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Axios Vitals: Paxlovid enigma

Plus, CDC advisors recommend new boosters | Friday, September 02, 2022
 
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Axios Vitals
By Tina Reed · Sep 02, 2022

We apologize for the delay this morning due to technical issues.

It's the start of a long weekend! We hope you have a safe and restful Labor Day. Today's newsletter is 1,035 words or a 4-minute read.

📺 1 fun thing: The tear-jerker NBC show "This is Us" helped reduce stigma around dementia and motivate family discussions about plans for aging, according to new research published in the Journal of Health Communication.

  • Maybe TV watching isn't so bad after all.
 
 
1 big thing: "Game-changer" Paxlovid turns into pandemic enigma
Illustration of a pill with a circular arrow on it.

Illustration: Shoshana Gordon/Axios

 

Paxlovid, once hailed as a "game-changer" for its ability to treat COVID-19 infections at home, is becoming one of the pandemic's biggest enigmas, Axios' Arielle Dreher writes.

The intrigue: There's growing concern about the link between Pfizer's antiviral pill and COVID rebound, in which patients test positive or have symptoms days after a course of the drug is completed.

  • President Biden, First Lady Jill Biden and NIAID director Anthony Fauci have each relapsed.

Zoom in: The FDA has asked Pfizer to investigate whether a second five-day course of the drug will prevent the virus from returning.

  • Pfizer executives in May suggested patients who can't clear the virus with the first course should take more, Bloomberg reported.
  • A large study of more than 109,000 people in the New England Journal of Medicine concluded the drug significantly reduced hospitalizations and deaths among patients aged 65 and older but that there was no evidence of benefit in younger adults.
  • Paxlovid could have the added benefit of warding off long COVID, or symptoms that linger beyond the first 30 days after testing positive, and studies to determine this are underway.

But availability of the drug could change before clear answers emerge.

  • The Biden administration has only bought enough pills to supply Paxlovid through the middle of next year, after which it will transition to the commercial market, HHS Assistant Secretary for Preparedness and Response Dawn O'Connell wrote in a blog post on Tuesday.

Between the lines: COVID rebound has also been observed in people who have not taken Paxlovid, and some experts believe it might be a natural course of the infection to see symptoms ebb, then return.

What they're saying: "The consensus by the vast majority of people caring for COVID patients is that the rebound is not really a side effect of Paxlovid, it is more that are we really treating people for long enough or not?" Sarju Ganatra, a cardiologist at Lahey Hospital and co-author of the Clinical Infectious Diseases study, told Axios.

Yes, but: "This is where having a well-designed, well-controlled study helps us understand disease better, and this is the challenge of anecdotal reports. Without a control, it's really hard to know what's actually happening," said Kara Chew, an infectious disease physician at the University of California Los Angeles.

Read the rest.

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2. Nursing home ownership is murky

Illustration: Sarah Grillo/Axios

 

A federal database intended to disclose nursing home ownership has spotty and incomplete information that can obscure whether a private equity firm controls a facility, Axios' Victoria Knight writes about a new report from Public Citizen.

Why it matters: A surge of private equity investment in the sector has coincided with worse health outcomes, studies show.

  • And the pandemic put a spotlight on the quality of care after more than 200,000 long-term care facility residents and staff succumbed to COVID-19.

Yes, but: The private-equity industry cites other research showing the quality of its firms' care is comparable to other types of nursing homes and didn't falter during COVID-19.

Flashback: During his first State of the Union speech in March, President Biden said he wanted to increase transparency around nursing homes, including the effects of private equity ownership.

  • "As Wall Street firms take over more nursing homes, quality in those homes has gone down and costs have gone up. That ends on my watch," Biden said.

Go deeper.

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3. Questions over Omicron booster timing

The CDC late yesterday recommended reformulated Pfizer and Moderna COVID-19 boosters that target the Omicron strain for people age 12 and up, Axios' Adriel Bettelheim and I report.

Why it matters: The recommendation came after an outside panel of vaccine advisors earlier Thursday endorsed the boosters in a 13-1 vote and marked the last regulatory hurdle before the updated shots can go into Americans' arms.

  • Shots are expected to become available to Americans within days.

Be smart: The recommendation from the Advisory Committee on Immunization Practices stated individuals should be at least two months out from getting their primary COVID series or a previous booster dose.

  • But several members raised concerns and said they'd prefer longer intervals between the most recent booster shot. A few panelists suggested at least three months and said they hope clinicians will consider recommending that.
  • While they ultimately voted to recommend an interval of at least two months, concluding most people are already far beyond two months from their last booster.
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A message from Humana

Medicare Advantage: Better care, better savingsnn
 
 

Eligible members don't have to choose between better health outcomes and savings.

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Here's why: Medicare Advantage members benefit from 43% lower avoidable hospitalizations and save nearly $2,000 every year compared to those who choose fee-for-service Medicare.

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4. Data du jour
Data: National Center for Health Statistics; Chart: Erin Davis/Axios Visuals

One of the more shocking elements from life expectancy data released earlier this week by the CDC was just how much some racial and ethnic groups saw their expected life span shorten.

Driving the news: American Indians and Alaska Natives saw their life expectancy fall six and a half years in the first two years of the pandemic to just over 65 years.

  • For perspective, that's what the life expectancy of the total U.S. population was in 1944, the CDC said.

Life expectancy between 2019 and 2021 fell 4.2 years for the Hispanic population, four years for the non-Hispanic Black population, 2.4 years for the non-Hispanic white population and 2.1 years for the non-Hispanic Asian population.

What they're saying: "There is nothing weird or unusual about our population," Ann Bullock, a former director of diabetes treatment and prevention at the federal Indian Health Services agency and a member of the Minnesota Chippewa Tribe, told the New York Times.

  • "This is simply what happens biologically to populations that are chronically and profoundly stressed and deprived of resources," she said, per the Times.
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5. Catch up quick

🏥 Atlanta is reeling from news of the planned Atlanta Medical Center closure by Wellstar Health System. (Axios)

👀 Gene-sequencing giant Illumina prevailed over the Federal Trade Commission in an administrative court trial over its $7.1 billion acquisition of Grail, a Menlo Park, California-based developer of liquid biopsies for early cancer detection. (WSJ)

👉 Industrial plants in Birmingham, Alabama, have polluted the air and land in historic Black communities for more than a century — and officials continue to fail in efforts to right those wrongs, an investigation found. (ProPublica

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6. Dog of the week

Ginger. Photo: Jaime Gialloreto

 

Meet Ginger, a 12-year-old cockapoo from New Jersey.

  • Her favorite food is bacon, and her favorite toy is a stuffed lamb (she has six of the same exact toy) and when she's not playing, she loves to snuggle up with whoever is closest, says her human Jaime Gialloreto.
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A message from Humana

Members can save on quality care with Medicare Advantage
 
 

Medicare Advantage can provide better health outcomes and lower costs.

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The proof: Members have a 43% lower rate of avoidable hospitalizations and savings of nearly $2,000 a year compared to those who choose fee-for-service Medicare.

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Learn more.

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