Faced with potential daily exposures to COVID-19, local businessman Chris Chandler opted this summer to take an extraordinary measure to fight the disease.
Chandler said he comes in contact with many people as founder of the Richmond-based food delivery service Chop Chop RVA, as well as his work as co-founder of the COVID-19 testing service Test Here.
“We are testing around 650 people per day,” he said about the Test Here service. “About 20 to 30% are positive.”
Because that puts him in a high-risk position, Chandler opted to get a monoclonal antibody infusion designed to help his immune system fight COVID-19.
Chandler met the requirements to get the antibody treatment as a preventative measure because he is in a high-risk category.
To get his treatment, he went to Infusion Solutions, an independent infusion center that opened in Henrico County in February and that has become a big provider of monoclonal antibody treatments for COVID-19.
“I chose them [Infusion Solutions] because whenever we have a customer that tests positive and they have symptoms, we send them to Infusion Solutions,” Chandler said. “Within 24-48 hours after having the antibody infusion done, people are doing better. It is such a good fighter of COVID that I also knew it would be a good preventive measure for me.”
Infusion Solutions was founded by Dr. Patrick Oliver; Annette Bennett, an entrepreneur with a background in managing clinical research; and Lucien Roberts, a health administrator.
Their goal was to create a facility where patients could get infusions for a variety of health conditions in a relaxing space outside of a hospital setting.
Bennett said she started thinking about creating an independent, free-standing infusion center in the Richmond area after seeing what her brother, Daniel, went through during a three-year battle with colon cancer.
“I had to go with him to different infusion locations,” Bennett said. “There was never a good setup. Patients were in an open room. There was not any privacy and no luxury. There was just a shower curtain with a chair.”
“I wanted to create a luxury infusion center,” said Bennett, who is also co-founder and CEO of Clinical Research Partners, a Henrico-based clinical research firm whose work has included doing clinical trials on COVID-19 vaccines.
“I think everyone deserves to be treated in a setting where they can be in their own room and have family there and watch TV,” Bennett said.
Infusion Solutions offers 13 private suites where infusions are given, with heated chairs, and a staff of nurses to take care of patients.
“One thing some patients don’t understand is they do have a choice as to where they get their infusions done,” Oliver said. “A lot of people think ‘I have to go to a hospital or I have to go to a specific infusion center,’ but they have a choice.”
Roberts, who is Infusion Solutions’ chief operating officer, said he was inspired to join the company after his father’s fight with congestive heart failure and kidney disease and his experiences with getting infusion treatments.
Infusion treatments can take up to six hours.
“You will have folks who want to hang out with buddies” during their infusions, Roberts said. “These are the non-COVID patients. This is an option we have for those patients.”
The clinic does not provide chemotherapy for cancer treatment, but it does offer infusions for numerous other conditions.
“We treat Crohn’s disease and rheumatological issues,” Oliver said. “We treat pregnant women who can’t keep anything down.
“Truthfully, our biggest one is infectious disease,” Oliver said. “We have private rooms and suites, and we have an infectious disease physician on staff. We take infection seriously.”
Dr. Bo Vaughan, an infectious disease specialist, serves as the practice’s infectious disease medical director.
Since March, the clinic has been giving monoclonal antibody treatments such as the Regen-COV treatment developed by pharmaceutical company Regeneron.
Infusion Solutions sets up a separate space of six rooms, on a separate floor of its office on Forest Avenue, to treat COVID-19 patients.
“What’s unique about our infusion center is that we have a dedicated COVID space,” Vaughan said. “That’s really beneficial so we can off-load the emergency departments around us from this type of therapy and be a dedicated center for this.”
Treatments take about three hours. One of Infusion Solutions’ goals is to help relieve local hospitals from tying up rooms for those, Bennett said.
The number of patients getting antibody treatments at the Infusion Solutions clinic has grown, jumping from about eight to 12 a day in the summer to about 30 a day by mid-September.
“We’ve had to pivot some things, but we’re happy that we’ve been able to help keep people out of hospitals,” Bennett said.
