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Over half of recent COVID cases in Nebraska are omicron variant; will soon be predominant strain

Possible therapeutic treatments released by Nebraska public health officials
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OMAHA, Neb. (KMTV) — The Nebraska Department of Health and Human Services (DHHS) announced Tuesday that 52% of specimens collected through the last two weeks are the omicron variant of COVID-19.

DHHS added that omicron will be the predominant strain across the state "very soon."

The State of Nebraska is deriving data using the National Institutes of Health (NIH) treatment algorithm.

Below are highlights from the update and considerations for therapeutic options:

  • 52% of sequenced specimens for Nebraska residents in the past two weeks are omicron, this will increase rapidly.
  • Two of the monoclonal antibody products in use as therapeutics [bamlanivimab-etesevimab and casirivimab-imdevimab (Regeneron)] are not effective against omicron
  • Remdesivir IV: antiviral effective for early treatment (outpatient three day IV course)
  • Sotrovimab (monoclonal antibody product): remains effective but is in short supply nationally and statewide
  • Oral antiviral medications (very limited supply currently, not widely available for prescriptions at this time)
  • Sotrovimab and oral antivirals will be prioritized until more widely available
  • NIH Treatment Guidelines pdf document is here: covid19treatmentguidelines.nih.gov

NIH treatment algorithm in setting of omicron predominance and limited therapeutic options, in decreasing order of preference:

  • Nirmatrelvir 300 mg with ritonavir 100 mg (Paxlovid) orally twice daily for 5 days
  • Sotrovimab 500 mg, administered as a single intravenous (IV) infusion
  • Remdesivir 200 mg IV on Day 1, followed by remdesivir 100 mg IV on Days 2 and 3
  • Molnupiravir 800 mg orally twice daily for 5 days

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