By BY STEPHANIE NOLEN AND MALIN FEZEHAI from NYT Health https://ift.tt/aZIwclj
Tuesday, January 17, 2023
Monday, January 16, 2023
Pfizer's COVID-19 drug Paxlovid in short supply in China
January 16, 2023
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When Li's 83-year-old father with diabetes started coughing and complaining of body aches last month, the Beijing resident became anxious about finding a treatment for COVID-19 in case his parent had caught the virus sweeping the city.
He heard at that time that Pfizer's anti-viral drug Paxlovid was an effective treatment, but patients could only get it prescribed if they were admitted to hospital, and only if the drug was in stock.
The first hospital they visited conducted a CT scan that showed his lungs were infected, but turned them away, saying no beds were available, said Li, who only gave his surname due to sensitivity over how authorities might view his account.
After two more days of frantic calls to families and friends, a contact finally found them a space at another hospital, but it took a further antigen test and second CT scan before it agreed to prescribe the drug.
With his father admitted to an intensive care unit, Li was worried that it had taken too long to get effective treatment.
"I’m not sure if Paxlovid can help him. I think it's because when he got the medicine he already had the virus for a week," Li told Reuters on Jan.12.
"Now we can do little but pray."
His father died the same day.
Li's experience, local media reports and online posts bear testimony to the difficulties faced obtaining Paxlovid in China through official channels.
Paxlovid - a combination of two anti viral drugs - is one of the few foreign oral treatments approved by Beijing and a clinical trial has found it to have reduced hospitalisations in high-risk patients by around 90%.
Having been approved in February last year, Paxlovid was scarcely used in China until December when the government started lifting its strict containment policy, and wave of COVID infections began to build.
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Ramping Up Supplies
Chinese authorities have acknowledged that supplies of Paxlovid are still insufficient to meet demand, even as Pfizer CEO Albert Bourla said last week that thousands of courses of the treatment were shipped to the country last year and in the past couple of weeks millions more were shipped.
"Pfizer is actively collaborating with Chinese authorities and all stakeholders to secure an adequate supply of Paxlovid in China. We remain committed to fulfilling the COVID-19 treatment needs of Chinese patients and partnering with the Chinese government," the company said in a statement.
Racing to defend against a rising death toll, China has also approved Merck & Co's COVID antiviral drug and is reviewing a treatment developed by Japan's Shionogi.
Paxlovid is covered by state insurance -- albeit temporarily until the end of March -- meaning patients in theory would only need to pay $29, a tenth of its usual price.
But China doesn't provide data on how many treatment courses are supplied and where it can be purchased, forcing most patients to rely on media reports, word-of-mouth or even importing through unauthorised channels in the grey market.
Those who do manage to find a supplier often end up paying exorbitant prices, as demand has shot up amid a giant wave of COVID-19 infections.
The official Guangzhou Daily reported that patients at the United Family Healthcare hospital in Guangdong were paying $891 for health checks before being allowed to get Paxlovid priced at 2,300 yuan at the hospital.
The hospital did not immediately reply to a Reuters' request for comment.
Health data firm Airfinity estimated in December that China would need 49 million courses of the COVID treatment over the next five months, with over 22 million needed in January alone.
The Pfizer drug can be also purchased for 2,170 yuan with prescription via online platforms, but it typically sells out within seconds.
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Paxlovid Gift
Several other people described to Reuters how they turned to the grey market to purchase Paxlovid. Some were looking to treat sick relatives, while others wanted it just in case.
Chen Jun, a resident of China's southern Hainan Province, said he bought Paxlovid from a supplier introduced by a business partner, who said the medicine was coming from Hong Kong.
Chen paid $2,972 on Jan. 2 for two boxes for his elderly parents, who suffer from cancer, and he said that some people had paid double that price.
"You'll think it cheap once your family members are in need, because anything is better than going to a hospital now," he said. "I know people who paid 20,000 yuan for one box of the medicine."
Another buyer who gave his name as Ray said he managed to get two boxes from the United States, where supplies are still ample and a doctor's prescription can be obtained after an online consultation.
"It's very straightforward, they don't ask questions," he said. Having made the online purchase, he then asked a friend there to help courier it to China.
An analyst at a Chinese securities house, who requested anonymity because of sensitivities over the subject, said his boss went to Hong Kong to stock up on Paxlovid to gift clients as it was more valued than a popular, expensive liquor.
"It is a better gift than Moutai."
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Saturday, January 14, 2023
Omicron subvariant XBB.1.5 possibly more likely to infect those who are vaccinated, officials say
January 14, 2023
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New York City health officials are warning residents that the infectious omicron subvariant XBB.1.5 may be more likely to infect people who have already been vaccinated or infected with COVID-19.
"Omicron subvariant XBB.1.5 now accounts for 73% of all sequenced COVID-19 cases in NYC," the NYC Department of Health and Mental Hygiene tweeted on Friday. " XBB.1.5 is the most transmissible form of COVID-19 that we know of to date and may be more likely to infect people who have been vaccinated or already had COVID-19."
The department added that getting vaccinated against the virus, including receiving an updated booster shot, remains the best way to protect against hospitalization and death, including from new variants.
According to data from the Centers for Disease Control and Prevention, XBB.1.5 accounts for 43% of cases in the U.S.
COVID XBB.1.5 VARIANT NOW ACCOUNTS FOR 43% OF ALL US CASES, CDC SAYS
In the first week of January, the subvariant accounted for about 30% of cases.
XBB.1.5, an offshoot of XBB, was first detected in October.
The World Health Organization warned earlier this week that it may lead to an increased number of cases based on genetic characteristics and early growth rate estimates.
