US Treatment shortages, packed hospitals: Why at-risk adults should be on COVID alert

18:20  13 january  2022
18:20  13 january  2022 Source:   usatoday.com

From newborns to teens, this hospital has a deluge of young Covid-19 patients. Here's what parents want others to know

  From newborns to teens, this hospital has a deluge of young Covid-19 patients. Here's what parents want others to know A 4-month-old baby with Covid-19 is struggling to breath. A teenager with Covid-19 is in a medically induced coma, unaware she gave birth to her new daughter 10 weeks early.At Texas Children's Hospital, 4-month-old Graysen Perry has Covid-19 and is struggling to breathe.

As the coronavirus tears across America, it is a particularly bad time for high-risk people to catch COVID-19.

And that means a lot of Americans are vulnerable. Nearly 40% of U.S. adults are considered at high risk for a serious infection because they're over 65, are carrying extra pounds or have certain medical conditions.

"It's a tough time, a challenging time," said Dr. Ali Khan, a chief medical officer with Oak Street Health, a national network of primary care centers specializing in vulnerable patients.

Start the day smarter. Get all the news you need in your inbox each morning.

Covid vaccine booster shots are here for kids ages 12 and up — here's what parents need to know right now

  Covid vaccine booster shots are here for kids ages 12 and up — here's what parents need to know right now Covid vaccine booster shots have been authorized for kids ages 12 to 15 in the U.S. Here's why health experts say the decision is a move in the right direction.On Wednesday evening, the Centers for Disease Control and Prevention authorized booster doses of Pfizer's Covid vaccine for kids ages 12 to 15, following a similar authorization from the U.S. Food and Drug Administration on Monday. Both agencies also authorized a booster dose for immunocompromised children ages 5 to 11 this week.

Khan, who is based in Chicago, said he'd like to be keeping more of his patients out of emergency rooms, but he simply doesn't have the tools right now. In Illinois, one of 20 states his network serves, they have access to just 100 courses of one of the two antivirals, he said.

At the same time, hospitals are nearly overwhelmed with patients, including those with COVID-19 as well as other ailments.

OVERBURDENED HOSPITALS: As COVID-19 surges, there's no hospital bed for others in need of care

And while there are good treatments to prevent infected people from needing hospital care, including two recently approved, they are almost totally unavailable across the country.

Two of the three monoclonal antibodies shown to help prevent hospitalizations don't work against the omicron variant that now accounts for more than 95% of cases nationwide. Many hospitals have stopped offering those entirely.

China Covid-19: What Xi'an's chaotic lockdown reveals about uncompromising top-down bureaucracy

  China Covid-19: What Xi'an's chaotic lockdown reveals about uncompromising top-down bureaucracy As harrowing stories continue to emerge from within the locked-down city of Xi'an, a wave of disbelief has washed over the Chinese public: why are such tragedies still unfolding two years into the pandemic, in a major metropolis of 13 million people? © Visual China Group/Getty Images XI AN, CHINA - JANUARY 06: A medical worker wearing personal protective equipment (PPE) sprays disinfectant to a resident, who completed the quarantine period, at the entrance of a residential community under closed-off management on January 6, 2022 in Xi an, Shaanxi Province of China.

"Right now, we've got nothing else to treat ambulatory patients with COVID," said Dr. Jeanne Marrazzo, who directs the division of infectious diseases at the University of Alabama at Birmingham. "We have no monoclonals right now. We don't have the oral drugs yet and we don't have any other options – so it's really really important to try to protect yourself."

The one monoclonal antibody that's still effective against omicron, called sotrovimab, is also the one that's least available.

GlaxoSmithKline and Vir Biotechnology announced Tuesday that they'd sold an additional 600,000 doses of sotrovimab to the U.S. government to be delivered by March 2022, bringing the total doses bought by the government to 1 million.

But the country reported more than 1.3 million cases of COVID-19 on Monday alone, so even those additional doses will go fast.

"There's clearly a huge mismatch between the demand because of the sheer number of cases of omicron and the supply of this one simple monoclonal antibody," said Dr. Joshua Barocas, an infectious disease expert at the University of Colorado School of Medicine Anschutz.

Coronavirus US: As the Omicron variant drives a steep rise in Covid-19 cases, Los Angeles hits record number of new infections

  Coronavirus US: As the Omicron variant drives a steep rise in Covid-19 cases, Los Angeles hits record number of new infections With the Omicron variant of coronavirus surging across the US, Los Angeles County recorded its highest number of new Covid-19 cases in one week since the start of the pandemic, according to health officials. © Bloomberg/Bloomberg/Bloomberg via Getty Images A Covid-19 testing site at Los Angeles International Airport (LAX) in Los Angeles, California, U.S., on Monday, Dec. 6, 2021. The first confirmed U.S. case of the omicron variant of the coronavirus was detected in California, the Centers for Disease Control and Prevention said, as the recently detected mutation continues its spread around the world.

