JHC MARCH 2020 CORONAVIRUS NEWS

WEEK OF FEB. 17-21

China reports sharp drop in new cases, but doubts re-emerge over data

The Hubei province at the center of the novel coronavirus outbreak reported a steep drop in new cases. However, another change in how China diagnoses infections raised concerns about the reliability of the data. The China death toll tops 2,000 and cases top 75,000. Initially, Chinese authorities were using nucleic acid tests to confirm virus presence, but those tests require days of processing and led to nucleic acid shortages. The Hubei province introduced a faster diagnostic method last week through CT scans to reveal lung infections and confirm the virus, leading to a sharp increase in cases. However, on Wednesday, authorities said they were removing that category of clinically diagnosed cases from their criteria of confirmed cases, resulting in 279 cases being removed from the Hubei count. Read more here.

Expert warns of mass U.S. medicine shortages by mid-March if COVID-19 continues to ravage China

Rosemary Gibson wrote the book, “China Rx: Exposing the Risks of America’s Dependence on China for Medicine,” and she predicts the U.S. will see shortages of medicines by mid-March if conditions do not vastly improve in China due to coronavirus. “We should never have been in this situation,” Gibson told WCNC (Charlotte, NC). “All roads lead to China in the core ingredients, the chemicals, the molecules – the real starting material to make our medicines. China’s dominance is global. The Europeans are in the same situation, [and] the Australians, Canadians. I’m speaking mostly generic medicines, which are 90% of the medicines we take.” Read more of Gibson’s opinions here.

Drugmakers in India particularly vulnerable to shortages due to coronavirus

Drugmakers in India, which produce 20% of the world’s drug supply by volume, are bracing for potential disruption from the coronavirus. The outbreak threatens to disrupt the supply of raw materials from China. Enough supplies are currently on hand to continue production, but operations could be threatened if the outbreak continues to cause disruption in China. Approximately 70% of the raw materials India uses in drug manufacturing are imported from China, and the Hubei province is a major production hub. India is the world’s largest exporter of generic drugs, sending large volumes to the U.S. It’s estimated that companies that make anti-infective and hormone therapies are most at risk from material shortages. Read more here.

Texas manufacturer caught in coronavirus supply chain panic

Prestige Ameritech (Fort Worth, TX), a full-line domestic surgical mask manufacturer, was producing 600,000 masks each day but struggling to meet demand as the number of coronavirus cases in China skyrocketed in the past week. CEO Mike Bowen was receiving cold calls on his cell phone from people saying they represented foreign governments and wanted to make bulk purchases. Bowen said this was the exact scenario he predicted 15 years ago when he asked federal agencies and U.S. lawmakers to boost U.S. production of medical masks. Bowen wrote President Barack Obama in 2010 and President Donald Trump in 2017, warning of the shortage. Prestige Ameritech can make 1 million masks a day if it runs its machines around the clock. However, Bowen is hesitant to ramp up production at his Texas facility, scarred by the boom-bust cycle that occurred after the swine flu pandemic in 2009. Read more here.

U.S. hospitals prep for spread of coronavirus in the states

Hospitals are bracing for the potential spread of coronavirus in the U.S. The strict quarantine and screening measures enacted by the CDC have given hospitals time to review their pandemic plans and stockpile needed equipment. “We’re buying some time now that it hasn’t really spread so much in the United States,” Dr. Mark Jarrett, the chief quality officer for Northwell Health (New York, NY), told MedicineNet. “That’s giving us a chance to gear up factories and address supply chain issues.” The coronavirus epidemic has hampered supply chains out of China and is highlighting the problems with U.S. hospitals’ dependence on “just-in-time” supply orders. That, on top of a tough U.S. flu season, is straining the capacity of many hospitals. Read more here.

Outbreak helps U.S. lawmakers push case on drug shortage bills

With no end in sight for the coronavirus outbreak, it is prompting fears of drug shortages in the U.S. due to the pharmaceutical supply chain’s reliance on China. The epidemic is helping U.S. lawmakers who were already working on bills to address drug shortages prove their point. Rep. Anna Eshoo (D-CA) chairs the Energy and Commerce Health Subcommittee and has been looking at this issue since last fall when her panel held a hearing on the drug supply chain. Read more about her thoughts here and what she told Roll Call, a newspaper and website in Washington, D.C., in a podcast.

SARS-like damage seen in dead coronavirus patient

A lung biopsy of a Chinese patient who died of the coronavirus COVID-19 found that he had lung damage reminiscent of two prior coronavirus-related outbreaks, SARS and MERS. The patient died on Jan. 27 after falling ill two weeks earlier. He was treated with various medications, including anti-infection treatment alfa-2b, HIV medications lopinavir and ritonavir and the antibiotic moxifloxacin to prevent secondary bacterial infection. His fever decreased as a result of the treatment, but his breathing worsened, and his blood-oxygen levels fell dramatically. According to a new report in The Lancet, “The pathological features of COVID-19 greatly resemble those seen in SARS and MERS coronavirus infection. In addition, the liver biopsy specimens of the patient with COVID-19 showed moderate microvascular steatosis and mild lobular and portal activity, indicating the injury could have been caused by either SARS-CoV-2 infection or drug-induced liver injury.” Read more here.

