Monday, December 13, 2021

The Road goes ever on and on ... Day 138 (638)

This afternoon I found an incredibly, well at least to me, interesting aspect of the coronavirus pandemic. It seems that the Merck antiviral, molnupravir, might insert errors into DNA which could in theory harm developing fetuses, sperm cells, or even children. It's not clear whether it might also cause mutations in human DNA and extend the risk to men wanting to be fathers. A member of an FDA advisory committee says,"Do we want to reduce the risk for the mother by 30 percent while exposing the embryo and the fetus to a much higher risk of harm by this drug? My answer is no, and there is no circumstance in which I would advise a pregnant woman to take this drug."

The antiviral works by disguising itself as a building block of RNA. When the virus enters a cell to replicate, the drug slips into the virus's RNA and inserts enough errors that the virus can not survive. But the same compound that interferes with the virus's genetic material can also resemble a building block of DNA--the patient's own or that of a developing fetus. At least it does in hamsters according to one study. Because the drug performs the error-insertion in developing cells, one doctor said her would not give it to pregnant women, breastfeeding moms, children, or teenagers, all of whom have cell division going on. Merck says that the hamster study exposed the animals to a longer course of the drug than people would get and that its own rodent studies showed no problems. That said, they have so far not released the results of their own rodent studies.

Merck said that it did not include pregnant or breastfeeding women in their clinical trials just in case there might be a problem. so there's really no way of knowing how the drug might act in a human. Are hamsters a valid stand-in for humans? I can't see infecting a pregnant chimpanzee with covid and then the antiviral, though that would be closer to a pregnant human. Is 30 percent efficacy worth the ethical dilemmas this raises? Would it be simpler not to authorize its use? I know that I would not have taken it while pregnant. (Note to self: Do not include comment about my kids having enough to deal with given they have half of my genes.)

Also of interest are the results of a survey of 1,089 adults in the US in early December. Compared with October, more Americans are worried about getting covid, but they are not taking more precautions. In December, 36 percent of respondents said that they were extremely or very worried about themselves or family members getting covid. In October, only 25 percent expressed those levels of concern. The October and December surveys both showed some 31 percent of people somewhat worried. Finally, 33 percent were not too or not at all worried in December compared with 43 percent in October. (Results have a 4.1 percent margin of error). But, (another discussion with a "But"), only 21 percent of respondents reported taking safety precautions such as wearing masks or avoiding long-distance travel. Behavior did not really change between October and December despite the changes in level of concern. 

As if those issues aren't of enough concern, only about half of US nursing home residents have gotten a booster shot. Only 44 percent of eligible adults ages 65 and older got a booster shot before Thanksgiving. Covid has killed one of every 100 Americans in this age group. There have been about 800,000 deaths from covid; about 600,000 or 75 percent have been in people over the age of 65. One in 100 older Americans has died of covid compared with one in 1,400 for people under 65. Covid is the third leading cause of death for older Americans after heart disease and cancer, causing about 13 percent of all deaths in that group. At least older Americans are the most vaccinated group; 87 percent are fully vaccinated. 

Fully vaccinated people in England who have had contact with a person who tested positive have been advised that they should take a rapid lateral flow test every day for seven days. The problem with this? They appear to be out of such tests in England. The government website from which such tests used to be ordered now announces, "There are no more home test kits available. Try again later." The website through which a test could be booked is overloaded. Just a wee bit of a problem there.

And last but not least, Elon Musk is Time magazine's 2021 Person of the Year. How jealous are Richard Branson and Jeff Bezos not to mention the ex-President who used to manipulate images so that he, too, could be Person of the Year?

1 comment:

Caroline M said...

Those of us who were previously on three covid tests a week have ample supplies, I know someone who is panicking for lateral flow tests now she's been told she has to take one for attending something - she has never taken a test. As someone in the group chat said, where have you been for the last two years?

Tomorrow the NHS site will fall over again, it's the date when all adults can book their third jab. I think that's effectively the 18-40 group as the others could have alrrady booked. There's a difference between the PM talking about it and the service having to be delivered