By: Mark Glennon*

Reported COVID cases are surging in Illinois and many hospitals are severely overburdened, so Gov. JB Pritzker and Illinois Department of Public Health Director Ngoze Ezike held a press conference Monday.

It was overwhelmingly devoted to vaccines and masks, to the exclusion of all else. Get vaccinated, boosted and wear a mask, they said over and over again. Vaccines and boosters, they said, are the key to lowering the burden on hospitals, avoiding the need for hospitals to shift to a crisis standard of care and reducing the risk of hospitalization and death.

But the subject of treatments was almost entirely ignored. None of the reporters questions addressed treatments.

That omission is baffling. Timely use of the right treatments for those infected unquestionably would reduce the number of deaths and hospitalizations. Prompt treatment, however, is essential, and that message is not being delivered.

The safety and effectiveness of various treatments are now well-established and the number of available options is growing. The effectiveness of monoclonal antibody treatments for the Delta variant, which is still the primary source of serious hospitalizations and deaths, has been known for over a year. Even Dr. Anthony Fauci acknowledged that, belatedly, in August, saying that the treatments can reduce the risk of COVID-19 hospitalization or death by 70% to 85%. Aside from antibody treatments, a new pill from Pfizer recently authorized reportedly decreases the risk of hospitalization and death from the virus by nearly 90%. A pill from Merck received authorization, though its not as effective as Pfizers. Some other treatments appropriate in certain circumstances were authorized earlier.

But the only mention of treatment in the Monday news conference was this, from Pritzker: We are also increasing testing and continuing to distribute monoclonal antibodies, anti-viral pills and any treatments or personal protective equipment communities need. That told us nothing.

The first question that should have been asked is why the state isnt warning those at risk to ask their doctors quickly about treatments after they know they have the virus?

Pfizers new pill has only proven effective if given within five days of symptoms appearing. Experts worry it may be unrealistic for patients to self-diagnose, get tested, see a physician and pick up a prescription within that narrow window, as reported often. Antibody treatments are also supposed to be given as soon as possible. Why is government not broadcasting that?

Other questions the state should be pushing out answers to should be obvious, especially in light of complexities raised by the new Omicron variant and new treatments. And standard tests do not tell you which variant you are infected with.

For example, arent the antibody treatments still of value, even though only one of those on the market (GlaxoSmithKlines sotrovimab) is effective against Omicron? Some treatments are in short supply and are being rationed. Which ones are available and for whom? Which treatments are available only at hospitals and how does one get them? What are the drug interaction risks for the new treatments? Issues have arisen for those taking widely used statins, blood thinners and even anti-depressants.

Regarding that last question, the best answer appears to be that those at risk should contact their doctors fast after an infection to get the right treatment. That message, however, is not being delivered. Look at IDPHs web page on what to do if you are infected. It is not there.

Weve speculated before about why the State of Illinois and federal health authorities seem to deliberately ignore the topic of treatments. They seem hell-bent on sticking to a doctrine that we always prefer prevention over treatment, as Ezike has stated it. Hence, they have been two-trick ponies since the start vaccines and masks.

That doctrine may make sense as a general epidemiological rule, but it certainly does not seem adequate at this time for COVID. None of this is to imply that vaccines dont significantly reduce the chances of hospitalization or death. They do, vaccines save lives, and thats something experts agree on, but thats no excuse for ignoring how those who nevertheless get infected should get treated.

*Mark Glennon is founder of Wirepoints.

UPDATE: Another remedy not initially mentioned in this column is Fluvoxamine. As the Wall Street Journal says in the article below, it is being overlooked. Because this is important, I am taking the liberty of reprinting their article on it below:

Is Fluvoxamine the Covid Drug Weve Been Waiting For?

A 10-day treatment costs only $4 and appears to greatly reduce symptoms, hospitalization and death.

By Allysia Finley Follow Dec. 28, 2021 6:44 pm ET

The Food and Drug Administration last week authorized two oral antiviral medicines for the early treatment of Covid-19. But dont get too excited. The U.S. will still have a meager treatment arsenal this winter.

The U.S. has been relying on monoclonal-antibody treatments, but most dont hold up against the Omicron variant. One, by GlaxoSmithKline and Vir Biotechnology, does better at neutralizing the variant, but supply is limited. Pfizers newly authorized antiviral pack Paxlovid will also have to be rationed. There will be more of Merck and Ridgeback Biotherapeutics newly authorized antiviral, molnupiravir, but patients may be reluctant to take the drug. Some scientists worry it could cause DNA mutations in people, though the FDA determined that the likelihood of this was low when used on a short-term basis.