Pharmacies may face shortage of antibiotics, other drugs if supply problems cannot be resolved

The head of a European business group in China warned Tuesday that the world’s pharmacies may face a shortage of antibiotics and other drugs if supply problems from China’s coronavirus outbreak cannot be resolved soon. EU Chamber of Commerce President Joerg Wuttke added that Beijing was making supply chain problems worse with a mandatory quarantine of arrivals from abroad. The capital city in China is requiring a 14-day quarantine for all arrivals, which Wuttke said would make it difficult to fly in technical experts to help if facilities are down. Wuttke called the measures against WHO guidelines. He also said the disruption from the epidemic had driven home diversifying away from China. Read more here.

Wuhan hospital director dies as death toll nears 2,000

Liu Zhiming, the director of Wuhan’s Wuchang Hospital, died Tuesday at the age of 51. Wuhan Municipal Health Commission confirmed the death in a statement saying, “Since the outbreak, Comrade Liu Zhiming, regardless of his personal safety, led the medical staff of Wuchang Hospital to fight the epidemic, and made important contributions to the prevention and control of new-type coronavirus pneumonia in our city.” Thousands of medical workers from across China have been sent to Wuhan in recent weeks to help the overwhelmed local authorities. Liu is the ninth known fatality among medical personnel battling the epidemic in China. The current death toll is 1,868 dead with 72,436 confirmed cases in mainland China. Read more here.

Worldwide concern for drug shortages grows as outbreak continues

China is the largest producer of active pharmaceutical ingredients (APIs) in the world and is the starting point in the global supply chain for many products. Some drugmakers in China have restarted production after an extended break for the Chinese New Year, but worldwide governments are trying to determine whether drug shortages will result from the continued coronavirus outbreak. Concerns were raised by health ministers from France and Finland at an emergency meeting Brussels (Belgium) about shortages. The FDA has stated that it is vigilant about added resources and is monitoring the situation closely. Historically, the FDA and drugmakers have turned to alternate suppliers to help make up shortfalls. Read more here.

FDA response to active supply chain surveillance amid outbreak

The FDA states that it is aware of the likely impact on the medical product supply chain, including potential disruptions to supply or shortages of critical medical products in the U.S., due to the coronavirus outbreak. The FDA states that it is not waiting for drug and device manufacturers to report shortages, but is proactively reaching out to manufacturers as part of its approach to identifying potential disruptions or shortages. It has dedicated additional resources to review and coordinate data to better identify any potential vulnerabilities to the U.S. medical product sector. Finally, it confirms that it has been in contact with hundreds of manufacturers of human and animal drugs and medical devices, as well as syncing up with global regulators, like the European Medicines Agency, to assess and monitor for indications and early warning signs of potential manufacturing discontinuances or interruptions due to the outbreak. Read more from the FDA here.


WEEK OF FEB. 10-14

Coronavirus more contagious than flu, less deadly

The new strain of coronavirus, now formally named COVID-19, is “a lot more contagious” than the flu, according to AstraZeneca CEO Pascal Soriot. “What we have all learned is that the virus leads to a lower mortality than the flu virus, but it’s a lot more contagious, the virus is very contagious,” Soriot told CNBC. At least 19 million people across the U.S. have been infected with the flu virus this flu season, according to the CDC, and it has resulted in 10,000 deaths and 180,000 hospitalizations. Soriot said, despite the high contagion rate of the COVID-19 virus he is optimistic that Chinese authorities would be able to contain the virus. Read more here.

CDC director says coronavirus could stay in U.S. through the year and beyond

Dr. Robert Redfield, the director of the CDC, says that the coronavirus will likely stay for “beyond this season, or beyond this year,” in the U.S. “Right now, we’re in aggressive containment mode,” said Redfield. “I think eventually the virus will find a foothold and we will get community-based transmission.” Redfield said it would become a disease like the seasonal flu and questioned whether China has the situation under control, suggesting that the country allow the CDC to conduct on-the-ground work. Only the World Health Organization (WHO) has been helping China assess the outbreak so far. Read more here.

Coronavirus exposes U.S. pharma’s supply chain vulnerability, writes Tennessee senator

It has been more than 50 years since the last federal quarantine was issued, to control a deadly smallpox outbreak. Dr. Janet Woodcock, the director of the FDA’s Center for Drug Evaluation and Research, testified before Congress this past October that the U.S. “has become a world leader in drug discovery and development, but is no longer in the forefront of drug manufacturing.” Sen. Marsha Blackburn (R-TN) writes on the U.S. pharma supply chain and its reliance on China here.

