Where are California's COVID-19 vaccine doses?
Governor Newsom says the state itself has received 'not one dose' of the coronavirus vaccine, explaining the doses come from partner providers.
Carl Court/GettyBy William G. Bain, Georgios D. Kitsios, and Tomeka L. SuberA year ago, when U.S. health authorities issued their first warning that COVID-19 would cause severe “disruption to everyday life,” doctors had no effective treatments to offer beyond supportive care.There is still no cure, but thanks to an unprecedented global research effort, several treatments are helping patients survive COVID-19 and stay out of the hospital altogether.COVID-19 treatments target two broad problems: the coronavirus’s ability to spread through the body, and the damage caused by the body’s immune system response. When the virus enters the body, it takes over cells and uses them to replicate itself. In response, the body sends inflammatory signals and immune cells to fight the virus. In some patients, that inflammatory response can continue even after the virus is under control, leading to damage in the lungs and other organs.The best tool is prevention, including using face masks and vaccines. Vaccines train the immune system to fight off attackers. With less risk of an uncontrolled infection, they can cut the risk of death from COVID-19 to near zero. But vaccine supplies are limited, even with a third vaccine now authorized for U.S. use, so treatments for infected patients remain crucial.This Drug Is a Staple of COVID Treatment. Should It Be?As doctors who work with COVID-19 patients, we have been following the drug trials and success stories. Here are six treatments commonly used today for COVID-19. As you’ll see, timing matters.Keeping you out of the hospitalTwo promising types of treatments involve injecting antiviral antibodies into high-risk COVID-19 patients before the person becomes severely ill.Our bodies naturally create antibodies to recognize foreign invaders and help fight them off. But natural antibody production takes several days, and SARS-CoV-2—the coronavirus that causes COVID-19—replicates fast. Studies show that injecting patients with antibodies soon after symptoms begin can help protect patients against serious infection.Monoclonal antibodies: These lab-engineered antibodies can bind to SARS-CoV-2 and prevent the virus from entering cells and infecting them. They include Bamlanivimab and the combined therapy casirivimab/imdevimab developed by Regeneron. The U.S. Food and Drug Administration granted emergency use authorization for these therapies because they have been found to protect high-risk patients from hospitalization and death. Once patients are sick enough to need hospitalization, however, studies haven’t found a proven benefit from them.Convalescent plasma: Another way to deliver antibodies involves blood drawn from patients who have recovered from COVID-19. Convalescent plasma is primarily given in research settings because the clinical evidence so far is mixed. Some trials show benefits early in the disease. Other studies have not shown any benefit in hospitalized patients.There may be a role for convalescent plasma as a supplemental therapy for some patients because of the growing threat of mutated SARS-CoV-2 variants, which may evade monoclonal antibody therapy. However, careful research is necessary.If you are hospitalizedOnce patients become so sick that they have to be hospitalized, treatments change.Most hospitalized patients have difficulty breathing and low oxygen levels. Low oxygen occurs when the virus and corresponding immune response injure the lungs, resulting in swelling in lung air sacs that restricts the amount of oxygen getting into the blood. Patients hospitalized with COVID-19 usually need supplemental medical oxygen to help them breathe. Doctors frequently treat patients on oxygen with the antiviral agent remdesivir and anti-inflammatory corticosteroids.Remdesivir: Remdesivir, originally designed to treat hepatitis C, stops the coronavirus from replicating itself by interfering with its genetic building blocks. It has been shown to shorten the length of hospital stays, and doctors may prescribe it to patients on oxygen shortly after arrival in the hospital.Chris Christie Says He’s Out of the Hospital After Week-Long Stay for COVID-19Corticosteroids: Steroids calm the body’s immune response and have been used for decades to treat inflammatory disorders. They are also widely available, cheap and well-studied medications, so they were among the first therapies to enter clinical trials for COVID-19. Several studies have shown that low-dose steroids reduce deaths in hospitalized patients who are on oxygen, including the sickest patients in the intensive care unit, or ICU. Following the findings of the landmark RECOVERY and REMAP-CAP COVID-19 studies, steroids are now the standard of care for patients hospitalized with COVID-19 who are treated with oxygen.Blood thinners: Inflammation during COVID-19 and other viral infections can also increase the risk of blood clots, which can cause heart attacks, strokes and dangerous clots in the lungs. Many patients with COVID-19 are given the blood thinners heparin or enoxaparin to prevent clots before they occur. Early data from a large trial of COVID-19 patients suggests that