COVID-19 hospitalizations soaring in England.

[whmk]

The UK is assuming that COVID-19 is endemic and that Omicron is mild. But the confluence of BA.2 subvariant rising and waning booster effectiveness is causing hospitalizations for those over 85 yo to soar to new record highs. Even those 65-84 yo are being hospitalized at a very high rate. A second booster or Evusheld is needed, although the latter's effectiveness against BA.2 is yet to be proven.

[AussieNeil Administrator]

Thanks for raising the importance of remaining vigilant.

This recent The Conversation article is relevant to our community No, catching Omicron is not ‘inevitable’ – here’s why we should all still avoid the virus

theconversation.com/no-catc...

The BA.2 variant is about 30% more contagious than Omicron BA.1, which it is quickly displacing, causing further surges around the world. The huge surge in deaths in Hong Kong (see plots below), seems in part to be due to the relatively lower rate of vaccination of their older citizens. Identifying and proactively responding the reasons for such surges as they are observed will save many lives, as sadly, this pandemic is not over yet.

Also relevant is this US centric MedpageToday article on the impact of waning immunity, which notes "CDC has recommended fourth shots for those who are immunocompromised."

medpagetoday.com/special-re...

"However, for people who have never been infected or never been vaccinated, or for people who are immunocompromised, there is still concern about the potential for severe disease, he noted. And though the average person can anticipate not being hospitalized, they also need to realize that, with waning immunity, they could very likely get infected and have light symptoms or mild disease, he added."

Neil

Normalised death rates per 100,000 people by country, showing Hong Kong surge.

[teakbank12]

We have not had any access to one Evushield dose let alone two!I know in the US a second dose is recommended as most first doses were six months ago and usefulness is waning.

Dave

[HopeME in reply to teakbank12]

In certain major hospitals in the US a patient can only get Evusheld if his/her antibody test is less than 300 -- I believe that is the cutoff -- so it isn't available to everyone. I saw my doctor yesterday and he was somewhat optimistic about Covid with more therapeutics available. He said January was a tough month as more of his patients came down with Covid that month then all of the previous months combined but things have improved since then. Let's hope the spring trends reverse as they did in 2021.

Dr. Scott Gottlieb, Pfizer Board Member and former FDA Commissioner, said today that cases in the US will likely uptick from here following the UK but then fall off. The bottom line is he doesn't predict another surge because of the vaccination levels in the US in combination with natural immunity from so many prior infections in the population. I have to imagine that is the same situation in the UK. He may be wrong as he has made miscalls in the past concerning Covid but in general his predictions have been accurate.

Best,

Mark

[bkoffman CLL CURE Hero in reply to HopeME]

Antibody threshold are not part of any labeling and the decisions made at individual sites due the the haphazard distribution and false shortages. 100s of 1,000 of doses are going unused in some sites while folks who might benefit are denied elsewhere.

[HopeME in reply to bkoffman]

Evisheld is readily available? I thought therapeutics were in abundant supply but not prophylactics. At least that is what I thought I heard yesterday but I could be wrong.

Best,

Mark

[HopeME in reply to bkoffman]

This article was written yesterday. There is mention of some doses going unused but from the sounds of it this drug is anything but abundant.

It Was Already Hard to Find Evusheld, a Covid Prevention Therapy. Now It’s Even Harder.By Hannah Recht

MARCH 17, 2022

As immunocompromised people across the country work to get Evusheld, a potentially lifesaving covid therapy, several hundred providers of the injections were removed from a federal dataset on Wednesday night, making the therapy even harder to locate.

White House officials had announced March 15 that a planned purchase of more doses would have to be scaled back without new federal funding.

And federal and state health departments aren’t making it easy to find, leaving patients whose hospitals say they don’t have enough of the drug to write desperate tweets and Facebook posts seeking the shots while unused vials sit in the refrigerators of other providers. Few states list on their websites where residents can find Evusheld — most provide no information or link to an incomplete federal map.

The therapy is a pair of monoclonal antibody injections designed to prevent covid infection. It received emergency use authorization in December for people 12 and older who are moderately to severely immunocompromised or unable to be vaccinated for medical reasons, more than 7 million people. For people who haven’t responded to a covid vaccine, it could offer lifesaving protection.

According to White House officials, the U.S. will likely run out of Evusheld by the end of the year.

The week before the White House’s announcement, the Department of Health and Human Services repeatedly told KHN that the problem was supply, not money. HHS spokesperson Elleen Kane stated multiple times that the federal government had bought every dose of Evusheld that AstraZeneca could supply in 2022. But an AstraZeneca spokesperson who declined to be named told KHN that more was available to buy. HHS did not respond to questions about the planned purchase.

HHS expects to receive enough Evusheld for 850,000 people by year’s end, Kane said last week. Even if all those doses come through, the supply would be nowhere near what is needed to treat the millions of people it could benefit.

So far, enough doses to treat 229,000 people have been sent to providers and about one-quarter of that has been used, according to Kane.

Evusheld Supply Shortfall

More than 7 million Americans are eligible for Evusheld.

There’s enough supply so far to treat 420,000 people.

430,000 more people could be treated by the additional supply expected by the end of the year.

After two years of immunocompromised people being left behind by the federal government, “the very least that the Biden administration could do is procure more than enough Evusheld so that everyone who” is eligible can receive the therapy, said Matthew Cortland, a senior fellow working on health care and disability issues at Data for Progress, a left-leaning think tank.

KHN’s analysis of Evusheld provider data published by HHS found that, until March 16, a data file published by HHS included several hundred providers that were omitted from the more user-friendly Covid-19 Therapeutics Locator map.

