
<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>With a potential winter and fall surge of the flu, Covid and RSV, some experts recommend getting all three shots at the same time, while limited research shows doing so might cause rare side effects.=</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>It’s “acceptable” to get the new respiratory syncytial virus (RSV) vaccine co-administered with other vaccines, including the flu and Covid vaccines,&nbsp;<a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-06-21-23/07-RSV-Adults-Britton-508.pdf" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the Centers for Disease Control and Prevention.</p>



<p>For the first time, two RSV vaccines have been greenlit by the FDA to protect&nbsp;<a href="https://www.forbes.com/sites/mollybohannon/2023/05/03/fda-approves-first-ever-rsv-vaccine-after-brutal-2022-season/?sh=3dd0ac5910b2">older Americans</a>&nbsp;and&nbsp;<a href="https://www.forbes.com/sites/roberthart/2023/08/21/fda-approves-first-rsv-vaccine-for-kids-given-to-pregnant-moms-heres-what-to-know/?sh=75ffd2ab813e">infants</a>&nbsp;against the virus, which are expected to be available this fall, and the agency also approved an&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/03/first-rsv-vaccine-for-infants-approved-by-cdc-and-fda-other-top-vaccines-and-their-effectiveness/?sh=7a5031872040">antibody shot</a>&nbsp;for infants and toddlers in August.</p>



<p>New monovalent&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=18f37e73438b">Covid boosters</a>&nbsp;to protect against variants of the dominant XBB lineage are being developed by Moderna, Pfizer and Novavax at the request of a Food and Drug Administration panel and also are predicted to be available this fall.</p>



<p>As the fall and winter seasons approach, there are concerns another respiratory virus “tripledemic”—caused by a simultaneous rise in flu, Covid and RSV cases, causing hospitals to become overwhelmed—may happen again this year.</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>It’s “more probable that we&#8217;ll have a high viral season” this year with people getting Covid, the flu and RSV around the same time, so getting vaccinated is an important preventative step, Sharon Nachman, the chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, told&nbsp;<em>Forbes.</em></p>



<p>Forbes Daily: Get our best stories, exclusive reporting and essential analysis of the day’s news in your inbox every weekday.Sign Up</p>



<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p><a href="https://covid.cdc.gov/covid-data-tracker/#variant-proportions" target="_blank" rel="noreferrer noopener">Covid</a>&nbsp;hospitalizations in recent weeks ticked up, increasing by almost 19% between August 13 and August 19, while deaths increased almost 18% between July 8 and August 26, as EG.5, or the Eris variant, made up the majority of cases. Though national&nbsp;<a href="https://www.cdc.gov/surveillance/nrevss/images/trend_images/RSV14Num_Nat.htm" target="_blank" rel="noreferrer noopener">RSV cases</a>&nbsp;have increased slightly since June—they went from 149 cases in the week of June 17 to 423 cases the week of August 26—cases were over four times higher around this time last year.&nbsp;<a href="https://www.cdc.gov/flu/about/season/index.html" target="_blank" rel="noreferrer noopener">Flu cases</a>&nbsp;aren’t witnessing a spike just yet, as flu season is expected to begin in October, but updated vaccines are available for the upcoming season.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>50,000. That’s how many people in the U.S. died from Covid infection between November 2022 and March 2023,&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_deaths-total" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the CDC. The&nbsp;<a href="https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm" target="_blank" rel="noreferrer noopener">flu</a>&nbsp;accounted for around 58,000 deaths during last year’s tripledemic and&nbsp;<a href="https://www.cdc.gov/rsv/research/rsv-net/dashboard.html" target="_blank" rel="noreferrer noopener">RSV</a>&nbsp;killed 10,000 people—mostly seniors—and caused twice as many hospitalizations than in prepandemic years.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>A good number of patients last year were admitted into Nachman’s hospital with “more than one virus” at a time. So, she recommends those who are eligible to first get their doctors’ approval and then get all three shots in preparation for the upcoming seasons. Other than approving the co-administration of the RSV shot with other vaccines, the CDC also&nbsp;<a href="https://www.cdc.gov/flu/prevent/coadministration.htm" target="_blank" rel="noreferrer noopener">endorses</a>&nbsp;co-administration of the Covid and flu vaccines. Nachman said there’s a “better immune response” when more than one vaccine is administered at the same time. A&nbsp;<a href="https://www.sciencedirect.com/science/article/pii/S0264410X22015687" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in&nbsp;<em>Elsevier&nbsp;</em>found dual vaccination of Covid and the flu saw a reduced risk of infection than in unvaccinated people.</p>



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>Epidemiologist Richard Reithinger told&nbsp;<em>Forbes</em>, “People are a little bit more cautious” about getting the RSV vaccines at the same time as the other two because they were only recently approved by the FDA this year. There is limited evidence on whether the new RSV vaccines negatively interact with the Covid and flu vaccines. However, there were rare instances in a clinical trial where people developed severe side effects after getting the RSV and flu shots at the same time. Two 71-year-old participants developed acute disseminated encephalomyelitis (<a href="https://www.ninds.nih.gov/health-information/disorders/acute-disseminated-encephalomyelitis#:~:text=Acute%20disseminated%20encephalomyelitis%20(ADEM)%20is,helps%20with%20electrical%20nerve%20signaling." target="_blank" rel="noreferrer noopener">ADEM</a>), a neurological disorder that causes widespread swelling in the brain and spinal cord that damages the nerves’ protective coating, according to a&nbsp;<a href="https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7229a4-H.pdf" target="_blank" rel="noreferrer noopener">report</a>&nbsp;by a CDC advisory committee. One of these instances resulted in death. However, researchers aren’t sure if these cases were a result of the vaccines being administered together, or just a coincidence. The study also found that RSV and flu antibodies were slightly lower when administered together, though the “clinical significance is unknown.” If people are unsure about getting all three vaccines at once, it’s okay to “just take the flu vaccine [right now] and then wait for the Covid-19 and RSV” vaccines to be released later this year, according to Reithinger. Although he believes getting all three vaccines at the same time is safe, he ultimately recommends people consult with their doctors on timing.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=18f37e73438b">New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2022/12/20/heres-why-there-is-a-shortage-for-childrens-tylenol-advill-and-motrin-and-what-to-do-about-it/?sh=3a6e33ce28f4">Here’s Why There Is A Shortage For Children&#8217;s Tylenol, Advil And Motrin—And What To Do About It</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/mollybohannon/2023/05/03/fda-approves-first-ever-rsv-vaccine-after-brutal-2022-season/?sh=3dd0ac5910b2">FDA Approves First-Ever RSV Vaccine After Brutal 2022 Season</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2023/08/21/fda-approves-first-rsv-vaccine-for-kids-given-to-pregnant-moms-heres-what-to-know/?sh=75ffd2ab813e">FDA Approves First RSV Vaccine For Kids—Given To Pregnant Moms—Here’s What To Know</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/03/first-rsv-vaccine-for-infants-approved-by-cdc-and-fda-other-top-vaccines-and-their-effectiveness/?sh=7a5031872040">First RSV Shot For Infants Approved By CDC And FDA: Other Top Shots And Their Effectiveness</a> (Forbes)</p>


Injection of the third dose of the covid 19 vaccine at a Covid-19 vaccination center in Dinan, Brittany

It’s Okay To Get Your Covid, Flu And RSV Shots At The Same Time, Experts Say


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Officials in New York City this week&nbsp;<a href="https://www.dailymail.co.uk/health/article-12471305/NYC-Health-Department-tells-New-Yorkers-MASKING-Labor-Day-good-idea-new-Covid-variants-drive-infection-rates.html" target="_blank" rel="noreferrer noopener">reportedly</a>&nbsp;urged residents to wear masks in public as a new strain of Covid-19 continues to spread throughout the country, while some hospitals and schools have also reimplemented mask mandates, though medical experts say masking requirements might not last long, and might not be necessary for the entire population.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>New York City Health Commissioner Dr. Ashwin Vasan this week warned the virulent Ba.2.86 variant is “likely to evade immunity that has developed from vaccination or prior infection,” while a city health official told the Daily Mail it would be a “good idea” to mask up in crowded indoor places over the holiday weekend.</p>



<p>In Atlanta, Morris Brown College—a historically Black university—implemented a&nbsp;<a href="https://www.fox5atlanta.com/news/morris-brown-college-implements-two-week-covid-19-mask-mandate-as-cases-climb" target="_blank" rel="noreferrer noopener">two-week mask mandate</a>&nbsp;for all students and faculty last week as students move back on campus, also re-imposing social distancing amid “reports of positive cases among students.”</p>



<p>California-based healthcare facility Kaiser Permanente&nbsp;<a href="https://www.pressdemocrat.com/article/news/kaiser-permanente-reinstates-covid-19-mask-mandate-amid-spike-in-cases-but/" target="_blank" rel="noreferrer noopener">reinstated</a>&nbsp;its mask mandate at its facilities in Santa Rosa, California last week “amid an uptick in patients testing positive,” while in New York, a group of hospitals also imposed mask mandates,&nbsp;<a href="https://www.fox4news.com/news/citing-rising-covid-cases-these-us-hospital-systems-have-now-reinstated-mask-mandates" target="_blank" rel="noreferrer noopener">including</a>&nbsp;United Health Services, Auburn Community Hospital and University Hospital in Syracuse, New York.</p>



<p>In Santa Monica, California, Hollywood studio<strong>&nbsp;</strong>Lionsgate<strong>&nbsp;</strong>also&nbsp;<a href="https://www.hollywoodreporter.com/movies/movie-news/hollywood-studio-covid-rates-mask-mandates-back-1235571466/" target="_blank" rel="noreferrer noopener">requested</a>&nbsp;employees wear masks in certain parts of its facilities in response to a rise in cases last month.</p>



<p>A mask mandate is also in effect in&nbsp;<a href="https://sf.gov/information/know-when-masks-are-needed#:~:text=There%20are%20no%20longer%20masking,or%20people%20living%20in%20jails." target="_blank" rel="noreferrer noopener">San Francisco</a>&nbsp;for healthcare workers when around patients, as well as for employees at jails.</p>



<p>Forbes Daily: Get our best stories, exclusive reporting and essential analysis of the day’s news in your inbox every weekday.Sign Up</p>



<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>Officials have been torn on mask mandate policies since the start of the pandemic, while studies have found mandates might not be a guaranteed safeguard from community-wide spread. George Washington University Dr. Leana Wen told&nbsp;<a href="https://www.cnn.com/2023/08/31/health/labor-day-coronavirus-increase-wellness/index.html" target="_blank" rel="noreferrer noopener">CNN</a>&nbsp;this week the decision to mask up also depends on an array of factors, including a person’s age and whether they’re at high risk of contracting the virus—she also said children in schools who are at low risk should not be required to mask up. When asked about Labor Day weekend precautions, Wen added people who didn’t cancel their plans last year probably don’t need to cancel them either, despite cases being on the rise.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>Vaccine boosters from drugmakers Pfizer, Moderna and Novavax are&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=6d037a70438b">expected</a>&nbsp;to be ready for use later this month and widely available in October, though they are still pending Food and Drug Administration approval. Those boosters, unlike their predecessors, target newer coronavirus strains, including the Eris strain and other XBB subvariants, adding to Americans’ arsenal to combat Covid, though only 17% of Americans have received the current bivalent booster shot,&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-booster-percent-pop5" target="_blank" rel="noreferrer noopener">according to</a>&nbsp;the Centers for Disease Control and Prevention.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>15,067. That’s the number of Covid hospitalizations in the U.S. over the week ending August 19, an increase of 18.8% from the week before, according to&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county" target="_blank" rel="noreferrer noopener">CDC data</a>. More than 6.27 million people in the U.S. have been hospitalized since the outbreak of the pandemic more than three years ago.</p>



