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How Can the US Confront Coronavirus With 28 Million People Uninsured? – Truthout

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As the coronavirus continues to spread around the world, we don’t yet know either the full scale of the unfolding global health disaster or the cumulative impact economically. But over the past week, as virus hotspots have emerged in South Korea, in Iran, in Italy and elsewhere, and as more and more countries find cases of the disease, we’re beginning to get a sense of the magnitude of what is unfolding.

China has spent two months trying to contain an outbreak. As an authoritarian country it hasn’t shied away from locking down megacities, even cocooning entire residential communities — allowing only one household member out every couple of days to go looking for food. Tens of millions of people are now living a dystopian existence essentially barricaded within their own apartment walls. Yet even with these emergency responses, large numbers have fallen sick and thousands have died. Meanwhile, consumer spending in the world’s second largest economy has all but ground to a halt. Month-on-month car purchases in the country are down by a staggering 92 percent.

South Korea has imposed extraordinary controls in Daegu, a city of roughly 3 million people. Italy has quarantined tens of thousands of people, deploying police and military to stop them from leaving the region that is at the center of that country’s outbreak. In Turkey, on Tuesday, a plane from Iran with a person on board suspected of carrying the virus was met at the airport by health officials and all the passengers were promptly quarantined for two weeks.

Until this week’s stock market swoon, the inevitable economic toll had gotten lost in the panicked coverage of the virus’s spread. When countries shut down rail and air and road routes in and out of regions, when schools are closed, when public gatherings are discouraged or banned, when curfews are imposed, and when nonessential businesses are shuttered, the economic cost is immense.

The intricately interconnected parts of the global trade and supply chain systems are unraveling at warp speed as the disease spreads, and, assuming these lockdowns last, the consequences will likely be economically devastating. If the stock market continues to sink, if factories remain shuttered, and if consumers pull back from spending, over the coming months there could be massive, and unexpected, spikes in unemployment and poverty, even in places not directly experiencing the mass transmission of the virus within their populations.

Trump’s Pollyannaish statements on coronavirus in the U.S. notwithstanding, this country will not, of course, remain inured to the epidemic’s consequences. That belated realization among investors was what triggered this week’s panicked stock market sell-off. Between Friday of last week and the close of business on Tuesday, the Dow Jones shed roughly eight percent of its value. On both Monday and Tuesday, the market dived on a scale reminiscent of the chaotic days during the summer and early autumn of 2008, as the housing crisis morphed into a broader financial crisis.

If the bad news about the virus’s spread continues, that market retraction will also continue over the trading days and weeks ahead, making what happened in the first days of this week only a prelude to a larger and longer crisis. Public health experts at the CDC and in the universities increasingly think it’s only a matter of time before the United States, too, experiences serious outbreaks. Indeed, the announcement late Wednesday afternoon that a Californian who had neither traveled to a hot zone nor been in close contact with someone who had has the virus signifies it is likely already starting to circulate within the U.S. If it is, the impacts will be huge, not just on the country’s overstretched health systems, but on the political and economic infrastructure. It’s not a stretch to imagine global stock market collapses over the coming weeks and a stark contraction of consumer spending and of employment in their wake.

Even if this dislocation doesn’t grow to the cataclysmic scale of the 1918-19 Spanish Flu, the coming months will surely force the U.S. to confront some glaring policy shortcomings — and to do so at speed.

Roughly 28 million Americans lack health insurance. That number has gone up every year of the Trump presidency and will continue to go up so long as current policies are in place that drive immigrants ever further outside the safety net, that encourage states to limit Medicaid access, and that make it harder for individuals to access health care exchanges set up under the Affordable Care Act. It’s pretty much impossible to rein in a pandemic, especially of a disease that is communicable before a sufferer becomes sick enough to visit the ER, with so many people entirely excluded from primary care coverage. Millions more, who do have insurance, are so under-insured and have such high deductibles that, in practice, they too do not visit primary care doctors nearly as often as they should.

So far, the Democratic candidates running for the presidency haven’t linked the virus outbreak to their calls for expanded and more affordable health care coverage. It’s past time for them to do so. With this outbreak, not only does the moral imperative for universal health care grow, but so does the pragmatic rationale: Germs don’t obey class and ethnic and national boundaries. If poor, uninsured people don’t get treated for viral pneumonia in proper facilities, they will spread that disease throughout the community. It will be impossible to bring regional outbreaks under control if huge swathes of the population cannot access doctors either because they are afraid they will be bankrupted by medical bills, or because they are terrified they will render themselves vulnerable to deportation by putting themselves onto medical system and government radars. And the more people remain untreated, the more the virus will spread, creating a cascading effect of health and economic consequences. Economically, it would likely prove to be far less expensive to expand health coverage to everyone now, rather than try to clean up the mess of an epidemic made worse by massive numbers of people being uninsured.

This isn’t an issue that can wait for a long policy debate post-election. In an emergency, policies have to meet new needs at speed. And right now, there’s an unprecedented need to expand the health care umbrella to everyone who lives in the United States.

