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除了新冠口服特效药,人类还会有其它创新疗法吗?

除了新冠口服特效药,人类还会有其它创新疗法吗?

Nicole Goodkind 2022年01月14日
无论新型抗病毒药物有多好,考虑到供应量和供应链的问题,它们对新冠疫情的控制力着实有限。

美国的新冠肺炎确诊病例和住院治疗人数都已经达到了历史最高水平。两年前,美国本土确诊了首例新冠病毒感染者。时至今日,却仍然看不到新冠疫情放缓的任何迹象。

美国卫生与公众服务部(Department of Health and Human Services)的数据显示,截至1月11日,因为感染新冠病毒而住院治疗的患者在短短两周内就已经翻倍,超过了145900人。这一数值创下了历史新高,刷新了2021年1月时曾经达到的峰值。

刚出现激增的迹象时,人们曾经希望能够凭借新研发的抗病毒药物平息奥密克戎变异毒株在全国扩散的热潮。美国食品与药品管理局(Food and Drug Administration)已经通过辉瑞(Pfizer)的Paxlovid(据称,该药可以将患者住院或死亡的风险降低89%)和默沙东(Merck)的molnupiravir(研究数据显示,该药能够将患者住院或死亡的风险降低30%)的紧急使用授权(EUA)。

这两种特效药均适用于轻到中度症状的新冠患者。患者需居家服用共计30粒至40粒胶囊,5天为1疗程。

美国政府以50亿美元的价格向辉瑞购买了1000万疗程的药物(本周官方宣布,将追购1000万疗程),并以22亿美元的价格向默沙东购买了300疗程的药物。然而,与疫苗这样的预防性药剂相比,口服特效药的供应量极为有限;在Moderna和辉瑞疫苗正式上市之前,美国政府就分别预订了1亿剂。

有医生表示,无论这种新型抗病毒药物有多好,考虑到供应量和供应链的问题,它们对新冠疫情的控制力着实有限。即便是抛开动辄上百万的大订单不谈,截至上周,辉瑞和默沙东公司只交付了365000个疗程的口服特效药。不过,美国总统乔·拜登保证,很快就会有更多的药物发放下去。

在上周的新闻发布会上,拜登解释说,因为药物的复杂性,“一粒胶囊的生产周期长达数月”。

本周,肯塔基州的大山综合健康中心(Mountain Comprehensive Health Center in Kentucky)只收到了200个疗程的默沙东抗病毒药物和40个疗程的辉瑞抗病毒药物。而该州完成新冠疫苗接种的居民仅占55%。

大山综合健康中心负责为7个县共计5万名患者提供医疗援助,其院长麦克·考迪尔在接受《路易斯维尔信使报》(Louisville Courier Journal)的采访时说:“这简直是杯水车薪。我们只能把药开给那些病情特别紧急的患者。”

旧金山康特拉科斯塔县卫生服务部门(Contra Costa Health Services)的发言人威尔·哈珀对此表示赞同,其说法和考迪尔相差无几。

他在接受《旧金山纪事报》(San Francisco Chronicle)的采访时称:“目前的供应量还不足以改变整个局面。”并补充说,“在每天新增1300多个确诊病例的情况下,120个疗程的口服特效药只是杯水车薪。”

新冠确诊病例的增长速度远远超过了抗病毒药物的生产和运输速度。联邦政府的应急准备与反应助理部长办公室(Office of the Assistant Secretary for Preparedness and Response)将直接负责此类药物的分配工作。

美国白宫的首席医疗顾问安东尼·福奇博士在回应发放迟缓的问题时,其说法与拜登所称的制药过程漫长相一致。他在2021年12月下旬的一场新闻发布会上表示:“虽然不尽如人意,但口服特效药的制作过程确实相当复杂。我们将与制药公司合作,找出周期长这一问题的症结所在,希望可以尽量缩短生产过程。”

虽然新冠疫苗和加强针能够有效防止奥密克戎变异毒株引发重症(重症监护病房不像先前的新冠疫情高峰期时一样人满为患),但许多美国人都出现了需要住院治疗的症状,医疗保健系统已经不堪重负。居高不下的死亡率也足以体现新冠疫情的严重程度。即便还远未达到历史最高水平,可仅在过去一周内,美国的新冠死亡率就上升了31%。

美国卫生与公众服务部的数据显示,全美约四分之一的医院目前正在面临着人手紧缺的窘境。伊利诺斯州和马萨诸塞州等地的医院系统宣布将推迟择期手术。俄勒冈州部署了美国国民警卫队(National Guard)来协助医院。马里兰州的州长拉里·霍根于上周宣布进入紧急状态,并预警称,“此次疫情最具挑战性的时刻”即将到来。