<h2 class="wp-block-heading" id="h-chief-critic">CHIEF CRITIC</h2>



<p>Despite the rise in cases, Republican lawmakers have slammed Covid mask mandates, with Mississippi Gov. Tate Reeves (R)&nbsp;<a href="https://mailchi.mp/5dd152f9c1de/governor-tate-reeves-mask-mandates?e=ae3824fee2" target="_blank" rel="noreferrer noopener">swearing off</a>&nbsp;potential mask orders, saying, “MIssissippians will not and should not submit to fear again.” In a&nbsp;<a href="https://truthsocial.com/@realDonaldTrump/posts/110979968873429026" target="_blank" rel="noreferrer noopener">video</a>&nbsp;posted on his social media platform Truth Social, former President Donald Trump argued mask mandates amounts to “fear mongering,” calling lawmakers “Covid tyrants,” and vowing: “We will not shut down our schools, we will not accept your lockdowns, we will not abide by your mask mandates and we will not tolerate your vaccine mandate.”</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=6d037a70438b">New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/williamhaseltine/2023/08/25/wastewater-analysis-update-on-ba286-in-the-united-states-its-here-be-careful/?sh=6ab2e5353cc0">Wastewater Analysis Update On BA.2.86 In The United States: It’s Here, Be Careful</a> (Forbes)</p>


Business owner setting up face mask required sign in cafe window

Will Covid Mask Mandates Return? Here’s Where They’re Making A Comeback


<p class="has-drop-cap">According to <em>MedicineNet</em>, at least 10% of the world’s population is affected by chronic pain. Eight out of those 10 patients are affected by depression, and lower back pain is the most common chronic condition, globally. It’s no wonder that pain clinics are popping up everywhere, some of them being called ‘pill mills’, one-stop shops for the medicine that specialists are becoming cautious of prescribing.</p>



<p>“Are they really clinics? My answer is no,” says Dr Marnin Romm, a specialist interdisciplinary pain management clinician and assistant and associate professor based in Boston, United States (US), but born in South Africa.</p>



<p>“A true pain clinic, by definition, is interdisciplinary.”</p>



<p>For Romm, one of the biggest problems with pain management is the commercial side of the business. “It’s ludicrous. Where’s the sustainability of the practitioner?” he asks. “Pain is more complex than just cracking your back, or going to a physiotherapist and feeling okay for a day or two until the pain comes back with a vengeance and you have to go back. That tells me you’re not managing the patient properly, you’re not doing the right treatment and if you keep doing the same thing day in and day out, where’s the ethics?”</p>



<p>Based on his training, clinical experience and work as an academic, Romm believes that pain management is about self-management.</p>



<p>His goal is to help his patients, many of whom have gone down the Dr Google rabbit hole, to stop relying on healthcare providers – including himself.</p>



<p>“It’s for the greater purpose of the good of the patient,” he explains. “I’m not here to fix them. I’m here to guide and navigate in terms of their self-management to different modalities, different tools, and a mixture of different tools, a mix of pharmacology.”</p>



<p>According to Romm, there has been a shift in terms of understanding the physiological and molecular mechanisms underlying chronic pain. Instead of understanding the pathophysiology underlying chronic pain, healthcare providers use pharmacological agents and invasive interventions.</p>



<div class="wp-block-media-text is-stacked-on-mobile" style="grid-template-columns:33% auto"><figure class="wp-block-media-text__media"><img loading="lazy" decoding="async" width="681" height="1024" src="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-681x1024.jpeg" alt="" class="wp-image-59398 size-full" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-681x1024.jpeg 681w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-200x300.jpeg 200w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-768x1154.jpeg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-1022x1536.jpeg 1022w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-1363x2048.jpeg 1363w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-scaled.jpeg 1703w" sizes="(max-width: 681px) 100vw, 681px" /></figure><div class="wp-block-media-text__content">
<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">
<p>“IN MEDICAL SCHOOL, THE AVERAGE AMOUNT OF TIME SPENT TRAINING DOCTORS OR PHYSIOTHERAPISTS (OR ANYONE INVOLVED IN PAIN) OVER THE SPAN OF SEVEN YEARS IS FOUR HOURS… FOUR HOURS. FOR A PANDEMIC. SO, YOU’RE SAYING YOU CAN LEARN EVERYTHING YOU NEED TO KNOW ABOUT PAIN MECHANISM IN FOUR HOURS? THAT’S IMPOSSIBLE.”</p>
<cite><strong>—Dr Marnin Romm</strong></cite></blockquote>
</div></div>



<p>“And it’s not their fault. The reason for this is that in medical school, the average amount of time spent training doctors or physiotherapists (or anyone involved in pain) over the span of seven years is four hours,” he says. “Four hours. For a pandemic. So, you’re saying you can learn everything you need to know about pain mechanism in four hours? That’s impossible.”</p>



<p>Romm, who spent two years in London doing a master’s degree in pain neuroscience, says that the reason healthcare practitioners find it difficult to treat chronic pain is because they’re unable to identify what mechanisms are at play.</p>



<p>“In my assessments, I find out what is going on in the body and then target those mechanisms. Whether the treatment is pharmacological, more invasive, or psychological to reduce stress and anxiety or even exercise-based, but one of the biggest problems in pain management now is that’s still not the case,” adds Romm.</p>



<h4 class="wp-block-heading has-text-align-center" id="h-making-money-off-pain">MAKING MONEY OFF PAIN</h4>



<p>There’s no question that opioids are both oversupplied and overprescribed in high-income countries. Patrick Radden Keefe’s 2021 exposé about Purdue Pharma and the opioid epidemic, <em>Empire of Pain</em>, pinpointed the Sackler family’s marketing strategy to generate billions of dollars – which resulted in millions of addicts.</p>



<p>In sub-Saharan Africa, there has been a sharp increase in treatment admission trends for opioids and opioid-related disorders. A <em>BBC </em>investigative documentary called <em>Sweet Sweet Codeine </em>uncovered corruption at major pharmaceutical companies in Nigeria with staff running drug syndicates to meet the high demands of the black market. A few years after banning cough syrup containing codeine, the National Agency for Food and Drug Administration and Control (NAFDAC) reportedly shut down three pharmaceutical firms. Whether used to combat pain or recreationally, the United Nations (UN) put in a report that west, north and central Africa jointly account for 87% of all pharmaceutical opiates seized globally.</p>



<p>Another problem sub-Saharan Africa faces is the use of fake or substandard medications. Drugs are big business which means counterfeits and poorly-made medication benefits the pharmaceutical company that doesn’t know these products are infiltrating their supply chain and the street vendors who knowingly peddle these drugs.</p>



<p>A report from the UN Office on Drugs and Crime showed that 267,000 deaths in Sahel countries (Burkina Faso, Chad, Mali, Mauritania and the Niger) were linked to fake or below-par antimalarial medication. Just under 170,000 deaths have been linked to falsified antibiotics used to treat severe pneumonia in children. Sahel countries rely on imports of medical products due to their own pharmaceutical industries being in the earlier stages of development.</p>



<p>It is believed the counterfeit drugs are imported from pharmaceutical exporters (like Belgium, France, China and India), and diverted from the legal supply chain, or manufactured in neighboring countries.</p>



<p>An alternative to opioids is cannabidiol, or CBD. Different to tetrahydrocannabinol (THC) which also comes from cannabis plants, CBD is non-intoxicating in its pure form. While regulations around the world differ due to the insufficiency of solid evidence to establish its benefit versus the risks, there are many countries that have approved its use for pain. A <em>Forbes </em>Health survey found that 60% of the adults who use CBD in America do so for its pain relief effects. When it comes to cancer pain, Canada has given the thumbs up for CBD and so has the UK to treat the pain that comes with multiple sclerosis stiffness and spasms. In Lesotho, marijuana has become a cash crop as the small landlocked country grows and exports medical cannabis to Europe. In South African President Cyril Ramaphosa’s State of the Nation Address, he said that the legal hemp and cannabis sector has the potential to create over 130,000 new jobs in the country – the pharmaceutical market has been estimated at over R100 billion ($53 million) a year. </p>



<h3 class="wp-block-heading has-text-align-center" id="h-brain-training-and-tech-to-track-and-treat-pain">BRAIN TRAINING AND TECH TO TRACK AND TREAT PAIN</h3>



<p>There’s more to the business of pain management than drugs, pharmaceuticals and otherwise. Exciting technology such as AI tools to monitor and track pain with big data to non-invasive devices that stimulate nerve fibers are being researched. Telemedicine has also become a big part of chronic pain care as some patients cannot travel to see specialists but still need to consult a doctor.</p>



<p>Another type of technology that’s up-and-coming in the pain space is virtual reality (VR) distraction therapy for pain relief. Dr David Binder, the director of innovation at Spaulding Rehabilitation Hospital in Boston, US, has been studying VR for a number of years. He explains that stimuli can distract the brain from receiving pain signals. In a paper for <em>Harvard Health Publishing</em>, he writes: “We already take advantage of this wiring all the time. For example, if you hit your elbow by accident, and it hurts, you rub the elbow and it feels better. You’re tricking the brain by producing the sensory reaction of touching the elbow, which cancels some pain signals.”</p>



<p>Dr Todd Maddox is part of AppliedVR, a company in Texas in the US that makes prescription VR-based therapeutics for chronic pain management. “One of the ways people learn to deal with chronic pain is with breathing mechanisms – this deals with a part of the brain that learns behavior and the goal is to engage those centers in the brain,” he explains.</p>



<p>Maddox explains chronic pain (and where technology fits in) as something that gets worse over time because the brain gets you into a habit that you cannot break out of. Chronic pain is not only about issues with the tissues as muscles, as one example, usually heal within six to 12 weeks, it’s how your brain processes information.</p>


<div class="wp-block-image">
<figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="576" src="https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1024x576.jpeg" alt="" class="wp-image-59396" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1024x576.jpeg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-300x169.jpeg 300w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-768x432.jpeg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1536x864.jpeg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-2048x1152.jpeg 2048w" sizes="(max-width: 1024px) 100vw, 1024px" /><figcaption class="wp-element-caption"><strong>AppliedVR makes prescription VR-based therapeutics for chronic pain management</strong></figcaption></figure></div>


<p>“So much of how we approach chronic pain is cognitive… but the behavior centers in the brain don’t listen to the cognitive centers very well,” says Maddox. This is why talking to someone and telling them what to do with chronic pain doesn’t always work – someone may do the exercises recommended by a physiotherapist but they also might not.</p>



<p>“Here’s what VR does: it broadly engages the brain. It engages your sensory and perception centers – the parts of the brain that say you’re there. It engages cognitive centers, emotional centers, you get motivated, excited and are poised for behavior change…” The research behind this non-pharmacologic form of chronic relief is exciting but it’s something that depends on good content which costs money to create. There’s also the fact that at this point, VR for pain isn’t covered by insurance unless you’re in a nursing home in America and on a CareWell plan. The alternative to what a company like AppliedVR offers is a patient buying their own VR headset and downloading a meditation app like TRIPP which combines tried- and-tested relaxation techniques with binaural audio – it just won’t be supervised by a specialist and the content won’t be specifically designed around pain relief.</p>



<p>Smartphones have given rise to numerous apps to track pain and others that take a more multidisciplinary approach, pairing users with a health coach who can create customized care plans. </p>



<p>One piece of wearable tech that is making the rounds on social media is Healy, an expensive, palm-sized device which delivers mild electrical currents to the wearer. Robyn Gilbert, a mom of two, discovered Healy from a friend. “I have pain from an autoimmune condition and Healy can mitigate it almost completely,” she says. “It has also improved my sleep, my overall energy levels, and my general sense of emotional wellbeing.” While Gilbert doesn’t feel the current – in fact, it is recommended to keep the stimulation levels low so the user doesn’t feel it – she says she felt a mental shift straight away. “People experience profound changes in many different ways, from the cessation of pain to an overall sense of wellbeing on an emotional and mental level,” she adds. Healy was invented by Marcus Schmieke, founder of the Existential Consciousness Research Institute. It isn’t approved by the FDA but that hasn’t stopped over 300,000 people from buying a device.</p>



