Coronavirus Files: White House promises test-to-treat while Ukraine invasion threatens pandemic progress

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Amber Dance | Courtesy Photo

THE CORONAVIRUS FILES

By Amber Dance

Ukraine is fighting a war amid a pandemic

There’s nothing like war to hasten the spread of a plague.

It’s impossible to maintain handwashing, social distancing and masking in the middle of a siege. The war in the Ukraine makes COVID-19 spikes in the region “inevitable,” writes Alice Park at Time; those surges in turn could provide fertile ground for new variants to emerge.

“War is an infectious disease’s best friend,” said epidemiologist Michael Osterholm of the University of Minnesota.

Just over 34% of Ukraine’s population is fully vaccinated. Refugees fleeing the country will be vulnerable in crowded buses, refugee trains and camps, notes Adeel Hassan at The New York Times, and they’ll bring the virus to neighboring nations such as Poland. Some of those who’ve stayed are taking refuge in packed subway stations, adds Andrew E. Kramer, also at The New York Times.

Invading Russian soldiers may also spread the disease; only about half of the Russian population is fully vaccinated.

Hospitals will be forced to prioritize war injuries over typical COVID prevention measures, making it easier for the virus to spread, writes Park.

According to the World Health Organization, Ukraine is facing a critical shortage of oxygen after at least three oxygen plants in the country have been forced to close since the war began, reports CNN Health’s Virginia Langmaid.

“If we do not get oxygen into the system and other critical drugs, people will die needlessly,” said Dr. Mike Ryan, executive director of the WHO Health Emergencies Program. “When you need it, you need it.”

Pandemic causes difficulties with utility bills, child care

Thousands of people have fallen behind on utility bills during the pandemic, writes Al Tompkins at Poynter

Sky-high home energy prices and inflation are compounding the problem for people who’ve struggled to make ends meet throughout the pandemic, writes Danielle Silva at NBC News.

The winter surge also hit low-income parents in the pocketbook, report Abha Bhattarai and Alyssa Flowers at The Washington Post.

When day care centers closed, parents were stuck at home with their kids, and those disruptions were most common in households that earn less than $25,000 per year, the pair report.

Staying home often meant taking unpaid leave; some parents were forced to quit their jobs. Others put off a job hunt or stayed with more flexible gig work.

Day care centers often charge the same fees even if they have to close, or if kids stay home due to illness or COVID-19 exposure, further compounding the problem for working parents.

“Pandemic-era child care disruptions have fallen heaviest on those without family or resources to lean on,” the Post reports. “A lack of child care is most likely to hurt mothers.”

Biden promises one-stop shopping for antivirals

A central component in the White House’s latest salvo against COVID-19 is a pharmacy-based “test to treat” program, in which high-risk people who test positive would then be handed a free pack of antiviral pills.

The program is expected to roll out to chain pharmacies this month.

Nonetheless, plenty of hurdles stand in the way.

Antivirals have so far been hard to come by, but President Joe Biden promised in his State of the Union address that more of Pfizer’s Paxlovid antiviral pills would be available soon.

Biden’s latest COVID plan will also require money from Congress, likely $30 billion or more. The White House requested $22.5 billion in new COVID funds last week, but several Republicans have questioned the need, report Ed O’Keefe and Melissa Quinn at CBS News.

Epidemiologist Michael Mina, a vocal proponent of rapid testing who is now the chief science officer of the home testing company eMed, tweeted the plan is “just smart,” because Paxlovid works best when treatment starts as early as possible, and fewer infected people will have to visit medical clinics to obtain a prescription.

But he acknowledged there are “some kinks to work on.”

There will need to be education campaigns so people know the program is available. Otherwise, more informed and affluent populations stand to disproportionately benefit, exacerbating COVID’s existing racial disparities.

Some medicines people might be taking can interact with Paxlovid, so recipients will need counseling from a pharmacist. The drug combination making up the pills doesn’t mix well with a variety of medications, including birth control pills, statins, and antipsychotics.

That could prove to be a big problem, writes physician-scientist Henry I. Miller of the Pacific Research Institute in the Wall Street Journal’s opinion pages. “Who’s going to decide whether the possibility of dangerous interactions outweighs the potential benefit of Paxlovid?” he writes. “Even the pharmacist is unlikely to be capable of making that judgment.”

Mina, in contrast, thinks “many pharmacists are as well as or better positioned to prescribe these medicines as MDs.”

Data disagree on vaccine efficacy in children

Vaccine-watchers endured another bout of whiplash last week with dueling studies on the efficacy of Pfizer’s vaccine in children ages 5 through 11.

Early last week, the New York State Department of Health released a preprint that found during the omicron surge, efficacy against infection in that young age group dropped as low as 12%, while protection against hospitalization dipped just below 50%.

Teens ages 12 through 17, who received a higher dose of the Pfizer vaccine, maintained greater protection against omicron infection and severe disease in the New York dataset.

But the following day, the CDC released data from 10 states suggesting there was no big difference in vaccine protection between the two children’s age groups. Two doses didn’t protect much against omicron infection in either group, but did forestall severe disease.

Pfizer told STAT’s Helen Branswell it remains confident that a third shot of the same lower dose will improve protection among children.

The company is testing an even lower dose in children younger than 5. Caroline Chen, after investigating the delays with that age group at ProPublica, reports that more results on both Pfizer’s and Moderna’s vaccines for young children could come within weeks. If the data look good, emergency authorization could happen by April or, at the latest, May.

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