Yet a promising alternative isnt getting its due: fluvoxamine, a pill the FDA approved in 1994 to treat obsessive-compulsive disorders. Doctors often prescribe it off-label for anxiety, depression and panic attacks. Studies show that fluvoxamine is highly effective at preventing hospitalization in Covid-infected patients, and its unlikely to be blunted by Omicron.

Doctors hypothesize that fluvoxamine can trigger a cascade of reactions in cells that modulate inflammation and interfere with virus functions. It could thus prevent an overreactive immune response to pathogenswhats known as a cytokine stormthat can lead to organ failure and death. It also increases nighttime levels of melatoninthe hormone that makes you sleepywhich evidence suggests can also mitigate inflammation.

While experimenting with mice in 2019, researchers at the University of Virginia discovered that fluvoxamine could be an effective

treatment for sepsis, or blood-borne infection. A large study in France during the early months of the pandemic found that Covid-19 patients treated with selective serotonin reuptake inhibitors such as fluvoxamine were significantly less likely to be intubated or to die.

A small randomized control trial last year by psychiatrists at the Washington University School of Medicine in St. Louis was a spectacular success: None of the 80 participants who started fluvoxamine within seven days of developing symptoms deteriorated. In the placebo group, six of the 72 patients got worse, and four were hospitalized. The results were published in November 2020 in the Journal of the American Medical Association and inspired a real-world experiment.

Soon after the study was published, there was a Covid outbreak among employees at the Golden Gate Fields horse racing track in Berkeley, Calif. The physician at the track offered fluvoxamine to workers. After 14 days, none of the 65 patients who took it were hospitalized or still had symptoms. Of the 48 who didnt take the drug, six, or 12.5%, were hospitalized and one died. Twenty-nine had lingering symptoms, which might have resulted from inflammatory damage to their organs. Those who took the placebo were more likely to be asymptomatic when they tested positive, so they would have been expected to fare better.

The studies drew the attention of Francis Collins, director of the National Institutes of Health. A big need right now is for a drug that you could take by mouth, that you could be offered as soon as you had a positive test, and that would reduce the likelihood that the virus is going to make you really sick, he said in an interview with 60 Minutes in March. Fluvoxamine could certainly be something you want to put in the tool chest, Dr. Collins added. It looks as if it has the promise to reduce the likelihood of severe illness.

Researchers at McMaster University in Hamilton, Ontario, last winter launched a large clinical trial in Brazil. The results from their trial, published in the Lancet in October, were stunning: Fluvoxamine reduced the odds of hospitalization or emergency care by 66% and death by 90% among unvaccinated high-risk patients who mostly followed the treatment regimencomparable to monoclonal antibodies. There was no difference in adverse effects between the fluvoxamine and placebo groups.

The three fluvoxamine trials were conducted while different variants were circulating, so theres no reason to think the drug wouldnt work as well against Omicron. A 10-day course of fluvoxamine costs $4, compared with the $2,100 the U.S. government has been paying for monoclonal antibodies, and $530 to $700 for a course of the Pfizer and Merck treatments. Multiple drugmakers manufacture fluvoxamine and could ramp up supply without much difficulty were demand to increase.

While the FDA doesnt need to grant fluvoxamine emergency-use authorization for doctors to prescribe it, some may be reluctant to do so unless the NIH recommends it in its Covid-19 treatment guidelines. Physicians have been investigated by state medical boards for prescribing the antiparasite ivermectin off-label for Covid-19.

The NIH states that there is insufficient evidence . . . to recommend either for or against the use of fluvoxamine for the treatment of COVID-19. It wants evidence from another large clinical trial. Yet the U.S. is recording nearly as many deaths from Covid-19 today as when Dr. Collins made his statement in March. If the NIH doesnt budge, states could enact laws that protect doctors who prescribe fluvoxamine, They could also order doses to administer to patients, which would cost little but could save many lives.

Ms. Finley is a member of the Journals editorial board. Appeared in the December 29, 2021, print edition.

The rest is here:
Why No Discussion Of COVID Treatments In Illinois? Updated Wirepoints - Wirepoints

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