<h3 class="wp-block-heading has-text-align-center">‘IT’S ALL IN YOUR… GUT?’</h3>



<p>Chronic pain may be common but it’s complex and the idea that it’s all ‘in your head’ is something not every doctor agrees on.</p>



<p>Dr Sarette Zecharia is a clinical psychologist who works with alternative forms of pain management, including traditional Chinese medicine and Ayurveda, and is on the board of the Association for Comprehensive Energy Psychology. “Medication is a quick fix but the issue is that it’s foreign to the body and you end up taking more medication to cover up the side effects,” she says. “What I recently heard is that for each decade you’re in, you have to be on two medications and if </p>



<p>you’re not, it’s mind-boggling. It’s no longer normal to not be on medication.”</p>



<p><img loading="lazy" decoding="async" width="20" height="20" src="">Zecharia has seen incredible (and less expensive) results with her pain patients by simply managing diet, using food as fuel. “In modern science, it’s very easy to find the one thing that’s the cause of everything – and medicate. Pain is in every single system, the energetic system, the physical system, the mental system, the emotional system, the spiritual system, and it has to be dealt with on all of those levels,” she adds.</p>



<p>New research from the Massachusetts Institute of Technology has shown that there is a connection between the gut and chronic pain because the bacteria living</p>



<p>in our gut can influence some neurological diseases – when the microbiome is disrupted, the communication between the gut and brain is disrupted. There is also research in the <em>Nature </em>science journal which validates that an out-of-balance microbiome can lead to chronic inflammatory disease. “If you think about all these psychotropic medications that people are given, it disrupts the gut and the gut is where you make the majority of your neurotransmitters. That’s where your mood comes from and that’s why food is so important,” she adds.</p>



<p>“Food is not important to people whose mood is regulated, but the moment your mood isn’t regulated, you start to realize the importance of food.”</p>



<p>The connection between pain, food and diet culture is complicated and can be attributed to various factors, including societal pressure, media influence and individual experiences. Living a ‘healthy lifestyle’ comes at a cost and the diet industry globally is worth billions ($282.53 billion by 2028 per <em>GlobeNewswire</em>), profiting off those who struggle with their relationship with food and body image.</p>



<p>While Zecharia does believe food is fuel and has seen regenerative diets work for those in pain, she says making money off pain is easy because you can charge people a fortune and “keep giving them stuff that’s just knocking them more off their center line”.</p>



<p>Where does the spend stop and relief begin? For those dealing with pain, chronic or acute, finding a quick fix can take a dark turn but as the field expands and researchers across different disciplines collaborate, there is hope. Says Zecharia: “I’m not saying don’t take psychotropic medication if you need it. The problem is when someone gets medication from a healthcare provider who doesn’t really know what they have. And if it doesn’t work, you keep upping the dosage, messing up your gut biome…”</p>


Closeup female hand neatly placing medicament at domestic first aid kit top view. Storage organization in transparent plastic box drug, pill, syringe, bandage. Fast health help safety emergency supply

The Business Of Pain Management: Expert-Speak From Africa


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>The degenerative brain disease chronic traumatic encephalopathy, commonly known as CTE, was found in more than 40% of athletes who died before 30, a study out Monday showed, illustrating the growing effects of a disease that has become synonymous with contact sports in recent years.</p>



<h2 class="wp-block-heading">KEY FACTS</h2>



<p>The study,&nbsp;<a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2808952" target="_blank" rel="noreferrer noopener">published</a>&nbsp;in the&nbsp;<em>JAMA Neurology</em>&nbsp;journal, examined 152 donated brains of athletes who were exposed to repetitive head impacts from contact sports and died before 30.</p>



<p>Almost all of the brains examined by researchers at Boston University’s CTE Center showed the earliest stages of CTE, the study&nbsp;<a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2808952" target="_blank" rel="noreferrer noopener">found</a>.</p>



<p>While suicide was the most common cause of death among those studied, researchers could not connect the clinical symptoms of depression with the athletes’ CTE, as nearly 70% of the athletes studied reported depression and apathy and 59% of them did not have CTE, researchers&nbsp;<a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2808952" target="_blank" rel="noreferrer noopener">said</a>.</p>



<p>Of the 152 donors, all of whom died between 2008 and 2022, 63 were diagnosed with CTE at the time of their death.</p>



<p>Most of the brains studied were those of football players, though researchers also examined ice hockey and soccer players’ brains who played at the youth, high school and college levels.</p>



<h2 class="wp-block-heading">SURPRISING FACT</h2>



<p>Researchers discovered the first American woman soccer player, a 28-year-old, to be diagnosed with CTE, in Monday’s study. The finding comes a month after Heather Anderson, a former Australian rules football player, became the first known woman in professional sports to be <a href="https://www.espn.com/afl/story/_/id/37956773/aflw-player-heather-anderson-first-woman-diagnosed-cte" target="_blank" rel="noreferrer noopener">diagnosed</a> with CTE.</p>



<h2 class="wp-block-heading">KEY BACKGROUND</h2>



<p>CTE is a head injury common in contact sports. It is known to cause memory loss, confusion, depression and dementia,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255271/" target="_blank" rel="noreferrer noopener">according to</a>&nbsp;the National Institutes of Health’s National Library of Medicine. Boston University’s CTE Center&nbsp;<a href="https://www.bu.edu/alzresearch/ctecenter/chronic-traumatic-encephalopathy-faqs/#getCTE" target="_blank" rel="noreferrer noopener">noted</a>&nbsp;that “this trauma includes both concussions that cause symptoms and subconcussive hits to the head that cause no symptoms.” For the past 30 years researchers have been looking into the effects of the repeated blows to the head that come with contact sports. And while the disease has been known to affect boxers as far back as the 1920s, it rose to the mainstream in the 2000s, when cases among professional athletes were confirmed. In 2007, the&nbsp;<em>New York Times&nbsp;</em><a href="https://www.nytimes.com/2007/01/18/sports/football/18waters.html" target="_blank" rel="noreferrer noopener">reported</a>&nbsp;that former football player Andre Waters sustained brain damage from his days as a professional athlete, which led to his depression and ultimately his death by suicide. In 2017, researchers&nbsp;<a href="https://edition.cnn.com/2017/11/16/health/cte-confirmed-in-first-living-person-bn/index.html" target="_blank" rel="noreferrer noopener">revealed</a>&nbsp;they discovered the first living person to be accurately diagnosed with CTE—Fred McNeill, a former NFL linebacker who played professional football for 12 seasons before retiring in the 1980s and who died in 2015 at age 63. Before McNeill, CTE was only identifiable through a postmortem brain examination.</p>



<h2 class="wp-block-heading">BIG NUMBER</h2>



<p>6.2 million. That’s how many children in the U.S. suffered traumatic brain injuries from sports equipment from 2000 to 2019,&nbsp;<a href="https://www.forbes.com/sites/brianbushard/2022/07/14/62-million-us-children-suffered-traumatic-brain-injuries-from-sports-equipment-from-2000-to-2019-with-a-higher-increase-among-girls-study-finds/?sh=6840eca22d11">according to</a>&nbsp;a study that came out last year.</p>



<h2 class="wp-block-heading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/brianbushard/2022/07/14/62-million-us-children-suffered-traumatic-brain-injuries-from-sports-equipment-from-2000-to-2019-with-a-higher-increase-among-girls-study-finds/?sh=6840eca22d11">6.2 Million U.S. Children Suffered Traumatic Brain Injuries From Sports Equipment From 2000 To 2019, With A Higher Increase Among Girls, Study Finds</a>&nbsp;(<em>Forbes</em>)</p>


Brain damage and sports injury concept

Researchers Found CTE In 40% Of Athletes Who Died Before Age 30


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>New Covid boosters pending approval will only target the coronavirus’ Eris strain and other XBB subvariants, which make up most cases in the U.S., causing some experts to encourage patients to wait for the new shots instead of getting a current bivalent booster.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>In June, a Food and Drug Administration panel&nbsp;<a href="https://www.fda.gov/media/169591/download?attachment" target="_blank" rel="noreferrer noopener">recommended</a>&nbsp;Pfizer, Moderna and Novavax formulate their new Covid booster shots to be monovalent and only protect against the XBB.1.5 variant and other XBB sublineages—as opposed to the currently available shots, which were designed to combat earlier coronavirus strains.</p>



<p>The companies are still awaiting FDA approval: The new vaccines are estimated to be ready by late September but probably won’t be widely available until October, CBS News&nbsp;<a href="https://www.cbsnews.com/news/covid-vaccine-booster-xbb-variants-september-2023/" target="_blank" rel="noreferrer noopener">reports</a>.</p>



<p>XBB.1.5 (also known as “Kraken”) is a descendent of the omicron variant and was the&nbsp;<a href="https://www.ama-assn.org/delivering-care/public-health/xbb15-omicron-subvariant-questions-patients-may-have" target="_blank" rel="noreferrer noopener">most dominant</a>&nbsp;strain in the U.S. earlier this year, but is now the eighth dominant strain.</p>



<p>The reason the FDA recommended monovalent boosters that protect against one strain is because most of the circulating variants are XBB descendants—as of June, over 95% of the Covid variants in the U.S. were XBB sublineages, the agency said in its report.</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/10/what-we-know-about-eris-covid-variant-eg5-the-dominant-stain-driving-an-uptick-in-cases/?sh=22a519ab1627">EG.5</a>&nbsp;or “Eris” is an XBB subvariant and the dominant strain in the U.S., accounting for 20.6% of all cases in the U.S. between August 6 and 10,&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#variant-proportions" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the Centers for Disease Control and Prevention.</p>



<p>The second most common variant, FL.1.5.1, made up 13.3% of cases in the country within that same time period and is also an XBB subvariant.</p>



<p>On Thursday, Moderna&nbsp;<a href="https://investors.modernatx.com/news/news-details/2023/Moderna-Clinical-Trial-Data-Confirm-Its-Updated-COVID-19-Vaccine-Generates-Robust-Immune-Response-in-Humans-Against-Widely-Circulating-Variants/default.aspx" target="_blank" rel="noreferrer noopener">said</a>&nbsp;its new Covid vaccine generated a “robust immune response” against Eris and other XBB variants.</p>



<p>A&nbsp;<a href="https://www.nature.com/articles/s41591-023-02228-4" target="_blank" rel="noreferrer noopener">report</a>&nbsp;published in&nbsp;<em>Nature Medicine&nbsp;</em>found that although any available booster offers good protection against Covid, variant-specific shots—like the new monovalent XBB ones awaiting approval—offer about 1.6 times more immunity.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>676,728,782. That’s how many vaccines have been administered in the U.S. according to CDC&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-booster-percent-pop5" target="_blank" rel="noreferrer noopener">data</a>. However, only 17% of the population has received an updated bivalent booster.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Some experts believe that since the new vaccines expected to release this fall are specifically aimed at targeting XBB variants, Americans should hold off on getting updated boosters until then. Paul Sax, the clinical director of the division of infectious diseases at Brigham and Women’s Hospital,&nbsp;<a href="https://www.nytimes.com/article/covid-booster-fall.html#:~:text=The%20short%20answer%2C%20according%20to,the%20Omicron%20XBB.1.5%20variant" target="_blank" rel="noreferrer noopener">told</a>&nbsp;the&nbsp;<em>New York Times&nbsp;</em>that “waiting makes more sense” for most people looking to get a new vaccine. The current booster is a bivalent shot designed to protect against omicron subvariants BA.4 and BA.5, which were once the dominant strains in the U.S. but now make up less than&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#variant-proportions" target="_blank" rel="noreferrer noopener">1%</a>&nbsp;of cases combined. A January&nbsp;<a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7205e1.htm?s_cid=mm7205e1_w" target="_blank" rel="noreferrer noopener">study</a>&nbsp;conducted by the CDC found the bivalent vaccines were about 50% effective at protecting against XBB and XBB.1.5 in most adults and about a third effective in those 65 years and older. Raina MacIntyre, head of the biosecurity program at the medical research organization the Kirby Institute,&nbsp;<a href="https://www.smh.com.au/national/nsw/four-fifths-of-australian-adults-have-failed-to-get-a-bivalent-booster-here-s-why-that-is-a-problem-20230814-p5dwb5.html#" target="_blank" rel="noreferrer noopener">told</a>&nbsp;the S<em>ydney Morning Herald</em>&nbsp;the available bivalent boosters “do not provide enough protection against EG.5.1, but the XBB subvariant boosters that are being made by most companies will protect against EG.5.1.” Similarly, University of Michigan infectious disease expert Preeti Malani&nbsp;<a href="https://www.npr.org/sections/goatsandsoda/2023/08/11/1193229029/coronavirus-faq-is-it-wiser-to-get-a-booster-now-or-wait-for-the-new-fall-booste" target="_blank" rel="noreferrer noopener">told NPR</a>&nbsp;the updated booster shots “will provide a better match to the currently circulating variants,” so most patients are better off waiting for it to be approved.</p>



