Monoclonal antibody treatments for COVID-19 have shown to be lifesaving. But just as the state gears up to make the drugs more widely available, a national shortage is limiting the state’s supply and requiring health care providers to curtail who can receive it.

The federal government has capped Hawaii’s weekly allocation at 680 treatments, half of what local health care providers had requested, according to Brooks Baehr, a spokesman for the state Department of Health. The state will have to wait and see whether it can get more supply in the coming weeks.

“There is no question that we would have loved to get more,” said Baehr.

The antibody treatments made by Regeneron and Eli Lilly were given emergency use authorization by the Food and Drug Administration in November, and clinical studies have shown they can significantly reduce the chance of becoming severely ill and dying from the virus. Regeneron’s antibody cocktail, which former President Donald Trump took when he was infected with COVID-19 in 2020, has shown to reduce the risk of being hospitalized by 70%. The drugs also have been shown to be highly effective at preventing someone from contracting the virus after a known exposure when taken as a preventive measure.

The treatment, which involves a series of shots or infusions, must be taken early on after the onset of symptoms. Once someone is hospitalized and in need of oxygen, health care officials say it is usually too late.

While the drugs have been widely available for months, there has been limited demand for them nationally as health officials concentrated on the rollout of the vaccines. But the surge in COVID-19 cases over the summer due to the highly contagious delta variant and resulting strains on health care resources have resulted in renewed attention on the drugs as a means to save lives and reduce the pressure on hospitals.

But that’s also resulted in a supply shortage, with seven Southern states, where vaccination rates are low, accounting for 70% of orders, according to The New York Times. Recently, President Joe Biden’s administration has taken over distribution of the drugs to help ensure they get to areas most in need.

Prior to last week, hospitals and other health care providers were ordering the drugs directly from the manufacturers.

In Hawaii, the state in recent weeks has been working to boost distribution, securing 30 federal clinicians who can help distribute the medications. The medical staff who arrived in Hawaii on Sunday have been deployed to The Queen’s Medical Center West Oahu, Waianae Coast Comprehensive Health Center, Straub Medical Center, Maui Memorial Medical Center, Kaiser Permanente and Hilo Medical Center.

Waianae Coast Comprehensive Health Center, which has been providing care to the state’s hardest-hit population, is expected to receive only 75 treatments as part of its weekly allotment, said Jacob Schafer, director of infection control and employee health at the clinic.

“It would be great if we could administer it to everyone, but we just don’t have the medication for it,” he said.

It’s not clear when those doses will arrive. As of midday Monday the state’s total supply still hadn’t shipped, according to the Department of Health.

The neighborhoods of Waianae and Nanakuli have some of the lowest vaccination rates in the state and experienced a major surge in case when the delta variant of the coronavirus hit this summer. Over the past two weeks, 649 new cases were reported in that ZIP code, according to state maps, far higher than other areas of the state.

Shafer said that due to the limited supply, the health center won’t be able to distribute the treatments as a preventive measure if someone who is at high risk of complications from the virus is known to have been exposed to it.

The treatment also will be limited to people who are considered to be at higher risk, including people over age 65, women who are pregnant and people who have diabetes or are overweight. The health clinic will not differentiate between people who are vaccinated and unvaccinated.

Shafer stressed that the antibody treatment shouldn’t be used as a substitute for the vaccine. Unlike the vaccines, the treatment doesn’t reduce the chance of someone getting reinfected and severely ill.

“This is absolutely not a substitution for vaccination,” he said. “Vaccination is safety. This is an additional layer of treatment to help relieve an overburdened health care system.”

Hilo Medical Center, which serves an area that has also experienced a high rate of infection, is expecting 70 treatments a week as well as a “little extra” for its emergency room and long-term care needs, said Elena Cabatu, a spokeswoman for the hospital.

“We are experiencing a shortage like everybody else,” she said. Cabatu said the treatment also will be limited to people who have risk factors for severe disease.

Health care officials say that while the treatment is currently in short supply, the local need for it is hopefully waning as the state appears to be on the back end of the surge. Still, the state is reporting high case numbers, including 431 new infections Monday. The state’s death toll from the virus has risen to 714. Among the deaths this month were two women who contracted the virus while pregnant and died shortly after delivery. KHON reported the second death Monday.