hospitalized patients benefit from higher doses of blood thinners.Some patients with COVID-19 become so sick that they need an ICU for high levels of oxygen support or a ventilator to help them breathe. There are several therapies available for ICU patients, but ICU patients have not been found to benefit from high doses of blood thinners.Treating the sickest patientsICU patients with COVID-19 are more likely to survive if they receive steroids, studies have found. However, low-dose steroids alone may not be enough to curb excessive inflammation.Tocilizumab: Tocilizumab is a lab-generated antibody that blocks the interleukin-6 pathway, which can cause inflammation during COVID-19 and other diseases. New results from the REMAP-CAP trial that have not yet been peer-reviewed suggest that a single dose of tocilizumab given within one to two days after being placed on respiratory support reduced the risk of death in patients already receiving low-dose steroids. Tocilizumab has also been shown to benefit patients with high levels of inflammation in early results from another trial.These innovative therapies can help, but careful supportive care in the ICU is also crucial. Decades of extensive research have defined core management principles for helping patients with severe lung infections who need ventilators. These include avoiding underinflation and overinflation of the lung by the ventilator, treating pain and anxiety with low levels of sedative medications, and periodically placing certain patients with low oxygen levels on their belly, among many other interventions. The same key principles likely apply to patients with COVID-19 to help them survive and recover from a critical illness that can last weeks or months.Medical progress since the start of the pandemic has been awe-inspiring. Doctors now have vaccines, antiviral antibodies for high-risk outpatients and several treatments for hospitalized patients. Continued research will be crucial to improve our ability to fight a disease that has already claimed more than 2.5 million lives worldwide.William G. Bain, Georgios D. Kitsios, and Tomeka L. Suber are assistant professors of medicine at the University of PittsburghRead more at The Daily Beast.Get our top stories in your inbox every day. Sign up now!Daily Beast Membership: Beast Inside goes deeper on the stories that matter to you. Learn more.
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The plane laden with vaccines had just rolled to a stop at Santiago’s airport in late January, and Chile’s president, Sebastián Piñera, was beaming. The source of that hope: China – a country that Chile and dozens of other nations are depending on to help rescue them from the COVID-19 pandemic. China’s vaccine diplomacy campaign has been a surprising success: It has pledged roughly half a billion doses of its vaccine to more than 45 countries, according to a country-by-country tally by The Associated Press.
Canada's National Advisory Committee on Immunization released new guidelines on Monday that advise against vaccinating people who are 65 years and older with AstraZeneca's COVID-19 vaccine, citing lack of information about efficacy in that age group. The vaccine was authorized for people who are 18 and older by drug regulator Health Canada on Friday. Health Canada's decision noted that available clinical trial data was too limited to reliably estimate how well the vaccine worked in people 65 and older.
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A U.S. national security commission is recommending that American universities take steps to prevent sensitive technology from being stolen by the Chinese military, a sign of growing concerns over the security of academic research. The National Security Commission on Artificial Intelligence (NSCAI), led by former Google Chairman Eric Schmidt, on Monday voted unanimously to approve its final report https://www.nscai.gov/wp-content/uploads/2021/03/Full-Report-Digital-1.pdf to Congress. A new section on university research was added to the final report, which also features numerous recommendations in areas including competition in artificial intelligence and the semiconductor supply chain.
The plane laden with vaccines had just rolled to a stop at Santiago’s airport in late January, and Chile’s president, Sebastián Piñera, was beaming. The source of that hope: China – a country that Chile and dozens of other nations are depending on to help rescue them from the COVID-19 pandemic. China’s vaccine diplomacy campaign has been a surprising success: It has pledged roughly half a billion doses of its vaccines to more than 45 countries, according to a country-by-country tally by The Associated Press.
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The Philippine president has dismissed his former ambassador to Brazil after she was seen on video physically abusing a Filipino member of her household staff. President Rodrigo Duterte said Monday night he had approved a recommendation to fire Marichu Mauro, revoke her retirement benefits and disqualify her from public office for life. The Department of Foreign Affairs in Manila said at the time that the unidentified victim had returned to Philippines and that it was trying to reach her amid an investigation.
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