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>The CDC&nbsp;<a href="https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html" target="_blank" rel="noreferrer noopener">still recommends</a>&nbsp;that most people receive at least one bivalent booster shot. The agency&nbsp;<a href="https://www.forbes.com/sites/madelinehalpert/2022/09/01/cdc-advisory-panel-recommends-new-covid-booster-shots-targeting-omicron-heres-what-you-need-to-know/?sh=e92dc701da8c">first signed off</a>&nbsp;on Pfizer and Moderna’s updated boosters almost a year ago.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>A new Covid variant called BA.2.86, or “Pirola,” was&nbsp;<a href="https://twitter.com/WHO/status/1692255671687794902" target="_blank" rel="noreferrer noopener">labeled</a>&nbsp;as a variant under monitoring by the World Health Organization on Thursday due to the “large number of mutations it carries.” That same day, the CDC&nbsp;<a href="https://twitter.com/CDCgov/status/1692326710262304890?s=20" target="_blank" rel="noreferrer noopener">said</a>&nbsp;it was monitoring the variant as it’s been reported in the U.S., Israel and Denmark. It is the descendant of omicron subvariant BA.2, which was the&nbsp;<a href="https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-ba2-omicron-subvariant" target="_blank" rel="noreferrer noopener">dominant strain</a>&nbsp;in the U.S. earlier this year, at one point making up 85% of cases in the country. An&nbsp;<a href="https://slides.com/jbloom/new_2nd_gen_ba2_variant?ftag=YHF4eb9d17#/3" target="_blank" rel="noreferrer noopener">analysis</a>&nbsp;by Jesse Bloom, an evolutionary biologist at Fred Hutch Cancer Center, found the variant had 36 additional spike protein mutations than XBB.1.5 and 34 more mutations than BA.2. The number of mutations BA.2.86 has in comparison to other variants makes it “comparable to [the] number of mutations in [the] first Omicron strains relative to” the original Covid strain, according to Bloom. Although its prevalence in the U.S. isn’t large enough to appear on the CDC’s variant tracker—it’s being lumped in with BA.2 cases—there might be concern that the new monovalent vaccines won’t protect against it because it’s not an XBB variant. However, in a report shared with&nbsp;<em>Forbes,&nbsp;</em>Pfizer-BioNTech said evidence shows their new monovalent boosters should offer some protection against BA.2.86.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/10/what-we-know-about-eris-covid-variant-eg5-the-dominant-stain-driving-an-uptick-in-cases/?sh=22a519ab1627">What We Know About ‘Eris’ Covid Variant EG.5: The Dominant Strain Driving An Uptick In Cases</a>&nbsp;(Forbes)</p>



<p><a href="https://www.nytimes.com/article/covid-booster-fall.html#:~:text=The%20short%20answer%2C%20according%20to,the%20Omicron%20XBB.1.5%20variant" target="_blank" rel="noreferrer noopener">Don’t Get Your Next Covid Booster Quite Yet</a>&nbsp;(New York Times)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/01/26/covid-vaccines-heres-evidence-they-work-despite-persistent-misinformation-along-with-side-effects-and-common-misconceptions/?sh=2d67186147c3">Covid Vaccines: Here’s Evidence They Work—Despite Persistent Misinformation—Along With Side Effects And Common Misconceptions</a> (Forbes)</p>


A healthcare worker administers the Pfizer-BioNTech (

New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Ozempic and Mounjaro manufacturers are being sued over claims that the drugs cause gastroparesis, a severe stomach disorder, but some experts believe this assertion is inaccurate because the drugs only cause a temporary delay in stomach emptying.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Earlier this month, a personal injury law firm filed a&nbsp;<a href="https://www.forthepeople.com/sites/default/files/2023-08/Morgan%20%26%20Morgan%20Ozempic%20Bjorklund%20complaint%208.2.23.pdf" target="_blank" rel="noreferrer noopener">lawsuit</a>&nbsp;against Novo Nordisk—the makers of Ozempic—and Eli Lilly, the makers of Mounjaro, claiming the drugs cause gastroparesis.</p>



<p>The lawsuit also alleges the manufacturers knew of the link between the GLP-1 drugs and “the risk of developing severe gastrointestinal issues, including gastroparesis.”</p>



<p><a href="https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787" target="_blank" rel="noreferrer noopener">Gastroparesis</a>, or stomach paralysis, slows or completely stops the movement of food from the stomach to the small intestine, preventing the stomach from properly emptying—neither drug lists gastroparesis as a potential side effect.</p>



<p>Semaglutide (the generic name for&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2022/12/26/what-to-know-about-ozempic/?sh=2336a35a5adb">Ozempic</a>) and tirzepatide (the generic name for&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/01/31/diabetes-drug-mounjaro-expected-to-be-approved-for-weight-loss-soon-what-to-know-and-how-it-compares-to-similar-drugs/?sh=68aef4ef477a">Mounjaro</a>) are a type of drug known as a GLP-1, and they work by&nbsp;<a href="https://www.uclahealth.org/news/semaglutide-weight-loss-what-you-need-know" target="_blank" rel="noreferrer noopener">interacting</a>&nbsp;with the hunger part of the brain and suppressing the appetite, causing patients to feel full quicker.</p>



<p>In July, CNN released a&nbsp;<a href="https://www.cnn.com/2023/07/25/health/weight-loss-diabetes-drugs-gastroparesis/index.html" target="_blank" rel="noreferrer noopener">report</a>&nbsp;about patients who’ve been diagnosed with severe gastroparesis, and their doctors believe weight loss drug Wegovy (manufactured by Novo Nordisk) and its sister diabetes drug Ozempic may be to blame.</p>



<p>The patients noticed they were vomiting days-old food and doctors noted it was common for people on Ozempic to have stomachs full of food when doing an endoscopy—one patient even had to have a stomach bypass surgery to help relieve the gastroparesis.</p>



<p>The American Society of Anesthesiologists (ASA) put out a&nbsp;<a href="https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/patients-taking-popular-medications-for-diabetes-and-weight-loss-should-stop-before-elective-surgery" target="_blank" rel="noreferrer noopener">warning</a>&nbsp;in June asking patients to stop taking GLP-1 drugs at least a week before elective surgeries due to an increased risk of the drugs causing vomiting during operation.</p>



<p>The ASA has received reports that an “increased risk of regurgitation and aspiration of food into the airways and lungs during general anesthesia and deep sedation” was potentially being caused by the drugs’ ability to “delay” stomach emptying.</p>



<h2 class="wp-block-heading" id="h-chief-critic">CHIEF CRITIC</h2>



<p>A spokesperson for Novo Nordisk&nbsp;<a href="https://thehill.com/policy/healthcare/4134614-ozempic-mounjaro-sued-stomach-paralysis/" target="_blank" rel="noreferrer noopener">told</a>&nbsp;The Hill “patient safety is of utmost importance” to the company and they continuously monitor “the safety profile of our products and collaborate closely with authorities to ensure patient safety, including adequate information on gastrointestinal side effects in the label.” In a similar statement, a spokesperson for Eli Lilly told The Hill patient safety is “top priority,” and it “actively [engages] in monitoring, evaluating and reporting safety information” for their medications.&nbsp;<em>Forbes&nbsp;</em>has reached out to both companies for comment.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Gastroparesis, also called delayed stomach emptying, affects the movement of food even though there isn’t a blockage in the small intestine or stomach,&nbsp;<a href="https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the National Institute of Diabetes and Digestive and Kidney Diseases. It typically takes about&nbsp;<a href="https://www.mayoclinic.org/digestive-system/expert-answers/faq-20058340#:~:text=After%20you%20eat%2C%20it%20takes,move%20through%20the%20entire%20colon." target="_blank" rel="noreferrer noopener">six to eight hours</a>&nbsp;for food to pass from the stomach to the small intestine, though the amount and type of food consumed can affect this. With gastroparesis, the&nbsp;<a href="https://www.medicalnewstoday.com/articles/318753#stomach-emptying" target="_blank" rel="noreferrer noopener">digestion process</a>&nbsp;is extended, and specific times differ from person to person.&nbsp;<a href="https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/symptoms-causes" target="_blank" rel="noreferrer noopener">Symptoms</a>&nbsp;include too much bloating, feeling full after starting a meal, feeling full long after finishing a meal, vomiting, heartburn, pain in the upper abdomen, poor appetite and too much burping. Gastroparesis has many causes, including diabetes, which is the most common cause of gastroparesis, the Centers for Disease Control and Prevention&nbsp;<a href="https://www.cdc.gov/diabetes/library/features/diabetes-digestion.html#:~:text=Nausea%2C%20heartburn%2C%20or%20bloating%20can,common%20known%20cause%20of%20gastroparesis." target="_blank" rel="noreferrer noopener">reports</a>. Though both Ozempic and Mounjaro are used off-label for weight loss, they are only approved by the Food and Drug Administration for use in treating Type 2 diabetes. High blood sugar can lead to gastroparesis. Besides suppressing the appetite, another result of Ozempic’s ability to slow down the digestion process is the lowering of blood sugar,&nbsp;<a href="https://www.ozempic.com/why-ozempic/how-ozempic-works.html" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to Novo Nordisk.</p>



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>Steven Batash, founder of Batash Endoscopic Weight Loss and an expert on nonsurgical weight loss procedures, told&nbsp;<em>Forbes&nbsp;</em>that “to say [Ozempic] causes gastroparesis is not really an accurate statement.” This is because gastroparesis is the “end product” when no food or almost no food moves in the digestive tract. Instead, Batash believes Ozempic causes a delay in gastric emptying. However, this delay only lasts for a short period of time and once the medication’s effects wear off, patients’ “motility will return to [their] baselines,” according to Batash. Ozempic and other GLP-1 drugs are known to&nbsp;<a href="https://www.ozempic.com/faqs.html" target="_blank" rel="noreferrer noopener">cause</a>&nbsp;gastrointestinal issues, like nausea, vomiting and diarrhea. Side effects of Ozempic will be present but will be “mild” in most patients. If these effects are too extreme, Batash recommends either lowering the dosage or stopping usage altogether.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>A&nbsp;<a href="https://pubmed.ncbi.nlm.nih.gov/28958851/" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in the&nbsp;<a href="https://www.thelancet.com/journals/langas/home" target="_blank" rel="noreferrer noopener"><em>Lancet Gastroenterology and Hepatology</em></a><em>&nbsp;</em>examined how liraglutide—another GLP-1 drug—affected digestion. Participants took either liraglutide or a placebo for five weeks and then ate a meal with a radioactive tracer so researchers could see how long the food stayed in their stomachs. It took those taking liraglutide 70 minutes for half their food to leave their stomachs compared to four minutes in the control group, a drastic slow in digestion. In some participants taking liraglutide, it took up to two hours and 30 minutes for half the meal to leave their stomachs. However, this group did see weight loss, and there was a correlation between a bigger delay in stomach emptying and the more weight participants lost.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2022/12/26/what-to-know-about-ozempic/?sh=13edf6c65adb">What To Know About Ozempic: The Diabetes Drug Becomes A Viral Weight Loss Hit (Elon Musk Boasts Using It) Creating A Shortage</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/07/what-is-berberine-supplement-dubbed-natures-ozempic-for-possible-weight-loss-benefits-but-evidence-is-limited/?sh=154e8d5a1068">What Is Berberine? Supplement Dubbed ‘Nature’s Ozempic’ For Possible Weight Loss Benefits—But Evidence Is Limited.</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/01/31/diabetes-drug-mounjaro-expected-to-be-approved-for-weight-loss-soon-what-to-know-and-how-it-compares-to-similar-drugs/?sh=68aef4ef477a">Diabetes Drug Mounjaro Expected To Be Approved For Weight Loss Soon: What To Know And How It Compares To Similar Drugs</a> (Forbes)</p>