亚利桑那州的医疗保健工作者也向州政府反映,当地的医疗保健系统已经临近崩溃的边缘。1月7日,图森市的急诊医生布拉德利·德赖富斯博士告诉记者:“患者出现心脏骤停、代谢失调、病情恶化,甚至在候诊室死亡的案例越来越多。”美国人似乎已经不再盼望着能够被奇迹般地治愈,或者是奇迹般地得到治疗了。Axios/Ipsos最近的一项民意调查显示,52%的人认为,要想回归到新冠疫情爆发前正常的生活,至少还需要一年的时间(也可能永远都回不去了)。(财富中文网)

译者:殷圆圆

美国的新冠肺炎确诊病例和住院治疗人数都已经达到了历史最高水平。两年前,美国本土确诊了首例新冠病毒感染者。时至今日,却仍然看不到新冠疫情放缓的任何迹象。

美国卫生与公众服务部(Department of Health and Human Services)的数据显示,截至1月11日,因为感染新冠病毒而住院治疗的患者在短短两周内就已经翻倍,超过了145900人。这一数值创下了历史新高,刷新了2021年1月时曾经达到的峰值。

刚出现激增的迹象时,人们曾经希望能够凭借新研发的抗病毒药物平息奥密克戎变异毒株在全国扩散的热潮。美国食品与药品管理局(Food and Drug Administration)已经通过辉瑞(Pfizer)的Paxlovid(据称,该药可以将患者住院或死亡的风险降低89%)和默沙东(Merck)的molnupiravir(研究数据显示,该药能够将患者住院或死亡的风险降低30%)的紧急使用授权(EUA)。

这两种特效药均适用于轻到中度症状的新冠患者。患者需居家服用共计30粒至40粒胶囊,5天为1疗程。

美国政府以50亿美元的价格向辉瑞购买了1000万疗程的药物(本周官方宣布,将追购1000万疗程),并以22亿美元的价格向默沙东购买了300疗程的药物。然而,与疫苗这样的预防性药剂相比,口服特效药的供应量极为有限;在Moderna和辉瑞疫苗正式上市之前,美国政府就分别预订了1亿剂。

有医生表示,无论这种新型抗病毒药物有多好,考虑到供应量和供应链的问题,它们对新冠疫情的控制力着实有限。即便是抛开动辄上百万的大订单不谈,截至上周,辉瑞和默沙东公司只交付了365000个疗程的口服特效药。不过,美国总统乔·拜登保证,很快就会有更多的药物发放下去。

在上周的新闻发布会上,拜登解释说,因为药物的复杂性,“一粒胶囊的生产周期长达数月”。

本周,肯塔基州的大山综合健康中心(Mountain Comprehensive Health Center in Kentucky)只收到了200个疗程的默沙东抗病毒药物和40个疗程的辉瑞抗病毒药物。而该州完成新冠疫苗接种的居民仅占55%。

大山综合健康中心负责为7个县共计5万名患者提供医疗援助,其院长麦克·考迪尔在接受《路易斯维尔信使报》(Louisville Courier Journal)的采访时说:“这简直是杯水车薪。我们只能把药开给那些病情特别紧急的患者。”

旧金山康特拉科斯塔县卫生服务部门(Contra Costa Health Services)的发言人威尔·哈珀对此表示赞同,其说法和考迪尔相差无几。

他在接受《旧金山纪事报》(San Francisco Chronicle)的采访时称:“目前的供应量还不足以改变整个局面。”并补充说,“在每天新增1300多个确诊病例的情况下,120个疗程的口服特效药只是杯水车薪。”

新冠确诊病例的增长速度远远超过了抗病毒药物的生产和运输速度。联邦政府的应急准备与反应助理部长办公室(Office of the Assistant Secretary for Preparedness and Response)将直接负责此类药物的分配工作。

美国白宫的首席医疗顾问安东尼·福奇博士在回应发放迟缓的问题时,其说法与拜登所称的制药过程漫长相一致。他在2021年12月下旬的一场新闻发布会上表示:“虽然不尽如人意,但口服特效药的制作过程确实相当复杂。我们将与制药公司合作,找出周期长这一问题的症结所在,希望可以尽量缩短生产过程。”

虽然新冠疫苗和加强针能够有效防止奥密克戎变异毒株引发重症(重症监护病房不像先前的新冠疫情高峰期时一样人满为患),但许多美国人都出现了需要住院治疗的症状,医疗保健系统已经不堪重负。居高不下的死亡率也足以体现新冠疫情的严重程度。即便还远未达到历史最高水平,可仅在过去一周内,美国的新冠死亡率就上升了31%。

美国卫生与公众服务部的数据显示,全美约四分之一的医院目前正在面临着人手紧缺的窘境。伊利诺斯州和马萨诸塞州等地的医院系统宣布将推迟择期手术。俄勒冈州部署了美国国民警卫队(National Guard)来协助医院。马里兰州的州长拉里·霍根于上周宣布进入紧急状态,并预警称,“此次疫情最具挑战性的时刻”即将到来。