But that alone is only one part of a much larger puzzle. Forty percent of Americans are only one missed paycheck away from poverty — they have no, or only minimal, savings to fall back on, and no cushion for paying monthly bills such as rent or mortgage, utilities, and car payments in the event of an unexpected economic jolt. If a region in the U.S. were to be locked down in the way that cities have been in China, South Korea, Italy and Iran, a vast number of that region’s residents would be quickly bankrupted, and a large proportion of small businesses that rely on a constant flow of customers would go under. Of course, this isn’t just about individuals; it’s also about the cascading economic impact on entire communities. Prolonged quarantines and lock-downs could devastate already financially on-edge neighborhoods as surely as de-industrialization devastated the Rust Belt and the 2008 housing crisis devastated everywhere from California Central Valley cities such as Stockton to urban regions of Nevada.

Unlike most of our peer nations, in the U.S. there is no legal right to paid sick leave, although the Family and Medical Leave Act does allow for up to 12 weeks of unpaid leave. In practice, the country’s sick leave rules are so ludicrously weak that they provide a strong disincentive for people, even in food processing and restaurants and other industries where germs spread particularly fast, to stay off work when sick. That’s as backward an approach as possible during a pandemic when health officials are urging the precautionary principle be adopted, and asking people to self-quarantine if they think they may have been in contact with a sick person. Again, while candidates such as Bernie Sanders have pushed for paid sick leave, they haven’t, as yet, linked it to the issue of quarantine.

During World War II, Winston Churchill’s government set up an insurance system, under the War Damages Act, in the U.K. to ensure that victims of the blitz who lost homes or businesses to the aerial bombardment wouldn’t be left to sink on their own. The insurance system was paid for out of tax receipts, and was designed so that that the state would cover these losses and large numbers of individuals, and communities heavily hit by the bombing, wouldn’t be left destitute. Surely, in an age of pandemic, of mass quarantines, and of sudden lockdowns, such an insurance system is similarly imperative in the U.S.

Yet, nothing in the Trump administration’s approach suggests it is thinking big-picture. Instead, it has asked Congress to appropriate a relatively paltry $2.5 billion to fight the virus’s spread — and half of that money will come from raiding other existing public health funds. That’s barely one-third of the amount that it is demanding from the Pentagon over the coming months to work on Trump’s border wall. While there seems to be no shortage of funds for the military and for crackdowns on asylum seekers and destitute migrants, the pool of resources isn’t there for a massive effort to buffer the impacts of coronavirus. Nothing suggests the administration would, for example, roll back tax cuts on the wealthy and on corporations to fund a mutual insurance program for its economic victims.

We are on the edge of the unknown, facing the possibility of a pandemic — and accompanying economic dislocation — on a scale not seen for generations. In the face of this, big and bold policy responses will likely be required, and required fast. Unfortunately, the Trump administration doesn’t inspire any confidence that it’s up to this enormous task.

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Merck’s COVID-19 pill significantly less effective in new analysis

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Merck & Co said on Friday updated data from its study of its experimental COVID-19 pill showed the drug was significantly less effective in cutting hospitalizations and deaths than previously reported.

The drugmaker said its pill showed a 30% reduction in hospitalizations and deaths, based on data from 1,433 patients. In October, its data nL1N2QX0QJ showed a roughly 50% efficacy, based on data from 775 patients. The drug, molnupiravir, was developed with partner Ridgeback Biotherapeutics.

The lower efficacy of Merck’s drug could have big implications in terms of whether countries continue to buy the pill. Interim data from 1,200 participants in Pfizer Inc’s trial for its experimental pill, Paxlovid, showed an 89% reduction in hopsitalizations and deaths.

Merck’s shares fell 3.5% to $79.39 in morning trading.

Merck released the data before the U.S Food and Drug Administration published a set of documents on Friday intended to brief a panel of outside experts who will meet on Tuesday to discuss whether to recommend authorizing the pill.

The agency’s staff did not make their own recommendation as to whether the pill should be authorized.

FDA staff asked the panel to discuss whether the benefits of the drug outweigh the risks and whether the population for whom the drug should be authorized should be limited.

They also asked the committee to weigh in on concerns over whether the drug could encourage the virus to mutate, and how those concerns could be mitigated.

Pills like molnupiravir and Paxlovid could be promising new weapons in the fight against the pandemic, as they can be taken as early at-home treatments to help prevent COVID-19 hospitalizations and deaths. They could also become important tools in countries and areas with limited access to vaccines or low inoculation rates.

EASIER TREATMENT

The Merck and Pfizer pills are cheaper to produce and easier to administer than existing treatment options such as antibody therapies from Regeneron and Eli Lilly, which are mostly administered as intravenous infusions.

The two experimental drugs have different mechanisms of action. Merck’s is designed to introduce errors into the genetic code of the virus. Pfizer’s drug, part of a class known as protease inhibitors, is designed to block an enzyme the coronavirus needs in order to multiply.

Merck filed for a U.S. authorization of molnupiravir on Oct. 11, following the interim data, and submitted the updated data to the FDA this week.