Ozempic Manufacturer Sued Over Side Effects Of Medication Used For Weight Loss

What To Know About Gastroparesis: Lawsuit Claims Ozempic And Mounjaro Causes The Severe Stomach Disorder


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>New research found that organs like the heart, liver and kidneys may still be affected by Covid well after the lungs have healed, affirming previous research that long Covid can affect multiple organs.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>A new&nbsp;<a href="https://www.science.org/doi/10.1126/scitranslmed.abq1533" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in&nbsp;<em>Science Translational Medicine&nbsp;</em>on Wednesday reviewed how Covid can negatively affect organs other than the lungs, resulting in long Covid.</p>



<p>Long Covid (also called post-Covid) is lingering symptoms—like loss of smell or taste, chest pain, shortness of breath or brain fog—following recovery from a Covid infection that can last for weeks or even years,&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the Centers for Disease Control and Prevention.</p>



<p>The cause of the issue stems from when the virus’ proteins bind to the genes of the mitochondria, the cells’ energy producer, which can negatively impact the body’s organs, leading to dysfunction.</p>



<p>The study also found that even if mitochondrial gene expression recovered in the lungs, the first organ&nbsp;<a href="https://www.lung.org/lung-health-diseases/lung-disease-lookup/covid-19/about-covid-19" target="_blank" rel="noreferrer noopener">affected</a>&nbsp;by Covid infection, it can still negatively impact other organs, including the heart, liver and kidneys.</p>



<p>Long Covid most commonly affects people who suffered from severe Covid symptoms, people with underlying conditions, the unvaccinated and those who had multisystem inflammatory syndrome—a rare&nbsp;<a href="https://www.cdc.gov/mis/index.html" target="_blank" rel="noreferrer noopener">condition</a>&nbsp;associated with Covid in which body parts like the kidneys and brain become inflamed—during or after Covid, the National Library of Medicine&nbsp;<a href="https://medlineplus.gov/postcovidconditionslongcovid.html" target="_blank" rel="noreferrer noopener">reports</a>.</p>



<p>A study published in February by the American College of Cardiology&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/02/23/long-covid-linked-to-heart-problems-here-are-the-symptoms--and-whos-at-risk/?sh=43b1469c6890">found</a>&nbsp;having long Covid doubled a person’s risk of developing cardiovascular health issues.</p>



<p>A separate&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955527/#:~:text=The%20results%20of%20these%20investigations,in%20long%2DCOVID%2D19." target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in the journal of&nbsp;<em>International Urology and Nephrology&nbsp;</em>found that long Covid may play a part in the development of chronic kidney disease and acute kidney injury.</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>“This study provides us with strong evidence that we need to stop looking at Covid-19 as strictly an upper respiratory disease and start viewing it as a systemic disorder that impacts multiple organs,” Douglas C. Wallace, the study’s coauthor, said in a statement. “The continued dysfunction we observed in organs other than the lungs suggests that mitochondrial dysfunction could be causing long-term damage to the internal organs of these patients.”</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>65 million. That’s how many people worldwide are estimated to suffer from long Covid, according to a&nbsp;<a href="https://www.nature.com/articles/s41579-022-00846-2" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in&nbsp;<em>Nature&nbsp;</em>in February.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>A recent&nbsp;<a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00354-6/fulltext" target="_blank" rel="noreferrer noopener">report</a>&nbsp;published in the&nbsp;<em>Lancet</em>&nbsp;found that Covid vaccines could potentially reduce the risk of developing long Covid, with data suggesting two doses is more effective at protection than one.&nbsp;<a href="https://medlineplus.gov/postcovidconditionslongcovid.html" target="_blank" rel="noreferrer noopener">According</a>&nbsp;to MedlinePlus, a site run by the National Institutes of Health’s National Library of Medicine, post-Covid symptoms may present in one of three ways: Patients may develop new health issues months after a Covid infection; they seem to recover from Covid, but their symptoms come back; or they have symptoms that can linger for a span of days to years. Long Covid&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html" target="_blank" rel="noreferrer noopener">symptoms</a>&nbsp;can include heart palpitations, chest pain, diarrhea, stomach pain, coughing, shortness of breath or neurologic symptoms—like brain fog, headaches or sleep problems. There is not a certain test for long Covid. To diagnose it, a physician will ask about a patient&#8217;s medical history, conduct a physical exam and they may order blood work and imaging tests.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>New&nbsp;<a href="https://www.medrxiv.org/content/10.1101/2023.06.29.23292056v1" target="_blank" rel="noreferrer noopener">research</a>&nbsp;published in&nbsp;<em>medRxiv&nbsp;</em>suggests that genetics may play a role in who develops long Covid. The researchers looked at data from 24 different studies with almost 6,500 participants and found that patients with long Covid were more likely to share DNA around a gene called FOXP4, which is a gene that may be involved in immune responses in the air sacs of the lungs. However, just because a patient has the FOXP4 gene doesn’t guarantee they will develop long Covid. The gene has previously been&nbsp;<a href="https://pubmed.ncbi.nlm.nih.gov/25994569/" target="_blank" rel="noreferrer noopener">found</a>&nbsp;to play a role in tumor growth in lung cancer.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/02/23/long-covid-linked-to-heart-problems-here-are-the-symptoms--and-whos-at-risk/?sh=43b1469c6890">Long Covid Linked To Heart Problems: Here Are The Symptoms – And Who’s At Risk</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/06/15/more-people-got-diabetes-during-the-covid-pandemic-heres-why/?sh=65ea758f31d3">More People Got Diabetes During The Covid Pandemic—Here’s Why</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/05/10/covids-no-longer-a-public-health-emergency-heres-how-that-may-affect-you/?sh=33db5d4d20e3">Covid’s No Longer A Public Health Emergency: Here’s How That May Affect You</a> (Forbes)</p>


TUNISIA-HEALTH-VIRUS-TOURISM-HOSPITAL

Long Covid May Affect Organs Like The Heart And Kidneys After Lungs Recover, New Research Says


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Moderna and BioNTech shares both cratered to their lowest price in years Monday as the companies behind the most widely-circulated mRNA Covid-19 vaccines grapple with investor disappointment with crashing revenues.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>BioNTech and Moderna’s stocks fell 8% and 6%, respectively, a decline spurred by BioNTech’s earnings report revealing the German firm’s sales fell 95% year-over-year last quarter.</p>



<p>Moderna’s fresh decline came after it reported a 93% annual decline in quarterly revenues in its own earnings release Thursday.</p>



<p>Moderna’s $101.20 close Monday was its lowest since November 2020, while BioNTech’s $98.50 close was its lowest since March 2021.</p>



<p>BioNTech, which developed a Covid vaccine with Pfizer, said Monday it expects to generate $5.5 billion in Covid vaccine sales this year, a 70% decline from 2022, while Moderna’s $6 billion to $8 billion in forecasted Covid jab sales is similarly about two-thirds below its $18 billion of revenue in the unit last year.</p>



<p>The stock crashes moved against broader market gains, with the Dow Jones Industrial Average’s 408-point, or 1.2%, rally its strongest since June 2.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Shares of Moderna are down 78% from their September 2021 high of $456, making the Massachusetts-based pharmaceutical company the worst-performing stock listed on the S&amp;P 500 during the period, according to FactSet data. BioNTech, which isn’t listed on the S&amp;P, is also down 78% from its 2021 peak share price. Moderna and Pfizer are among the worst-performing stocks listed on the S&amp;P this year as the rival firms both grappled with&nbsp;<a href="https://www.forbes.com/sites/dereksaul/2023/01/31/pfizer-expects-covid-vaccine-and-pill-revenues-will-fall-60-in-2023/?sh=182d46027bee">declining demand</a>&nbsp;for Covid prevention and treatment.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>About $340 billion. That’s how much market capitalization BioNTech (down $85 billion) and Moderna (down $157 billion) have lost over the last two years.</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>Until BioNTech gets “the COVID guidance monkey off its back, this will remain purgatory for most investors,” Jefferies analysts led by Akash Tewari wrote in a Monday note to clients.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/dereksaul/2023/07/03/worst-stocks-of-2023s-first-half-battered-banks-and-vaccine-makers/" target="_blank" rel="noreferrer noopener">MORE FROM FORBES<strong>Worst Stocks Of 2023&#8217;s First Half: Battered Banks And Vaccine Makers</strong><small>By <strong>Derek Saul</strong></small></a></p>


In this photo illustration the medical syringe is seen with

Covid Vaccine Makers’ Stocks Crash To Multiyear Lows Monday As Sales Keep Sliding


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Pfizer CEO Albert Bourla said during an investor call Tuesday the Food and Drug Administration could authorize the company’s new Covid-19 booster shot by the end of the month—moving closer to a system of regular flu-like vaccinations that keep up with the coronavirus as it evolves and as people’s immunity wanes.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>In June, Pfizer, along with its German partner BioNTech,&nbsp;<a href="https://www.pfizer.com/news/announcements/pfizer-and-biontech-submit-applications-us-fda-omicron-xbb15-adapted-monovalent" target="_blank" rel="noreferrer noopener">asked the FDA</a>&nbsp;to approve a new version of its Covid-19 vaccine booster designed to protect against XBB.1.5, a coronavirus subvariant that emerged in late 2022.</p>



<p>XBB.1.5 is no longer the dominant strain, having been usurped by XBB.1.6, according to the Centers for Disease Control and Prevention, but experts say the two are similar enough that a new booster should protect against both (XBB.1.5 represented 12.3% of all new cases in late July while XBB.1.6 represented 14.8%, according to&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#variant-summary" target="_blank" rel="noreferrer noopener">CDC data</a>).</p>



<p>Bourla said he and his colleagues expect “a new Covid wave to start in the U.S. this fall” and want the new version of the vaccine to be available prior to that.</p>



<p>However, with only 17% of the U.S. population having received a fall 2022 booster shot that was updated for the Omicron variant, according to&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-booster-percent-pop5" target="_blank" rel="noreferrer noopener">the CDC</a>, it’s unclear how many Americans will choose to adopt the latest booster.</p>



