Fact COVID vs. COVID Science Fiction # 2 – “Treatment is (NOT) our best course of action”

Band RICHARD SKOLNIK


Los Allamos

We continue to hear from a number of people, including in our own community, that “treatment should have been our focus from the start”.

Such comments reflect a lack of understanding of how vaccines work and their costs. They also reflect a lack of understanding of the costs and effectiveness of COVID treatments and who bears those costs.

With that in mind, I present below some facts about the relative costs and effectiveness of vaccines and some of the available and coming soon COVID treatments. References are given at the end of all data used in the article.

As I have mentioned in previous articles, COVID vaccines, like many other vaccines, do not provide lifelong immunity and need boosters. Yet, they still offer huge benefits at low cost. Latest data (Oct. 18) for New Mexico shows unvaccinated people have 4.5 times the risk of infection, 6.0 times the risk of hospitalization, and 11.7 times the risk of death higher than the vaccinated.

It is even in the face of decreased immunity to vaccines. In addition, these data do not take into account the probable effect of the boosters currently administered. The Pfizer vaccine costs the US government about $ 20, or about $ 60 for a full dose plus a booster.

Below are some key data on the costs and effectiveness of COVID-related treatments:

  • In clinical trials, Regeneron monoclonal antibody therapy reduced hospitalizations by approximately 70%, symptom duration by 4 days, and symptomatic infections in exposed individuals by 80%. Such treatment is authorized for post-exposure prevention in people over 12 years of age who are at high risk of progressing to serious disease and in people who test positive for the SARS-CoV-2 virus and are at high risk. progress to serious illness. . Regeneron’s monoclonal antibody costs about $ 1,250 and has typically been given by infusion in some settings. However, a lower dose has also been approved for injection use. The results of clinical trials published in September 2021 concluded that Regeneron treatment given by injection was more than 60% effective in preventing infection in close contacts of infected cases. It also reduced the duration of symptoms and the high viral load.
  • Remdesevir costs about $ 3,120 for a typical patient. In clinical trials, those who received Remdesivir had a median recovery time of 10 days, compared to 15 days in those who received a placebo. This medication is indicated for people over 12 years of age in hospital and is given by injection in a hospital setting, usually over 5 to 10 days.
  • Clinical trial reports suggest that Merck’s new pill to treat COVID, molnupiravir, will reduce serious illness and hospitalizations by about 50%, compared to a placebo, if used soon after infection . It has been suggested that the cost of treating 40 tablets could be around $ 700. The drug has not been tested on pregnant women or children.
  • The average cost of treating a patient for COVID in hospital has been estimated to be around $ 20,000.
  • ECMO (Extracorporeal Membrane Oxygenation) is a treatment for critically ill COVID patients. Various reports estimate the cost per day of ECMO between $ 20,000 and $ 40,000. The latest studies show that the median length of stay on ECMO for COVID patients was around 20 days for those placed after May 2020. The mortality rate for these patients was 48%.

Of course, when considering the value of vaccines and therapies, we must also consider the full cost to individuals and society of the COVID disease. It must also include what we know – and what we don’t know – about the long term COVID.

I fully support the development of treatments, as quickly as possible. They are essential. In fact, if I had been responsible for government policy, I would have been much more forceful than the federal government in using advanced trade commitments and other tools to spur treatment development.

Nonetheless, the above data should make it clear to us why vaccines, in conjunction with masking and social distancing, must remain the foundation of our approach to tackling COVID for now. Profitability is a key principle of public health. We must fight COVID at the lowest cost that is effective. This is all the more important given that a significant portion of the costs associated with COVID are borne by taxpayers rather than individuals.

The references:

Editor’s Note: Richard Skolnik is the former Regional Director of Health for South Asia at the World Bank. He was director of an AIDS treatment program at Harvard and taught global health at George Washington University and Yale. He is the author of Global Health 101 and the instructor of Yale / Coursera’s Essentials of Global Health. Skolnik wrote this article in a personal capacity.

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