Marrazzo said her facility had just 16 doses of sotrovimab available last week. "We don't have anything," she said in a Tuesday media call with Barocas, set up by the Infectious Disease Society of America.

Antiviral pills that were authorized by the Food and Drug Administration last month and are expected to transform treatment for COVID-19 are just becoming available. Marrazzo and Barocas said their institutions have not yet received any doses.


At Massachusetts General Hospital, the situation is much the same, with monoclonal antibodies being reserved for those most at risk, said Dr. Richelle Charles, an infectious disease physician who joined a Tuesday media briefing by the Massachusetts Consortium on Pathogen Readiness.

In the fall, anyone who was even a little overweight or over 50 years old would be immediately given monoclonal antibodies to prevent their infection from getting worse, said Dr. Dorry Segev, a transplant surgeon and epidemiologist at Johns Hopkins University.

We’re Having the Wrong Conversation About School

  We’re Having the Wrong Conversation About School Critics of teachers and their unions are repeating attacks from the early pandemic, and not paying attention to the real culprits of the crisis.A chorus of critics wants schools open for in-person learning no matter the cost to educators. For example, Dr. Leana Wen, previously the health commissioner of Baltimore, took to Twitter and urged teachers unions to stop unspecified “delays.” She added, “We need all schools to be in-person, now.

"Now, you have to be incredibly high risk and it's only for treatment (not prevention), because we have so little supply," he said.

When one of his transplant patients comes down with omicron he has been "desperately" trying to find a dose of sotrovimab to give them. "It's critical for them," he said, because many transplant recipients don't get good protection from vaccines.

More doses to come

Hopefully, the shortage will be short-lived, Segev and others said.

"It's starting to get better but it's not there yet," said Dr. Daniel Griffin, an infectious disease specialist at Northwell Health on Long Island.

Griffin said there are about 3,000 doses of antivirals available a week for all of New York state – and they could probably use 300,000.

He predicts the situation will change by March, when more drugs will be available, cases will have fallen and physicians and pharmacists will understand which patients will most benefit from which treatment.

"I think it's going to get better," he said. "I can't imagine it getting worse."

More drugs are also in the pipeline.

The federal government is currently funding a trial of another monoclonal antibody designed to keep people out of the hospital, Dr. Tony Fauci, a presidential COVID advisor said in a Wednesday briefing.

Biden team regroups after court loss on COVID shots-or-test

  Biden team regroups after court loss on COVID shots-or-test WASHINGTON (AP) — Concerned but not giving up, President Joe Biden is anxiously pushing ahead to prod people to get COVID-19 shots after the Supreme Court put a halt to the administration's sweeping vaccinate-or-test plan for large employers. At a time when hospitals are being overrun and record numbers of people are getting infected with the omicron variant, the administration hopes states and companies will order their own vaccinate-or-test requirements. And if the presidential “bully pulpit” still counts for persuasion, Biden intends to use it.

The government has also been increasing its orders for drugs like sotrovimab and the antivirals.

Remdesivir, an antiviral that has been used for hospitalized patients, is also being made available to those earlier in the course of their disease. A three-day course has been shown to prevent hospitalizations. But it's not yet widely available, either, and has to be delivered by infusion, so either in the person's home or to someone who can come back to a facility three days in a row.

"We would love to be connecting our patients to outpatient remdesivir," Khan said. "That has not been readily available across most of our 20 states."

Even though the best tools for preventing disease are in short supply, Barocas said he feels like medical care is in a totally different place now than it was in March 2020.

"I felt helpless," he said of that time. "I felt that absolutely all I was doing was shuffling deck chairs and trying to keep a boat afloat at the same time."

Now, there are preventive measures and treatments and viral surveillance to help understand where infections are headed, he said.

"I can go to the hospital, and no matter how overwhelmed and how exhausted we all are, it's a vastly different landscape."

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: Treatment shortages, packed hospitals: Why at-risk adults should be on COVID alert

How Americans think Joe Biden has done on their most important priorities after one year .
President Joe Biden entered office promising to end the Covid-19 pandemic, boost a lagging economy, get Americans back to work, restore US credibility abroad and heal a divided nation. © Andrew Harnik/AP President Joe Biden speaks during a meeting with the President's Council of Advisors on Science and Technology at the Eisenhower Executive Office Building on the White House Campus, Thursday, Jan. 20, 2022. After one year, the reviews from the American people in public polling on those topics, in many cases, have not been kind.

usr: 2
This is interesting!