<h2 class="wp-block-heading" id="h-what-we-don-t-know">WHAT WE DON’T KNOW</h2>



<p>The CDC will ultimately recommend who should receive the updated boosters, but that announcement likely won’t come until after the FDA authorizes them. The most recent boosters released in fall 2022 were eventually recommended by the CDC for everyone above the age of six.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>The first Covid-19 vaccine booster shots, authorized by the FDA in fall 2021, were meant to help replenish waning immunity to the virus. However, after the coronavirus’ Omicron variant launched a new vicious wave of the pandemic last year, drugmakers released a modified “bivalent” booster shot in fall 2022 that was designed to protect against both the original virus strain as well as Omicron, which was more resistant to the original vaccines. This new booster is attempting to do what that bivalent booster did with Omicron, but with an update for the XBB strains. The news comes as 8,035 people were hospitalized for Covid-19 in the week ended July 22, according to the most recent&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county" target="_blank" rel="noreferrer noopener">CDC data</a>&nbsp;available. That’s a 12.1% increase over the week before, but a far cry from the peak in January 2022, when there were around 150,000 hospitalizations a week.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>This new booster falls in line with doctors’ long held predictions that the Covid-19 vaccines would likely need to become similar to the influenza vaccine, where a new iteration is released annually to update the formulation to new strains of the virus. Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases and the leader of the federal government’s response to the pandemic, said at a White House briefing in September 2022: “We likely are moving towards a path with a vaccination cadence similar to that of the annual influenza vaccine, with annual updated Covid-19 shots matched to the currently circulating strains for most of the population.”</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/willskipworth/2023/07/31/nih-opens-clinical-trials-for-long-covid-treatment/?sh=27c710007331">NIH Opens Clinical Trials For Long Covid Treatment</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2023/06/01/fda-approves-pfizers-rsv-vaccine-for-older-adults-it-could-be-available-this-fall/?sh=742adb6435ca">FDA Approves Pfizer’s RSV Vaccine For Older Adults—It Could Be Available This Fall</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2023/05/18/rsv-vaccine-fda-advisors-recommend-pfizer-shot-to-protect-infants-from-infection-heres-what-to-know/?sh=55dc2bf33859">RSV Vaccine: FDA Advisors Recommend Pfizer Shot To Protect Infants From Infection—Here’s What To Know</a> (Forbes)</p>


Coronavirus Vaccination In Gaza, Palestine

Pfizer Expects Signoff For New Covid Boosters As Soon As This Month. Here’s What To Know—And Why They’re Needed


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>The National Institutes of Health is launching a second phase of clinical trials for treatments of long Covid, the&nbsp;<a href="https://www.nih.gov/news-events/news-releases/nih-launches-long-covid-clinical-trials-through-recover-initiative-opening-enrollment" target="_blank" rel="noreferrer noopener">agency announced</a>&nbsp;Monday—the latest step in addressing the poorly understood long-term impacts of Covid-19.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>The NIH is&nbsp;<a href="http://www.trials.recovercovid.org/" target="_blank" rel="noreferrer noopener">seeking people</a>&nbsp;who are experiencing long Covid symptoms to participate in one of four trials as part of its Researching Covid to Enhance Recovery, or RECOVER, initiative.</p>



<p>The first trial—dubbed “RECOVER-VITAL”—will seek to study how Covid-19’s long-term effect on patients’ immune system can be treated.</p>



<p>The second—RECOVER-NEURO—will attempt to find interventions to the neurological impacts of long Covid like brain fog, memory issues and difficulty paying attention, problem solving or critical thinking.</p>



<p>The third—RECOVER-SLEEP—will try to find treatments for sleep-related issues, and the final trial—RECOVER-AUTONOMIC—will study treatments for Covid-19-induced problems in the autonomic nervous system, which controls a range of bodily functions including heart rate, breathing and digestive system activity.</p>



<p>Additionally, the NIH is working on a fifth trial that it hopes can find a treatment for the long-term impacts Covid-19 has had on some people’s ability to exercise, but that trial is still in the works.</p>



<p>These trials will involve a number of medicines and therapies including Pfizer’s drug Paxlovid, which was initially developed to treat Covid-19 immediately after a positive test, and a web-based brain training program called BrainHQ the NIH hopes will help people regain neurological function.</p>



<p>Forbes Daily: Get our best stories, exclusive reporting and essential analysis of the day’s news in your inbox every weekday.Sign Up</p>



<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<h2 class="wp-block-heading" id="h-what-to-watch-for">WHAT TO WATCH FOR</h2>



<p>More trials in the future. In addition to the in-development exercise trial, the NIH said it expects to launch at least six more trials in the coming months. These trials will enroll participants on a rolling basis, the NIH said.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>$1.15 billion. That’s how much the NIH is spending on its RECOVER initiative, making it the largest program in the world aimed at understanding, treating and preventing long Covid.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Long Covid occurs when patients continue experiencing symptoms and after-effects of Covid-19 months after the virus has left their body. Those include brain fog, difficulty exercising and other issues.&nbsp;<a href="http://www.kff.org/policy-watch/long-covid-what-do-latest-data-show/" target="_blank" rel="noreferrer noopener">A study</a>&nbsp;from the Kaiser Family Foundation found that 15% of all U.S. adults have at some point experienced long Covid symptoms and in January, when the study was being conducted, 6% were currently experiencing symptoms. It was&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539940/" target="_blank" rel="noreferrer noopener">first identified</a>&nbsp;around spring 2020 by online groups of patients who were initially ignored by the larger medical community, but later gained acceptance. Doctors still know very little about long Covid, but these clinical trials mark the most significant attempt to treat these symptoms.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/02/23/long-covid-linked-to-heart-problems-here-are-the-symptoms--and-whos-at-risk/?sh=538b0a246890">Long Covid Linked To Heart Problems: Here Are The Symptoms – And Who’s At Risk</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/alexknapp/2023/06/14/innovationrx-scientists-may-have-figured-out-whats-behind-long-covid/?sh=919c89c602b2">InnovationRx: Scientists May Have Figured Out What’s Behind Long Covid</a> (Forbes)</p>


Researcher working in a biochemist laboratory

NIH Opens Clinical Trials For Long Covid Treatment


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>The Food and Drug Administration <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-prevent-rsv-babies-and-toddlers" target="_blank" rel="noreferrer noopener">approved</a> the monoclonal antibody treatment Beyfortus to prevent respiratory syncytial virus—the leading cause of hospitalizations in U.S. infants less than a year old.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>The drug—made by AstraZeneca—will be administered as a single injection to infants prior to RSV season in the latter months of the year.</p>



<p>Beyfortus is a monoclonal antibody, meaning it provides proteins that imitate the immune system’s function to combat viruses like RSV.</p>



<p>Around 2% of children less than a year old are hospitalized by RSV every year, according to the American Academy of Pediatrics.</p>



<p>The FDA listed rash and injection site reactions as possible side effects of Beyfortus.</p>



<p>The drug received a&nbsp;<a href="https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/fast-track" target="_blank" rel="noreferrer noopener">fast track</a>&nbsp;designation—a process meant to accelerate the review process of drugs that “fill an unmet medical need,” according to the FDA.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p><a href="https://www.lung.org/lung-health-diseases/lung-disease-lookup/rsv/symptoms-diagnosis#:~:text=Initial%20signs%20of%20RSV%20are,own%20in%20a%20few%20days." target="_blank" rel="noreferrer noopener">RSV symptoms</a>&nbsp;include fever, cough, wheezing and sore throat. Most infections go away on their own but infants are prone to becoming irritable or fatigued, or developing breathing difficulties. The 2022 to 2023 season was particularly challenging: Some 50.9 people were hospitalized per 100,000,&nbsp;<a href="https://www.cdc.gov/rsv/research/rsv-net/dashboard.html" target="_blank" rel="noreferrer noopener">according to the CDC</a>—a number mostly composed of children four years old or younger. The season’s peak hospitalization rate was two to four times higher than the peaks of recent years. Beyfortus will be the second RSV-focused antibody meant to protect children, joining the company of Synagis—a treatment given to vulnerable infants born prematurely. However, Synagis, approved by the FDA in 1998, only lasts about a month compared to the approximately five months that Beyfortus lasts. French pharmaceutical company Sanofi will be in charge of marketing Beyfortus.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p><a href="https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-prevent-rsv-babies-and-toddlers" target="_blank" rel="noreferrer noopener">Around 2%</a>&nbsp;of children less than a year old are hospitalized by RSV every year, according to the American Academy of Pediatrics.</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>“Today’s approval marks an unprecedented moment for protecting infant health in the U.S., following an RSV season that took a record toll on infants, their families, and the U.S. healthcare system,” Thomas Triomph, Sanofi’s executive vice president of vaccines, said in a statement.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/04/06/first-fda-approved-rsv-vaccines-expected-later-this-year-the-top-vaccines-and-their-effectiveness/?sh=5db0e1f95f81">Several vaccines</a>&nbsp;for the treatment of RSV are in development, some of which focus on the elderly, another group of people at greater risk for complications. For example, Moderna is developing a vaccine for RSV that is similar to its messenger RNA Covid shot. In January, the biotech giant shared findings from a trial that revealed the vaccine was&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/04/06/first-fda-approved-rsv-vaccines-expected-later-this-year-the-top-vaccines-and-their-effectiveness/?sh=5db0e1f95f81">83.7% effective</a>&nbsp;at protecting against RSV-related lower respiratory tract infection.</p>



<h2 class="wp-block-heading" id="h-what-to-watch-for">WHAT TO WATCH FOR</h2>



<p>Regulatory applications for Beyfortus are currently under review in China, Japan and many other countries, according to Sanofi.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-prevent-rsv-babies-and-toddlers" target="_blank" rel="noreferrer noopener">FDA Approves New Drug to Prevent RSV in Babies and Toddlers</a>&nbsp;(FDA)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/04/06/first-fda-approved-rsv-vaccines-expected-later-this-year-the-top-vaccines-and-their-effectiveness/?sh=5db0e1f95f81">First FDA-Approved RSV Vaccines Expected Later This Year: The Top Vaccines And Their Effectiveness</a>&nbsp;(<em>Forbes</em>)</p>



<p><a href="https://www.cnn.com/2023/07/17/health/rsv-antibody-nirsevimab" target="_blank" rel="noreferrer noopener">FDA approves antibody to protect infants from RSV</a>&nbsp;(CNN)</p>


Intensive care unit of the pediatric clinic at St. Joseph Hospital

FDA Approves Antibody For RSV After Challenging 2022 Season


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Johnson &amp; Johnson is allowing Stop TB Partnership, a Switzerland-based nonprofit, to distribute a generic version of its tuberculosis drug SIRTURO, or bedaquiline, in low- and middle-income countries, a move that averts fears the drug will stay out of reach financially for many communities around the world.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Under an agreement announced Thursday, the nonprofit Global Drug Facility, an arm of Stop TB Partnership, will be able to tender, procure and supply generic versions of bedaquiline for most low- and middle-income countries, including countries where Johnson &amp; Johnson’s patents remain in effect.</p>



<p>This will allow the drug to be offered at much lower prices, expanding the amount of people who can afford it.</p>



<p>Brenda Waning, chief of Global Drug Facility, said in an interview with&nbsp;<em>Forbes</em>&nbsp;this gives them the ability to sell generic versions of the drug in 44 countries—-including Mozambique, the Philippines and Zambia—-where, because of the patent, they wouldn’t otherwise be able to.</p>



<p>That’s in addition to 52 countries where they can already sell as Johnson &amp; Johnson’s patents expired there.</p>



<p>Waning said her and her colleagues have already coordinated with two Indian manufacturers, Lupin and Macleods, to produce the drug, and the organization will soon be accepting bids and selecting a primary and secondary manufacturer, adding that “everything is already in place.”</p>



<p>However, Johnson &amp; Johnson previously established&nbsp;<a href="https://pharmstd.com/archivedetails_64_2747.html" target="_blank" rel="noreferrer noopener">an exclusive agreement</a>&nbsp;with Russian pharmaceutical company Pharmstandard in many countries, particularly in eastern Europe and Asia, meaning Stop TB Partnership won’t be able to offer the generic in those countries, but Waning said the company gave them access to “every low- and middle-income country they could.”</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>“In my knowledge, I can’t recall a similar deal to this,” Waning said, adding she hopes the deal will “set a model” for future arrangements.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Tuberculosis kills 1.5 million people every year, according to&nbsp;<a href="https://www.who.int/health-topics/tuberculosis#tab=tab_1" target="_blank" rel="noreferrer noopener">the World Health Organization</a>. That makes it the world’s deadliest infectious disease and the 13th-leading cause of death globally. This is despite the fact that the disease is curable. Bedaquiline, which was first produced by Johnson &amp; Johnson with the&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500616/" target="_blank" rel="noreferrer noopener">help of hundreds of millions of dollars</a>&nbsp;from the U.S. government, was approved by the Food and Drug administration in 2012, and soon was distributed globally. As of 2023, Johnson &amp; Johnson still holds a patent on bedaquiline in many countries, preventing cheaper generic versions of the drug that many might be able to afford from entering the market (Johnson &amp; Johnson charges $272 for the total six-month course needed to treat tuberculosis, but&nbsp;<a href="https://academic.oup.com/jac/article/72/4/1243/2884272" target="_blank" rel="noreferrer noopener">one study</a>&nbsp;published in 2017 estimated that if generics entered the market, the price would fall to somewhere between $48-$102). Johnson &amp; Johnson’s patent was set to expire July 18, but due to some legal maneuvering known as “evergreening,” where the company filed for a secondary patent, the company will maintain its exclusive right to sell the drug in many countries. This created fears, including from organizations like&nbsp;<a href="https://www.msfaccess.org/msf-demands-jj-give-its-patent-monopoly-tb-drug-put-lives-over-profits" target="_blank" rel="noreferrer noopener">Doctors Without Borders</a>, that Johnson &amp; Johnson would keep the price of the drug too high for many low- and middle-income countries to afford, leading to unnecessary deaths from the disease. This deal averts some of those fears.</p>



