel herd-immunity mindset, and a substitute for a proactive vaccination drive, which he lost interest in after vaccines became particularly controversial among his hard-right base. It also feels rushed: DeSantis breezed into Jacksonville last week, announced the site, then scurried away, leaving local officials the difficult task of figuring out where to actually set it up. And that rushed effort showed: There weren't enough wheelchairs for the incredibly sick patients seeking treatment, which is why some of them were left suffering on the floor, an appalling visual. These are mere basics.

The timing, the shoddy execution, the rhetoric: They reek of gimmickry, not serious policy, and gimmicks aren't enough to save a state on life support.

Nate Monroe's City column appears every Thursday and Sunday.

nmonroe@jacksonville.com