亚利桑那州的医疗保健工作者也向州政府反映,当地的医疗保健系统已经临近崩溃的边缘。1月7日,图森市的急诊医生布拉德利·德赖富斯博士告诉记者:“患者出现心脏骤停、代谢失调、病情恶化,甚至在候诊室死亡的案例越来越多。”美国人似乎已经不再盼望着能够被奇迹般地治愈,或者是奇迹般地得到治疗了。Axios/Ipsos最近的一项民意调查显示,52%的人认为,要想回归到新冠疫情爆发前正常的生活,至少还需要一年的时间(也可能永远都回不去了)。(财富中文网)

译者:殷圆圆

COVID-19 cases have reached record highs, and so have hospitalizations. Two years after the first patient was diagnosed on American soil, the pandemic appears to show no signs of slowing down.

More than 145,900 people were hospitalized with the virus as of January 11, according to data from the Department of Health and Human Services. That’s a 100% increase in two weeks and a record high, surpassing the previous peak in January 2021.

At the beginning of the surge, there was hope that a new group of antiviral drugs could help quell the rush of Omicron across the country. The Food and Drug Administration issued emergency use authorization (EUA) for Pfizer’s Paxlovid, which the company says cuts the risk of hospitalization or death by 89%, and Merck’s molnupiravir, which data showed cut hospitalization or death by 30%.

Both regimens are for patients with mild to moderate COVID and require 30 to 40 pills to be taken at home over the course of five days.

The U.S. purchased 10 million courses of Pfizer’s treatment in a $5 billion deal (officials announced this week that they would order 10 million more) and 3 million courses of Merck’s treatment for $2.2 billion. However, supplies of the pills are extremely limited compared with preventative treatments like vaccines; the U.S. ordered 100 million doses each of the Moderna and Pfizer vaccines prior to when they launched.

And no matter how potent the new antiviral drugs might be, shortages and supply-chain issues have rendered them relatively ineffective, doctors say. Even considering relatively small orders of a few million, as of last week, only about 365,000 courses of the Pfizer and Merck pills had shipped out, though President Joe Biden assured more were coming.

Because of the complexity of the medicines, explained Biden at a press conference last week, “it takes months literally to make a pill."

The Mountain Comprehensive Health Center in Kentucky, a state in which just 55% of people are fully vaccinated, received only 200 treatment courses of the Merck antiviral and 40 of the Pfizer antiviral this week.

"Basically, it's just a drop in the bucket," Mike Caudill, CEO of Mountain Comprehensive, which serves 50,000 patients in seven counties, told the Louisville Courier Journal. "We're going to try to use it in such a way to treat people at extreme risk."

Will Harper, a spokesman for Contra Costa Health Services in San Francisco, echoed that view, and even used the same language.

“At this point, there’s simply not enough of it for it to be a game changer,” he told the San Francisco Chronicle, adding that “120 courses is a drop in the bucket when we are seeing more than 1,300 new COVID cases each day.”

The rate of increase in COVID-19 cases far outstrips the rate at which the antiviral medications, the allocation of which is being managed by the federal government’s Office of the Assistant Secretary for Preparedness and Response, can be produced and shipped out.

Dr. Anthony Fauci, the president’s chief medical adviser, echoed Biden's explanation about the lengthy pill-making process as explanation for the delay. “The sobering news is, unfortunately, it is really a quite complicated and complex synthetic process, which we will be working with the company to figure out how we can help alleviate the stress of the long duration that it takes to make it,” he said at a press briefing at late December 2021. “Hopefully we’ll be able to shorten that process.”

Vaccinations and boosters have protected against the severity of Omicron (ICUs are not as busy as they were during previous spikes), but many Americans are still experiencing symptoms that require hospitalization, and health care systems are overwhelmed. Death rates are also typically a lagging indicator of severity of illness, and while they’re still far from record highs, they’ve increased by 31% nationwide over the past week.

About a quarter of hospitals in the U.S. are now experiencing critical staffing shortages, according to the Department of Health and Human Services. Some states, like Illinois and Massachusetts, have delayed elective surgeries. Oregon deployed the National Guard to help in hospitals. Maryland Gov. Larry Hogan, declared a state of emergency last week, and warned that this will be the "most challenging time of the entire pandemic."

Health care workers in Arizona, meanwhile, told state leaders that their health care system is on the brink of collapse. "We've had more events where people are having cardiac arrests, or decompensating and getting very sick and even dying in the waiting rooms," Dr. Bradley Dreifuss, an emergency medicine physician in Tucson, told reporters on January 7. Americans, meanwhile, appear to be losing hope for a miracle cure or treatment. A new Axios/Ipsos poll found that 52% of respondents believe it will be more than a year—or never—before they can return to their normal, pre-COVID lives.

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