<p>Forbes Daily: Get our best stories, exclusive reporting and essential analysis of the day’s news in your inbox every weekday.Sign Up</p>



<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>The deal comes amid a pressure campaign from novelist and social media figure John Green, who had been publicly calling on Johnson &amp; Johnson to make the drug available as a generic prior to this deal’s announcement. In&nbsp;<a href="https://www.youtube.com/watch?v=tMhgw5SW0h4&amp;t=4s" target="_blank" rel="noreferrer noopener">a scathing YouTube video</a>&nbsp;entitled “Barely Contained Rage: An Open Letter to Johnson &amp; Johnson” that received nearly 1 million views, Green called Johnson &amp; Johnson’s decision to extend its patent through evergreening “reprehensible and completely out of line with their credo” and encouraged his viewers to contact the company with their concerns. His followers also got #PatientsNotPatents briefly trending on Twitter. However, Green’s anger turned to elation when the deal was announced, telling&nbsp;<em>Forbes&nbsp;</em>in a statement: &#8220;I am grateful to the Stop TB Partnership, TB activists everywhere, and to Johnson &amp; Johnson for living up to their corporate credo. They really are putting patients first with this decision, and should be commended for it.&#8221;</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/roberthart/2023/03/06/breakthrough-for-tuberculosis-one-of-the-worlds-biggest-killers-as-new-vaccine-shows-promise-in-early-trials/?sh=90943f293f38">Breakthrough For Tuberculosis—One Of The World’s Biggest Killers—As New Vaccine Shows Promise In Early Trials</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2021/10/14/tuberculosis-deaths-are-rising-again-as-covid-pandemic-unravels-years-of-progress/?sh=3ca1d32f1ed3">Tuberculosis Deaths Are Rising Again As Covid Pandemic Unravels Years Of Progress</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/russellflannery/2023/06/15/gates-foundation-to-donate-50-million-partner-with-beijing-and-tsinghua-to-fight-infectious-disease/?sh=54e336f54465">Gates Foundation To Donate $50 Million, Partner With Beijing And Tsinghua To Fight Infectious Disease</a> (Forbes)</p>


In this photo illustration a close up of a hand holding a

Johnson & Johnson Letting Nonprofit Distribute Life-Saving Generic Tuberculosis Drug—Greatly Expanding Access In Poorer Countries


<p><strong>South Africa&#8217;s National Health Insurance bill aims to bridge the gap between private and public healthcare sectors. However, concerns about impact on private medical aid coverage and potential for reduced innovation and employment within the healthcare sector have sparked confusion around its implementation.</strong></p>



<p>South Africa stands on the brink of a significant transformation in its healthcare sector with the passing of the National Health Insurance (NHI) bill on June 14, surpassing the first legal obstacle to implementation. The legislation aims to bridge the gap between the private and public healthcare sectors, promising to bring equity to a system that has long been divided.</p>



<p>However, the bill has not been without its detractors, who express concerns about potential government inefficiency, the impact on private medical aid coverage, and the potential for reduced innovation and employment within the healthcare sector.</p>



<p>“Technically, I don’t think it’s feasible,” says Professor Alex Van den Heever, an expert on healthcare governance at the University of the Witwatersrand in Johannesburg, to FORBES AFRICA. “The aim is to ensure that somehow that both the public and private services are of an equivalent standard of care… and that is beyond the capacity of this government at this point in time.”</p>



<p>The South African healthcare system has been grappling with a stark divide for decades. Public healthcare infrastructure has been marred reportedly by poor service delivery and corruption, as evidenced by challenges in Tembisa Hospital procurement, the closing of Charlotte Maxeke Academic Hospital, and continued staffing and supply issues at Chris Hani Baragwanath Academic Hospital, to name a few.</p>



<p>In contrast, private medical aid services have filled this gap, collaborating with private hospitals to provide world-class medical care, albeit at exorbitant rates. The cost of private healthcare has become a significant burden on the South African economy, with the average South African medical aid subscriber paying over $100 per month in a country where the average person earning minimum wage makes around $400 per month.</p>



<p>The NHI, first announced as part of the ANC ruling party’s national conference in 2007 and later introduced to Parliament in 2019, passed earlier this year. The legislation seeks to address the disparities between public and private health, envisioning a state-run medical insurance scheme that leverages both public and private facilities and resources, thereby ensuring that individuals seeking healthcare have access to the same facilities and benefits as those enrolled in private medical schemes.</p>



<p>“The issue we have with the current proposal of the NHI… is Section 33 of the bill, which states that once the NHI is fully implemented, medical schemes would no longer be allowed to provide any cover that is provided by the NHI,” said Discovery Health CEO Ryan Noach in an interview with BizNews last week.</p>



<p>Discovery Health accounts for 40% of South Africans with medical insurance. “It’s not because we have an aversion to government business, but rather because we believe their chosen contracting model doesn’t align with our fully integrated approach to administration and managed care services.”</p>



<p>The bill has raised several concerns among critics and private sector medical providers.</p>



<p>Further critiques include the vague wording of the bill itself, with little clarity as to the &#8220;basic healthcare services&#8221; to be rendered, and how it will be funded as per &#8220;mandatory prepayment&#8221;, neither of which are officially defined.</p>



<p>However, a government factsheet recently surfaced indicating that funding for the NHI might be sourced from a mandatory private income tax as well as payroll tax, without specifying what taxation rates might be levied. The 2015 whitepaper on the NHI provides possible indicative tax rates of payroll and personal income, ranging from 1% to 4% for payroll and a surcharge on taxable income across different scenarios over the next five years.</p>



<p>Van den Heever drives home the challenges of this method of financing for the NHI, stating that the 2015 whitepaper is threadbare and lacks crucial financial analysis. Moreover, payroll taxes and income surcharges are likely to place a further burden on an already strained tax base, the middle class – not high-income tax earners, who primarily earn through dividends and other instruments. “Tax dymanics come in to play,” says Van den Heever. “When you overburden your tax base and you increase tax rates too high, you actually get less revenue.”</p>



<p>Healthcare in South Africa is in need of improvement – the country currently spends around 8.5% of its Gross Domestic Product on healthcare, with the lion&#8217;s share of this funding going to private medical insurance–while such insurance services less than 20% of the population according to recent Council for Medical Schemes Data. This trend runs counter to global movements towards universal care and mirrors circumstances in countries such as the United States, where healthcare has become a prohibitive expense.</p>



<p>The NHI aims to correct this imbalance, aligning with the country&#8217;s commitment to Universal Health Care as part of the 2030 National Development Plan. However, experts such as Van den Heever do not believe that the NHI is the place to begin. “Nothing in the NHI proposals is going to change what’s going on… what the government wants to do is raise taxes and allocate that into the system, while they’ve done nothing about corruption.”</p>



<p>The South African government’s position remains firmly committed to the NHI’s implementation; “Government considers the passing of the NHI Bill by the National Assembly as a key milestone to ensure all the people of South Africa have access to the same clinic or hospital,” said Minister of Health Joe Phaahla in a recent press release.</p>



<p>However, there is as yet little clarity as to how this implementation will occur.</p>



<p>With historical inequality deeply ingrained in healthcare along economic and racial lines, it’s no question that the issue of health services in the country needs redress, as per rights declared in the country’s constitution. However, with a lack of clarity in law, the future of the bill once it becomes practice remains uncertain.</p>


Cholera Outbreak In Hammanskraal

A Step Towards Equitable Healthcare In South Africa But Concerns Around Implementation


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Novo Nordisk, Eli Lilly and Pfizer have all entered the race for FDA approval of a first-in-class oral weight loss and diabetes drug, and because pills are cheaper to manufacture, these oral weight loss drugs may signal a more affordable (and easier) alternative to drugs—like Ozempic, Wegovy and Mounjaro—that require injections.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Known generically as semaglutide,&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2022/12/26/what-to-know-about-ozempic/?sh=792660675adb">Ozempic</a>&nbsp;and Wegovy—both manufactured by Novo Nordisk—are weekly injections and glucagon-like peptide-1 (GLP-1) receptor agonists (a class of drugs used to treat diabetes).</p>



<p>Wegovy was&nbsp;<a href="https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014" target="_blank" rel="noreferrer noopener">approved</a>&nbsp;by the Food and Drug Administration for weight loss in 2021 and while Ozempic is only FDA&nbsp;<a href="https://www.fda.gov/media/110526/download" target="_blank" rel="noreferrer noopener">approved</a>&nbsp;for use in type two diabetics, doctors regularly prescribe it off-label for weight management.</p>



<p>The popularity of both medications caused a&nbsp;<a href="https://www.accessdata.fda.gov/scripts/drugshortages/dsp_SearchResults.cfm" target="_blank" rel="noreferrer noopener">supply shortage</a>, with Novo Nordisk&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/05/05/wegovy-shortage-drug-maker-limits-distribution-heres-when-supplies-should-improve/?sh=2eaa52ab1fa4">limiting</a>&nbsp;Wegovy’s distribution of lower doses earlier this month to combat supply problems.</p>



<p>Manufactured by Eli Lilly,&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/01/31/diabetes-drug-mounjaro-expected-to-be-approved-for-weight-loss-soon-what-to-know-and-how-it-compares-to-similar-drugs/?sh=12d6194a477a">Mounjaro</a>&nbsp;(known generically as tirzepatide) is a weekly injection and also a GLP-1 receptor agonist, which works by controlling blood sugar—it was&nbsp;<a href="https://www.fda.gov/news-events/press-announcements/fda-approves-novel-dual-targeted-treatment-type-2-diabetes" target="_blank" rel="noreferrer noopener">approved</a>&nbsp;for use in type two diabetics by the FDA in May 2022, though it’s also used off-label for weight loss.</p>



<p>The heightened popularity of weight loss medications has caused an increase in investor interest in the weight loss treatment market, which is&nbsp;<a href="https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-rivals-see-room-compete-100-bln-weight-loss-drug-market-2023-05-04/" target="_blank" rel="noreferrer noopener">estimated</a>&nbsp;to reach $100 billion by the end of the decade.</p>



<h2 class="wp-block-heading" id="h-news-peg">NEWS PEG</h2>



<p>On Sunday, Novo Nordisk presented findings from a new phase three trial that focused on oral semaglutide tablets. The&nbsp;<a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01185-6/fulltext" target="_blank" rel="noreferrer noopener">study</a>, published in the&nbsp;<em>Lancet,</em>&nbsp;lasted 68 weeks and followed 667 participants. 85% of the participants who took the semaglutide tablet lost at least 5% of their body weight compared to just 26% of those who took the placebo. On average, participants who took semaglutide saw a loss of about 15% of their body weight, around six times more than the placebo.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>69.9%. That’s how many Americans are either obese or overweight,&nbsp;<a href="https://www.hsph.harvard.edu/obesity-prevention-source/obesity-trends-original/obesity-rates-worldwide/" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to&nbsp;<a href="https://www.hsph.harvard.edu/obesity-prevention-source/obesity-trends-original/obesity-rates-worldwide/" target="_blank" rel="noreferrer noopener">data</a>&nbsp;from the Harvard School of Public Health.</p>