The molnupiravir arm of the study had a hospitalization and death rate of 6.8%, according to the updated data. The placebo group had a hospitalization and death rate of 9.7%.

One patient in the molnupiravir arm died, versus nine in the placebo group.

The United Kingdom conditionally approved molnupiravir, branded as Lagevrio, earlier this month.

Merck expects to produce 10 million courses of the treatment by the end of this year, with at least 20 million set to be manufactured in 2022. It has a contract with the U.S. government to supply as many as 5 million courses at a price of $700 per course. Several other countries have already secured millions of courses of the pill.

Merck has said data shows molnupiravir is not capable of inducing genetic changes in human cells, but men enrolled in its trials had to abstain from heterosexual intercourse or agree to use contraception. Women of child-bearing age also had to use birth control.

Still, the FDA said in its briefing document that there are safety concerns about potential birth defects from the drug and asked the panel to discuss whether the drug should be available to pregnant women.

(Reporting by Manas Mishra in Bengaluru and Michael Erman in New JerseyEditing by Shounak Dasgupta, Frances Kerry and Emelia Sithole-Matarise)

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Brazil health regulator calls for Africa travel restrictions, Bolsonaro noncommittal

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Brazilian health regulator Anvisa recommended on Friday that travel be restricted from some African countries due to the detection of a new COVID-19 variant, though it was unclear if President Jair Bolsonaro would adopt any measures.

Anvisa said its recommendation, which would need government approval to be implemented, was to immediately suspend flights from South Africa, Botswana, Lesotho, Eswatini, Namibia and Zimbabwe.

The EU and Britain are already tightening border controls as researchers look into whether the new mutation is vaccine-resistant.

Brazil’s Health Ministry said in a separate note that the new B.1.1.529 variant named Omicron poses a potential future threat, but that its epidemiological impact was unclear.

After the Anvisa statement, Bolsonaro told journalists he was considering taking measures related to the variant but continued to emphasize that he was against severe coronavirus-related restrictions.

“Brazil can’t handle another lockdown. There’s no use getting terrified,” he said after a military event in Rio de Janeiro. “I’m going to take rational measures.”

Bolsonaro has been widely criticized by public health experts for his management of the pandemic, railing against lockdowns, often refusing to wear a mask in public and choosing not to get vaccinated. Brazil has the world’s second-highest death toll from the virus, behind only the United States.

The World Health Organization (WHO) has cautioned countries against hastily imposing travel restrictions due to the variant, saying they should take a “risk-based and scientific approach.”

In its technical note, Anvisa said that foreigners who have been to at least one of the six African countries cited in the prior 14 days should not be allowed to land in Brazil, while Brazilians arriving from those nations should be required to quarantine.

The health agency said, “The new variant appears to have a higher transmissibility.”

Anvisa President Antonio Barra Torres told news channel GloboNews that travel restrictions are a necessary preventive measure and he expected the government to make a decision as soon as possible.

The news of the variant hammered travel stocks in Brazil.

(Reporting by Gabriel Araujo in Sao Paulo and Lisandra Paraguassu in BrasiliaAdditional reporting by Rodrigo Viga Gaier in Rio de Janeiro and Eduardo Simoes in Sao PauloWriting by Stephen Eisenhammer and Gram SlatteryEditing by Brad Haynes and Alistair Bell)

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Novavax developing vaccine that targets new COVID-19 variant

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Novavax Inc said on Friday it had started working on a version of its COVID-19 vaccine to target the variant detected in South Africa and would have the shot ready for testing and manufacturing in the next few weeks.

The company’s COVID-19 shot contains an actual version of the virus’ spike protein that cannot cause disease but can trigger the immune system. The vaccine developer said it had started developing a spike protein specifically based on the known genetic sequence of the variant, B.1.1.529.

“The initial work will take a few weeks,” a company spokesperson said. Shares of the company closed up nearly 9% on Friday.

Novavax’s vaccine received its first emergency use approval earlier this month in Indonesia followed by the Philippines.

The company has said it is on track to file for U.S. approval by the end of the year. It has also filed for approvals with the European Medicines Agency as well as in Canada.

Other vaccine developers, including Germany’s BioNTech SE and Johnson & Johnson, have said they are testing the effectiveness of their shots against the new variant, which is named Omicron by the World Health Organisation.

Inovio Pharmaceuticals Inc said it had begun testing its vaccine candidate, INO-4800, to evaluate its effectiveness against the new variant. The company expects the testing to take about two weeks.

Inovio also said it was simultaneously designing a new vaccine candidate that specifically targeted Omicron.

“Best case scenario, INO-4800 … will be completely resilient against omicron, but if that’s not the case then we will have a newly designed vaccine ready to go if need be,” said Kate Broderick, senior vice president of Inovio’s R&D division.

Earlier this month, Inovio resumed a late-stage trial of its vaccine in the United States after 14 months on clinical hold.

(Reporting by Manojna Maddipatla and Mrinalika Roy in Bengaluru; Editing by Anil D’Silva)

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