By Peter White. Ethnic Media Services.
Vaccines, tests and treatments for COVID-19 will no longer be free once the public health emergency ?PHE? on January 11, even as the US faces a new, more infectious XBB 1.5 sub-variant.
The new subvariant accounts for 75 percent of new infections on the East Coast and 40 percent of new cases in the country as a whole. In addition, the XBB 1.5 subvariant contains five new mutations not found in Omicron, on which current vaccine boosters are based.
"It can evade antibodies better and infect human lung tissue more easily than previous strains," said Dr. Ben Neuman, chief virologist at the Global Health Research Complex, Texas A&M, at an Ethnic Media Services press conference on August 6. January.
Also speaking at the briefing were Dr. Oliver Brooks, Chief Medical Officer, Watts Healthcare, who stressed the importance of continuing to vaccinate, boost and test as XBB 1.5 emerges; Jill Rosenthal, director of Public Health Policy at the Center for American Progress, who predicted a significant drop in people seeking treatment, testing and vaccines as PHE ends; and Sophia Tan, Research Data Scientist at UC San Francisco, who discussed a novel new study published in Nature that studied the impact of COVID-19 on the prison population.
"Anyone who tells you that COVID is over is misinformed," said Dr. Neuman, noting that in each of the last three years, COVID was the third leading cause of death in the US after heart disease and cancer.
Neuman said that the respiratory syncytial virus ?RSV? it peaked in November and flu season peaked in December. But COVID-19 is not slowing down. So far it hasn't overwhelmed hospitals and some experts say it might not turn as bad as the Omicron surge last year.
Neuman noted that the Omicron virus has seven or eight mutations compared to the original Alpha strain and the XBB has 12. “Based on the rapid increase, it would appear that it is fulfilling its genetic destiny. It appears that it is highly infectious and is overcoming at least some components of immunity."
Americans returned to work and resumed their lives as if the pandemic was over, Dr. Brooks noted. Many people have refused vaccinations and have stopped wearing masks.
Brooks treats COVID patients and talks to them about vaccine confidence, vaccine appropriateness, and vaccine complacency. He says that public health messages have not addressed these "three Cs."
He noted that only 15 percent of the US population has received the updated bivalent booster. Only a third of older adults, who are most at risk of dying from COVID, have taken the updated booster, while a very low percentage of children are fully vaccinated, as parents resist fears based on misinformation.
“It is our job to vaccinate the community. So when I hear that we don't get vaccinated anymore, to me that's just a challenge. I can't stop," Brooks said. "If you get vaccinated, you not only protect yourself, but also your community."
When the pandemic began three years ago, supplies of tests and masks could not keep up with the advance of COVID. The country could be caught flat-footed again.
Last March, the White House asked Congress for $22.5 billion in emergency spending that would replenish funds for COVID-related tests, treatments, vaccines and other infrastructure. But Congress rejected the request in the 2023 budget bill.
“This myopic failure to invest in the response leaves us without the tests, treatments and vaccines we need in the future, unable to continue to track the disease and unprepared for future waves,” said CAP's Jill Rosenthal.
Without the money to pay for it, the White House abandoned its National Preparedness Plan. Unlike the past two years, people without health insurance will have to pay $120 for vaccines that now cost the government $30.
The US government bought 20 million doses of Paxlovid at $530 each, but supplies are expected to run out by 2024. The price of Paxlovid on the private market is expected to skyrocket by then.
Once the PHE ends, people enrolled in private insurance and the Affordable Care Act will again have to pay copays for tests, vaccines, and treatments the same way they did before the PHE. An estimated 27.5 million people in the US are uninsured: they will have to pay full price for tests, vaccines, and treatments.
“In the new budget that just passed, the federal budget allows states to disenroll people from Medicaid at the end of the first quarter of 2023. When that happens, people can lose their Medicaid coverage that provides access to vaccines and treatments. Rosenthal said.
Medicaid covers low-income people and older adults, who are at higher risk of getting infected and sick with COVID. For example, Black and Latino adults who have had higher rates of workplace exposure to disease have had higher rates of COVID and then eventually long-lasting.
“So once again, there is a disproportionate impact on vulnerable communities. It is very worrying not to have a federal commitment to continue responding to the pandemic because we do not know where it is going, "he said.
Some states, including California and Rhode Island, are looking at ways to automatically enroll people who will lose Medicaid coverage into low-cost marketplace plans. Oregon has developed a health bridge program that will allow existing Medicaid members who earn a certain percentage of the federal poverty level to remain enrolled in Medicaid, Rosenthal said.
Researchers at the University of California San Francisco and UC Berkeley had good news. They looked at advanced infections, reinfections, and people who had both in California prisons and published their findings last week.
"The question we were really asking ourselves is what are the benefits of vaccination in terms of preventing future transmission of COVID," said Tan of UC San Francisco.
They couldn't find better test subjects than inmates living in enclosed spaces whose movements are highly regulated. The researchers tested, traced infections and secondary cases, tracking the virus as it spread through the prison population.
The results showed that either type of vaccine had a 22 percent reduction in infectivity; one or two previous infections reduced it by 23 percent; inmates with prior vaccination and prior infection had 40 percent reductions in their infectivity.
"So vaccines not only ideally protect you from infection, but if you do get infected, we see that there's this hidden benefit that they're preventing and reducing the risk of you passing the disease on to other people," Tan said.
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