<h2 class="wp-block-heading" id="h-rybelsus">RYBELSUS</h2>



<p>Rybelsus is manufactured by Novo Nordisk (which also makes Ozempic) and is a once-daily oral version of semaglutide. The drug was FDA&nbsp;<a href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-glp-1-treatment-type-2-diabetes" target="_blank" rel="noreferrer noopener">approved</a>&nbsp;in 2019 for type two diabetes management and became the first GLP-1 receptor drug to gain approval for type two diabetics. In a late-stage&nbsp;<a href="https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=166110" target="_blank" rel="noreferrer noopener">study</a>&nbsp;released Monday, the manufacturer released the results from a 68-week trial with 667 adults who are either obese or overweight with one or more comorbidity. On average, participants lost 15.1% of their body weight after 68 weeks compared to 2.4% of body weight from those on the placebo. The results are similar to those from a Wegovy&nbsp;<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in&nbsp;<em>The New England Journal of Medicine.&nbsp;</em>In that trial, participants saw an average change of body weight of 14.9% compared to a 2.4% change in the placebo group over a span of 68 weeks. The Rybelsus study, which has not been published in a peer-reviewed journal, acknowledged the side effects were comparable to the semaglutide injections, with mainly mild to moderate gastrointestinal adverse events (like nausea or diarrhea) being the most common side effect. These adverse events mainly occurred when the dosage was increased. Novo Nordisk plans to “file for regulatory approval in the US and the EU” this year with availability depending on manufacturing capacity and how it prioritizes its medications. Martin Holst Lange, executive vice president for development at Novo Nordisk said in the study the ability for consumers to pick between a once daily oral pill and weekly injection for obesity “has the potential to offer patients and healthcare providers the opportunity to choose what best suits individual treatment preferences.”</p>



<h2 class="wp-block-heading" id="h-danuglipron">DANUGLIPRON</h2>



<p>Pfizer published a&nbsp;<a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805054" target="_blank" rel="noreferrer noopener">study</a>&nbsp;in&nbsp;<em>JAMA Network Open&nbsp;</em>on the effects of the drug danuglipron in type two diabetics. Similar to rybelsus, the drug is an oral GLP-1 receptor, but it’s taken twice daily as a pill. The trial included 422 people with type two diabetes and found danuglipron not only lowered blood sugar and hemoglobin A1C at all doses, but it also reduced body weight at the highest dosage. Participants on the 80 milligram pill saw weight loss of 4.5 pounds and those on the 120 milligram pill experienced weight loss of 9.2 pounds by the 16 week mark. The pill was administered to participants once in the morning and once in the evening, both times with food. The most common side effects were nausea, vomiting and diarrhea. Pfizer’s CEO Albert Bourla also explained the importance of an oral obesity pill at J. P. Morgan’s Health Conference,&nbsp;<a href="https://www.fiercepharma.com/marketing/pfizer-ceo-talks-experimental-oral-glp-1-diabetesobesity-hopeful-90b-lilly-novo-battle" target="_blank" rel="noreferrer noopener">saying</a>&nbsp;it’s “significantly more important…in the obese market than it is in the diabetic population.” Pfizer is also testing another oral medication called lotiglipron (though data isn’t available yet), but the company plans to choose only one of the drugs to advance into late-stage clinical trials in both diabetes and obesity, slated to begin in 2024, Barron’s&nbsp;<a href="https://www.barrons.com/articles/eli-lilly-novo-pfizer-stock-weight-loss-pills-dd516c95" target="_blank" rel="noreferrer noopener">reports</a>.</p>



<h2 class="wp-block-heading" id="h-orforglipron">ORFORGLIPRON</h2>



<p>Eli Lilly (the manufacturer of Mounjaro), has its own oral GLP-1 drug, orforglipron, that&nbsp;<a href="https://investor.lilly.com/static-files/c0604a2b-5e58-4f00-bb77-d25da59d991e" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to Eli Lilly, shows people without type two diabetes seeing weight reduction between 14% and 15% over the course of 36 weeks, whereas those with type two diabetes saw weight loss of about 9.6% over the same time frame. Orforglipron is in two trials slated to end in 2025,&nbsp;<a href="https://clinicaltrials.gov/ct2/show/NCT05803421" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to information posted on the U.S. National Library of Medicine’s Clinical Trials website. Evaluate Vantage&nbsp;<a href="https://www.evaluate.com/vantage/articles/news/corporate-strategy-snippets/lilly-steps-its-oral-obesity-push" target="_blank" rel="noreferrer noopener">reports</a>&nbsp;Eli Lilly admitted orforglipron won’t be as powerful as Mounjaro because the former is just a GLP-1 receptor agonist, whereas Mounjaro is a GLP-1 receptor agonist and a glucose-dependent insulinotropic polypeptide (GIP) receptor drug.&nbsp;<a href="https://www.yourhormones.info/hormones/glucose-dependent-insulinotropic-peptide/" target="_blank" rel="noreferrer noopener">GIP</a>&nbsp;is a hormone that helps with the release of insulin after food consumption. GIP receptors have been&nbsp;<a href="https://pubmed.ncbi.nlm.nih.gov/32459834/" target="_blank" rel="noreferrer noopener">reported</a>&nbsp;to reduce weight gain and cause weight loss in animals including nonhuman primates. According to a&nbsp;<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2206038" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in&nbsp;<em>The New England Journal of Medicine,&nbsp;</em>participants lost up to 22.5% of their body fat after 72 weeks on Mounjaro. Orforglipron’s side effects haven’t yet been made available, but Mounjaro’s most common&nbsp;<a href="https://www.mounjaro.com/how-to-use-mounjaro" target="_blank" rel="noreferrer noopener">side effects</a>&nbsp;include nausea, diarrhea, vomiting, constipation, stomach pain and indigestion.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>According to a&nbsp;<a href="https://www.nps.org.au/australian-prescriber/articles/oral-or-intravenous-antibiotics" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in the&nbsp;<em>Australian Prescriber&nbsp;</em>that compares oral antibiotics to injectable antibiotics, it was found oral drugs were cheaper to manufacture than the injectable ones. A&nbsp;<a href="https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05147" target="_blank" rel="noreferrer noopener">report</a>&nbsp;published in&nbsp;<em>Health Affairs&nbsp;</em>estimated the cost of oral medication rose by 9% between 2008 and 2016, whereas injectable drugs rose by 15% in the same time frame. This signals the potential approval of oral weight loss medication may be a cheaper, more affordable option than the already available injectables.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/05/05/wegovy-shortage-drug-maker-limits-distribution-heres-when-supplies-should-improve/?sh=2eaa52ab1fa4">Wegovy Shortage: Drug Maker Limits Distribution—Here’s When Supplies Should Improve</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2022/12/26/what-to-know-about-ozempic/?sh=6d645b6b5adb">What To Know About Ozempic: The Diabetes Drug Becomes A Viral Weight Loss Hit (Elon Musk Boasts Using It) Creating A Shortage</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/01/31/diabetes-drug-mounjaro-expected-to-be-approved-for-weight-loss-soon-what-to-know-and-how-it-compares-to-similar-drugs/?sh=21c4eb23477a">Diabetes Drug Mounjaro Expected To Be Approved For Weight Loss Soon: What To Know And How It Compares To Similar Drugs</a> (Forbes)</p>


African American man pouring medications out of a bottle into his hand.

Ozempic As A Pill: Drug Makers Race For Cheaper Weight Loss Drugs (Without The Shots)


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Drugmaker GSK <a href="https://www.gsk.com/en-gb/media/press-releases/gsk-shares-positive-data-for-arexvy-its-respiratory-syncytial-virus-older-adult-vaccine-indicating-protection-over-two-rsv-seasons/" target="_blank" rel="noreferrer noopener">said</a> Wednesday its RSV vaccine gave long-term protection in older adults after a single shot, according to results from its late stage clinical trial, promising news for efforts to combat the common and potentially lethal infection.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>GSK said the shot, which is designed to protect adults ages 60 and older and is marketed as Arexvy, conveyed strong protection against lower respiratory tract disease and severe disease from RSV over two full seasons.</p>



<p>The findings, which have yet to be fully published, come from the company’s late stage trial of around 25,000 people testing the safety and efficacy of a single dose of Arexvy against RSV, a very common respiratory infection that normally only causes mild, cold-like illness in healthy adults but can trigger severe, possibly fatal, disease in older adults, young infants and those with underlying health conditions.</p>



<p>Lasting protection was also observed in people with underlying health conditions or of advanced age, GSK said, a particularly important finding given the vulnerability of these groups following infection.</p>



<p>Tony Wood, GSK’s chief scientific officer, said the result “reinforces our confidence in [the vaccine’s] potential to make a significant public health impact.”</p>



<p>Other data, notably the shot’s safety and ability to provoke an immune response, were consistent with earlier observations from the trial, which showed the shot to be safe and have side effects in line with other vaccines.</p>



<h2 class="wp-block-heading" id="h-what-we-don-t-know">WHAT WE DON’T KNOW</h2>



<p>It’s not clear how often people will need to be vaccinated against RSV and the seasonal nature of the virus—similar to what happens with flu—suggests vaccines could be yearly. This is still an open question and one that will be guided over time by public health policy, real-world data and other concerns in addition to clinical trial data. GSK evaluated an annual revaccination schedule in around half of its trial participants. The findings were similar to those who had only received the one shot and suggested “revaccination after 12 months does not appear to confer additional benefit for the overall population,” GSK said. The company said it will continue to “evaluate longer term follow up” and assess the “optimal timing for potential revaccination.”</p>



<h2 class="wp-block-heading" id="h-what-to-watch-for">WHAT TO WATCH FOR</h2>



<p>The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices is set to&nbsp;<a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/agenda-archive/agenda-2023-06-21-23-508.pdf" target="_blank" rel="noreferrer noopener">meet</a>&nbsp;Wednesday. The group, comprised of vaccine and public health experts, meets regularly to discuss the science surrounding vaccines and infectious diseases and develop guidelines for how vaccines should be administered to the civilian population. These guidelines form the basis of official immunization schedules. RSV vaccines for older adults are on the agenda and talks will determine how they are rolled out for the very first time. There are now&nbsp;<a href="https://www.forbes.com/sites/mollybohannon/2023/05/03/fda-approves-first-ever-rsv-vaccine-after-brutal-2022-season/?sh=505f124410b2">two</a>&nbsp;<a href="https://www.forbes.com/sites/roberthart/2023/06/01/fda-approves-pfizers-rsv-vaccine-for-older-adults-it-could-be-available-this-fall/?sh=8ef1bb335ca2">authorized</a>&nbsp;shots intended to protect older adults from RSV, both of which were only approved this year after years of setbacks. GSK’s shot was the first to gain clearance, followed closely by Pfizer’s shot, Abrysvo. FDA advisors have&nbsp;<a href="https://www.forbes.com/sites/roberthart/2023/05/18/rsv-vaccine-fda-advisors-recommend-pfizer-shot-to-protect-infants-from-infection-heres-what-to-know/?sh=4e0f12523859">recommended</a>&nbsp;the agency clear Pfizer’s shot for use in pregnant people to protect infants in their first months of life.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/roberthart/2023/06/01/fda-approves-pfizers-rsv-vaccine-for-older-adults-it-could-be-available-this-fall/?sh=8ef1bb335ca2">FDA Approves Pfizer’s RSV Vaccine For Older Adults—It Could Be Available This Fall</a>&nbsp;(Forbes)</p>



<p><a href="https://qz.com/rsv-vaccine-pfizer-global-south-1850401425" target="_blank" rel="noreferrer noopener">Pfizer&#8217;s RSV vaccine promise to the Global South is already several years behind schedule</a>&nbsp;(Quartz)</p>


Category: Health

FORBES AFRICA SOCIAL MEDIA

More from Health