Test Here has set up a COVID testing and vaccination clinic outside of the Infusion Solutions office and refers patients who test positive to the clinic.
“We want to be a one-stop shop for COVID,” Bennett said.
Infusion Solutions is one of about 50 locations in Virginia where monoclonal antibody treatments are available, according to Virginia Department of Health numbers.
Most of the sites are hospitals, with some physician practices or urgent care clinics also offering the treatments, said Dr. Brooke Rossheim, a public health physician specialist for the Virginia Department of Health.
Some pharmacies also are able to offer the treatments. For instance, Amber Specialty Pharmacy, which has a location in the Reynolds Crossing development off Broad Street along with several other states, announced Thursday that it is offering infused medications produced by Eli Lilly.
Hospitals around Virginia also are offering monoclonal antibody treatments, such as Bon Secours Richmond Community Hospital and its Rappahannock General Hospital in Kilmarnock. At those two locations, COVID-19 patients can get infusions for monoclonal antibody treatments.
But for other health care issues, Bon Secours also has other locations in the Richmond region where people can get outpatient infusion treatments not requiring a hospital admission. Those include office locations attached to one of its hospitals or at Bon Secours Patterson Family Practice on Patterson Avenue.
The U.S. government placed monoclonal antibody treatments on an allocation system by state in September, with health departments distributing the treatments as needed.
Rossheim said Virginia’s supply of doses has been increasing, from about 1,500 doses the first week, which was about 200 short of the demanded amount, to about 4,400 doses the last week of September, which was a surplus.
Patients need to meet certain criteria to be eligible for monoclonal antibody treatments. The treatments are intended for non-hospitalized patients with mild to moderate COVID over 12 years old.
Patients also need to be at risk for progression to severe COVID, including having underlying risk factors such as being over age 65 or having other chronic conditions such as heart disease, hypertension or obesity. Patients also need to get the treatment within 10 days of symptoms onset.
The earlier within a positive test or onset of symptoms, the better, Vaughan said.
“We really want to get the therapies done early, within eight to 10 days,” he said. “The studies show it decreases your risk of advancing to severe disease somewhere between 70% and 80%.”
Antibody treatments made by Regeneron and pharmaceutical maker Eli Lilly also have been approved for “post-exposure prophylaxis,” or prevention of the disease, for people who have been exposed to COVID and meet certain other criteria, such as Chandler.
“These drugs are useful, because the truth is they save lives,” Rossheim said. “They have good data behind them. When used according to their package label for the treatment of mild to moderate COVID, they keep people out of the hospitals and emergency departments. We certainly encourage their use within what the FDA has laid out.”
But Rossheim and the staff at Infusion Solutions stressed that monoclonal antibody treatment is not a substitute for being vaccinated against COVID-19. The goal is to prevent the disease in the first place, he said.
“The way to go is prevention,” Rossheim said. “That is, without question, the prime directive. We want people to be fully vaccinated. We strongly encourage complete vaccination because that is the best way to protect yourself and people around you.”
Infusion Solutions is one of more than 4,000 non-hospital infusion sites in the nation.
The number is increasing especially with the demand for COVID treatments, said Brian Nyquist, CEO of the National Infusion Center Association, a trade group.
“As we have seen eligibility expand [for COVID-19 treatments], we have seen a huge spike in demand” for alternative independent infusion centers, Nyquist said.
Faced with a large number of COVID-19 patients, hospitals have had to divert some with mild or moderate COVID to alternative treatment locations.
“There are some non-hospital infusion centers who have been able to expand their capacity to accommodate COVID patients,” Nyquist said.
Heather Cooper of Powhatan County and her husband went to Infusion Solutions in July after coming down with COVID-19 after a family trip to Florida.
They had both been vaccinated previously but developed mild to moderate symptoms for the disease.
Cooper, a nurse, said she received the monoclonal antibody treatment about five days after the onset of her symptoms.
“It significantly relieved our symptoms,” she said. “The total time was about three hours, and we had a good experience with them. They had a private room and a nurse assigned to you and someone to take your vital signs, and a clean area with a recliner and a TV.”