On Wednesday evening, HHS updated the downloadable data file for the first time in eight days, removing hundreds of providers that hadn’t reported how many Evusheld doses they had used in the past week. Several data columns were also removed, including the total number of doses that had been delivered to each site and the most recent delivery date. This information was not publicly available elsewhere; now people seeking Evusheld won’t find those providers on any federal website and data analysts cannot track the pace at which the therapy is being used.

KHN had flagged several discrepancies between the map and the data file to HHS as part of an investigation into the Evusheld rollout across the country. The data file is now nearly identical to what is used on the map, albeit with a few days’ lag.

In Mississippi, for example, 35 Evusheld providers were shown on the map on March 11. Only half of those were also included in the data file. And the data file included yet more providers that weren’t shown on the map.

[HopeME in reply to bkoffman]

Yes. I agree that there is no labeling that says xyz antibody threshold is necessary to receive this prophylactic. However, when a hospital doesn’t have enough of a drug like this one they restrict it to those who are most in need and that is where an antibody testing cutoff can come into play.

[bkoffman CLL CURE Hero in reply to HopeME]

It's a mess.

[HopeME in reply to bkoffman]

Yes. I can understand your frustration. I didn’t understand the issues causing the shortages in some areas were tied to funding and distribution. I assumed there was a manufacturing bottleneck.

[Davidcara in reply to HopeME]

Every time I hear Dr. G, it is always optimistic news. It’s behind us, this is the last surge, things will get better. I mean really…

[HopeME in reply to Davidcara]

I’ve found his opinions to be balanced, accurate and thoughtful. He is a board member at Pfizer so clearly he has a financial incentive to slant his opinions to the downside but he hasn’t done that in my opinion. He is neutral.

Best

Mark

[Davidcara in reply to HopeME]

I need to disagree, but that’s ok, right? Ok, just listened to some recent comments from him. He is concerned about China, most epidemiologist are concerned about Europe. He said, USA could get an uptick but, he does not expect a surge going into spring, summer, or winter. So we will see. Hope he is right about USA.

[HopeME in reply to Davidcara]

Yes. That is perfectly fine. We all have differences of opinion. The problem is no one wants to move to the middle and compromise. In this case I find Scott Gottleib to represent the middle ground of the Covid debate, at least from my view of the world😁.

Best,

Mark

[Psmithuk]

It is getting beyond a joke now. I know we still have to shield in my brain, but my heart is desperate for normal interaction. In my seventies I accept that my time left is getting shorter, but the feeling of 'is this all there is?' overwhelms at times.Chrisx

PS Just read KrisBren 01 s post below - so we are able to hope again - perhaps,

[Phil4-13 in reply to Psmithuk]

Psmithuk, how normal you are to feel that way. I'm 73 and have allowed an opened door to my mind to the stress generating in this world. As I try to shut it, with prayer, (there is no worldly power to shut it), the storm winds of stress challenge my strength. I will not give in and wallow in these worries. It's hard, but I know where my strength comes from. Philippians 4:13 We each have more to do to encourage others and where possible, physically help them. 🙂Sandra

[LeoPa]

I've read a quote somewhere. THE PANDEMIC WILL END WHEN NOBODY CARES ABOUT HOW MANY PEOPLE DIE THANKS TO IT ANYMORE. Or something to that tune. People are sick of it and fed up with counter measures. Nobody wants to follow any rules anymore. Everybody is on his own now. Those who die, die. The rest survives. I recognize immune compromized people easily these days. They wear their masks properly. I'm one of them.

[Doggoneit101 in reply to LeoPa]

I totally agree with you. I'm one of the maskers as well. I could care less what people think or say about my mask. I have a couple of friends that I haven't seen in over 2 years because they are not vaccinated. I have talked to them over the phone and they want to see me. I'm in the US and very few people are still wearing mask. My mom in her 80's doesn't wear one anymore even though she has health issues. I have tried my hardest to explain to her that she can still get it but she doesn't understand. She thinks since she has had the vaccine she can't catch it. It's so hard to take care of elderly parents! I'm taking her to her heart doctor next week and I'm going to have them talk to her about it. It's stressful for me when I'm trying my absolute hardest not to get infected and my mom won't wear a mask. I have to care for my mom daily so I don't want her to catch anything and give it to me by accident. I'm to the point of it is what it is. I wear my N95 mask everywhere outside my home. We do what we have to for our survival.

[LeoPa in reply to Doggoneit101]

Can she wear a mask out of consideration for you?

[Doggoneit101 in reply to LeoPa]

You would think she would but she doesn't. She has a artery in her heart that is 90% clogged we just found out Wednesday. It causes her shortness of breath so she doesn't wear one because she says she can't breathe. We meet with her heart surgeon this coming Tuesday and they will tell us a game plan on fixing her heart issues. I say issues because she also has a leaking aortic heart valve. My plate is overflowing here lately it seems. One day at a time lately for me.

[LeoPa in reply to Doggoneit101]

I'm sorry about that. You are a brave soul and will push through this too. There's no other way but ahead.

[MV29]

I received my first Evusheld a month ago. Then informed last week to say new research was indicating it had not been enough dose. Requested to come back next week for another round to protect for the full 6 months as first one was supposed to do. It's a process they explained. Information evolving daily.

[bkoffman CLL CURE Hero]

Evusheld is thought to be quite effective against BA.2, probably better than the original Omicron.

[NoClew in reply to bkoffman]

Thank you Brian, I was a bit thrown when I heard they had approved a newer prophylactic MAB designed for OmBA.2 just as I got my full dose of Evusheld. And many thanks to all of you who shared the database info - I struck gold with it. Highly recommend METRO INFECTIOUS DISEASE CONSULTANTS. Located in the suburbs of Chicago, 844.227.6432. Well organized, discreet entrance for the immunocompromised, given a private (negative air flow) room for entire process and 1 hour observation, and they called me to come back for the balance of the Evusheld dose.