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January 13, 2023

COVID-19 roundup: HHS renewed the PHE for the 12th time. Could it be the last?

Daily Briefing

    HHS has renewed the COVID-19 public health emergency (PHE) in the United States for the 12th time, NIH has launched a pilot telehealth program to test and treat COVID-19, and more in this week's roundup of COVID-19 news.

    • People with long COVID may see their persistent symptoms ease after a year, according to a new study published in BMJ. For the study, researchers from the KI Research Institute analyzed 1,913,234 patient records from Maccabi Healthcare Services, a large health maintenance organization in Israel, collected from March 2020 to October 2021. Using a list of 70 long COVID symptoms, the researchers searched for them at different time points and compared almost 300,000 patients who had tested positive to comparable patients who had tested negative. Any patients who were hospitalized due to COVID-19 were excluded. Over the year-long follow-up period, the researchers found that patients who tested positive had an increased risk of a loss of smell and taste, concentration and memory problems, breathing difficulties, strep throat, and more. Later on, patients also had more hair loss, chest pain, cough, muscle aches and pains, and respiratory. However, these lingering symptoms cleared up within a year for most patients who had mild COVID-19 infections." According to Benjamin Abramoff, director of the Penn Medicine Post-COVID Assessment and Recovery Clinic, the study was "reassuring in that most ongoing symptoms following COVID do improve over the first several months following the acute infection." Still, Abramoff noted that his clinic had seen many patients who continued to have severe long COVID symptoms even over a year later. "This is particularly true in those individuals who had severe persistent symptoms early after their acute infection," he said. (Habeshian, Axios, 1/11; Cooney, STAT, 1/11)
    • HHS on Wednesday renewed the COVID-19 PHE for the 12th time. "The COVID-19 Public Health Emergency remains in effect, and as HHS committed to earlier, we will provide a 60-day notice to states before any possible termination or expiration," an HHS spokesperson said. According to The Hill, the latest renewal comes as a highly transmissible omicron subvariant, XBB.1.5, continues to spread rapidly. Currently, XBB.1.5 makes up over 70% of new COVID-19 cases in the Northeast and roughly 28% of new cases nationwide. So far, COVID-19 cases have been on the rise, but a major winter surge like those seen in prior years has not yet occurred. According to three people with knowledge of the matter, this latest renewal may also be the last, with senior health officials potentially aiming to end the PHE by the spring. However, the Biden administration could still choose to issue short-term extensions if it needs more time with the transition or if another variant emerges. "All the signs around them are that we're going to be battling episodic surges," said Lawrence Gostin, a professor of public health at Georgetown University who has informally advised the White House. "It's going to be déjà vu all over again." (Choi, The Hill, 1/11; Cancryn, Politico, 1/10)
    • NIH has launched a pilot program to test and treat patients for COVID-19 from their homes through telehealth. Other partners in the program include eMed, VentureWell, and UMass Chen Medical School. Under the program, participants will be able to receive at-home rapid tests, telehealth visits, and antiviral treatments free of charge. It will begin in Berks County, PA, and up to 8,000 eligible residents are expected to participate. "At-home testing for COVID-19 is now widely available in the United States, as are antiviral treatments, and this program combines easy home access to both," said Bruce Tromberg, director of the National Institute of Biomedical Imaging and Bioengineering and leader of the Rapid Acceleration of Diagnostics Tech program. "The Home Test to Treat program allows those who are sick an alternative to venturing out for testing or treatment, potentially reducing the spread of COVID-19 in the community." The government plans to gather data from the pilot program and use this information to potentially scale it to roughly 100,000 people nationwide this year. (Bruce, Becker's Hospital Review, 1/6)
    • In a study published in Cell, researchers from Stanford University and the University of California, San Francisco, have pinpointed potential routes SARS-CoV-2 takes to enter and exit nasal cavity cells—which could help lead to the development of a prophylactic nasal spray to reduce the risk of infection. In the study, the researchers closely examined cilia and microvilli on multiciliated epithelial cells. Using a sophisticated tissue culture method to create airway epithelial organoids that mimic normal airways, they inoculated the culture with samples of the coronavirus to observe what happens during a viral infection. According to the researchers, only ciliated cells became infected, suggesting that they were the entry point for the virus. Once the coronavirus was in the cell, it activated intracellular enzymes that caused microvilli to enlarge and branch enough to penetrate the mucus-mucin layer and then infect more cells. These findings helped the researchers identify targets that could either impede ciliary motion or microvilli gigantism, and if used in a nasally applied drug, could prevent viral infections. "Delaying viral entry, exit or spread with a locally applied, short-duration drug would help our immune systems catch up and arrive in time to stop full-blown infection and hopefully limit future pandemics," said Peter Jackson, a professor of pathology, microbiology, and immunology at Stanford and one of the study's senior authors. (Goldman, Stanford Medicine, 1/5)
    • Moderna is considering pricing its COVID-19 vaccine at between $110 to $130 per dose after the United States transitions from federal contracts for the vaccine to commercial purchase. This projected cost for commercial insurer is significantly higher than what the federal government previously paid, which ranged from $15-16 for the original vaccines and around $26 for the updated boosters. According to the Wall Street Journal, the price range is similar to what Pfizer said it was considering for its own COVID-19 vaccine developed with BioNTech. "I would think this type of pricing is consistent with the value" provided by the vaccine, said Moderna CEO Stéphane Bancel. Currently, Moderna is in discussions with hospital systems, pharmacies, and pharmacy benefit managers about distributing its vaccine ahead of a potential booster campaign in the fall. Bancel also noted that any booster shots for the fall may be updated to match with any new circulating variants. (Loftus, Wall Street Journal, 1/9)

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