COVID OMICRON SUBVARIANT XBB: WHY THE NUMBER OF CASES IS LIKELY FAR GREATER THAN REPORTED
Scientists have cautioned that the virus will surely keep evolving.
"Our concern is how transmissible it is," Maria Van Kerkhove, the WHO’s technical lead on COVID-19, said.
"The more this virus circulates, the more chances it will have to change," she noted.
Van Kerkhove said there is no data yet to prove that XBB.1.5 causes more severe disease, but that the agency is working on a new risk assessment of the variant that it expects to release soon.
Reuters and The Associated Press contributed to this report.
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Remember the fear about flu flare-ups over the holidays? Didn't happen, says CDC
January 14, 2023
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Ahead of the holidays, there was fear in certain medical circles that holiday gatherings among millions and millions of families across America would spark a dangerous surge in respiratory diseases.
Now, new U.S. government data suggests that was not the case.
On Friday, the Centers for Disease Control and Prevention (CDC) reported that visits to doctors’ offices for flu-like illnesses fell for the sixth straight week.
CDC IDENTIFIES POSSIBLE ‘SAFETY CONCERN’ FOR CERTAIN PEOPLE RECEIVING COVID VACCINES
"Seasonal influenza activity continues but is declining in most areas," the CDC wrote on its website.
The CDC also said that reports of RSV, a common cause of cold-like symptoms that can be serious for infants and the elderly, are also down.
In the fall, when flu and RSV cases surged and caused overloads at pediatric emergency rooms, some doctors feared winter might bring a so-called tripledemic of flu, RSV and COVID-19.
They were concerned that holiday gatherings might be the spark. But it apparently did not occur.
"Right now, everything continues to decline," said the CDC’s Lynnette Brammer.
She leads the government agency’s tracking of flu in the United States, according to the Associated Press.
MOST ‘LONG COVID’ SYMPTOMS AFTER MILD CASE OF VIRUS RESOLVE IN ABOUT A YEAR: NEW STUDY
RSV hospitalizations have been going down since November — and flu hospitalizations are down, too.
Dr. Marc Siegel, a Fox News medical contributor, told Fox News Digital on Saturday morning, agreed that "there was some immune pause" recently for a variety of reasons, including the recent "fierce lockdowns" in Australia.
That doesn't mean some people haven't gotten sick. Plenty of families reported that at least one or more of their members came down with something over the holidays after group get-togethers.
The situation is uneven across the country, the Associated Press reported — with some areas seeing more illnesses than others.
But some doctors say patient traffic is easing.
"It has really eased up, considerably," Dr. Ethan Wiener, a pediatric ER doctor at the Hassenfeld Children’s Hospital at NYU Langone in New York City, told the AP.
Dr. Jason Newland, a pediatric infectious disease physician at St. Louis Children’s Hospital in Missouri, also told the outlet that "it has slowed down, tremendously."
Newland said he wasn’t surprised that flu and RSV continued to trend down in recent weeks — but added, "The question is what was COVID going to do?"
COVID-19 hospitalizations rose through December, including during the week after Christmas, the CDC said.
COVID OMICRON SUBVARIANT XBB: WHY THE NUMBER OF CASES IS LIKELY FAR GREATER THAN REPORTED
One set of CDC data appears to show they started trending down after New Year’s, although an agency spokeswoman noted that another count indicates an uptick as of last week.
Because of reporting lags, it may be a few weeks until CDC can be sure COVID-19 hospitalizations have really started dropping, Newland told the AP.
He also said there was an increase in COVID-19 traffic at St. Louis Children’s in December.
But he noted the situation was nothing like it was a year ago, when the then-new omicron variant was causing the largest national surge of COVID-19 hospitalizations since the pandemic began.
"That was the worst," he said.
This past week, Dr. Siegel also told Fox News Digital that the relatively new COVID-19 omicron subvariant XBB.1.5 "is the most easily transmissible subvariant so far."
He said that "it not only binds well to cells, but it is also the most immunoevasive." Siegel is a professor of medicine at NYU Langone Medical Center in New York City.
The subvariant — nicknamed "Kraken" by some — is spreading across the globe, too.
Maria Van Kerkhove, Ph.D, technical lead of the World Health Organization, said XBB.1.5 is "the most transmissible subvariant that has been detected yet," WebMD reported.
Though this subvariant continues to spread at a faster pace than other versions of COVID-19 did, the CDC recently revised downward its estimate of how much XBB.1.5 is circulating in the U.S.
The fall RSV and flu surge was felt most acutely at health care centers for children.
Wiener said the pediatric emergency department traffic at Hassenfeld was 50% above normal levels in October, November and December — "the highest volumes ever" for that time of year, he said, according to the AP.
The RSV and flu surges likely faded because so many members of the vulnerable population were infected "and it just kind of burnt itself out," he said.
It makes sense that respiratory infections could rebound amid holiday travel and gatherings — and it’s not exactly clear why that didn’t happen, Brammer said.
With all that said, flu season isn’t over, the AP pointed out.
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Thirty-six states are still reporting high or very high levels of flu activity, it noted.
It’s always possible that a second wave of illnesses remains up ahead, experts said.
Dr. Siegel said, "I think we're over the worst" in terms of the flu in the United States — though he said that flu season does usually peak in January.
The CDC continues to recommend that everyone "six months and older" get the flu vaccine.
"An annual flu vaccine is the best way to protect against flu. Vaccination helps prevent infection and can also prevent serious outcomes in people who get vaccinated but still get sick with flu," the CDC says on its website.
The Associated Press contributed reporting.
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