Coronavirus cases spike in China; death toll over 1,300, caseload over 60,000

Doctors in China have adopted a new way of diagnosing the novel coronavirus, leading to a spike of 23% in confirmed cases and a jump in the number of deaths blamed on the virus. China previously only counted a coronavirus case as confirmed when a person tested positively for the virus, but the government is no longer requiring a positive test. New cases are now being confirmed if a person is simply diagnosed by a doctor. Officials in Hubei province, the heart of the outbreak, reported 254 new deaths and 15,152 new cases of coronavirus. The increase brought the death toll to at least 1,369 and the number of confirmed cases to more than 60,000. “We’re now getting a better indication of what’s actually happening in the community,” John Nicholls, a professor of pathology at the University of Hong Kong and a prominent researcher during the SARS outbreak in 2003, told CBS News. Read more here.

Coronavirus test kits shipped to U.S. states are not working as expected

Some of the coronavirus test kits shipped to labs across the U.S. are not working as they, according to the CDC. As a result, the CDC is remaking parts of the test kits after some produced inconclusive test results. The kits were sent to states to speed up the testing process, but the states discovered the flaw during the verification process. However, not all states have been affected. For example, the Illinois Department of Public Health said it has not had any issues with the kits and it is continuing with its testing for the coronavirus. There have been 14 confirmed coronavirus cases reported in the U.S. with the latest one reported among U.S. evacuees at a military base in San Diego County, CA. Read more here.

Moody’s indicates healthcare companies to see mixed results from expanded coronavirus outbreak

U.S. healthcare companies would see mixed effects of a more significant coronavirus outbreak within and outside of China, according to a new stress report from Moody’s Investors Service. If the outbreak spreads significantly in China, it would dampen demand for U.S. healthcare companies that sell products there. Moody’s said it is already seeing evidence of that on medical device companies’ earnings calls. Companies that use Chinese components, including pharmaceutical ingredients, to make their products could also suffer supply chain disruptions. The outbreak also provides some opportunity. U.S. drug companies like Gilead Sciences and Johnson & Johnson (J&J) are working to develop novel medications or use existing ones to treat or prevent conditions. Read more here.

CMS reminds providers to review infection control protocols amid outbreak

CMS sent a memo to state survey agency directors, encouraging all healthcare facilities to carefully review their infection control information and protocols amid the coronavirus outbreak. “Because coronavirus infections can rapidly appear and spread, facilities must take steps to prepare, including reviewing their infection control policies and practices to prevent the spread of infection,” CMS said in the memo. The memo includes information and links to resources to combat the illness caused by the novel coronavirus. It also states that healthcare staff and surveyors, including federal, state and local contractors are expected to adhere to standard infection control practices, such as CDC recommendations on standard hand hygiene practices. Read the full memo here.

Coronavirus death toll surpasses 1,000 in mainland China

Monday saw the largest single-day death tool yet in mainland China as 108 people died, bringing the total to more than 1,000 deaths. More cases were identified, bringing that total to 42,638 in mainland China. Meanwhile, two senior health officials in the Chinese province of Hubei, the epicenter of the outbreak, have been fired. Read more about the latest updates here.

Coronavirus may be over by April in China, but WHO warns of global threat

Coronavirus infections in China may be over by April, according to China’s senior medical advisor, but the WHO warns of a “very grave” global threat. China’s foremost medical advisor on the outbreak, Zhong Nanshan, has said numbers of new cases were falling in some places and held out hope the epidemic may peak this month. Zhong won fame for his role in combating the outbreak of SARS in 2003. However, WHO chief Tedros Adhanom Ghebreyesus appealed for the sharing of virus samples and speeding up research into drugs and vaccines. “With 99% of cases in China, this remains very mush an emergency for that country, but one that holds a very grave threat for the rest of the world,” he says. Read more here.

Hospitals stockpile supplies amid coronavirus-related mask shortage; Schein makes statement

The coronavirus has fueled fears of a shortage of key protective medical devices, namely the specialized N95 respirator masks that are needed to protect health workers treating infectious patients. The CDC recommends that medical employees working with coronavirus patients wear N95 masks, specifically. Any disruption in the distribution of supplies like N95 masks could pose a risk to medical practitioners who rely on certain pieces of protective equipment. Henry Schein’s website now includes a notice for consumers in the U.S. stating, “Due to the coronavirus outbreak, we are experiencing higher than normal demand globally for infection control products such as masks, goggles and face shields, among other items. We are working with our manufacturing and supply chain partners, as well as global health organizations including the Pandemic Supply Chain Network, WHO, the Chinese Ministry of Health, and the CDC, to address shortages as they occur. Given this situation and acute market needs, we anticipate disruptions to orders for certain infection products in various markets. Please contact your local Henry Schein consultant for specific inventory inquiries.” A spokesperson for Henry Schein, speaking to Business Insider, said, “It’s too soon to say what the long-term effects will be on business from the outbreak. Henry Schein reports on our Q4 financial results later this month, and we’ll have a better sense by then of the impact of the outbreak.” Read more about the concerns to medical practitioners here.

Boston Scientific puts dollar amount on possible losses to coronavirus, absorbs hits in supply chain

Boston Scientific (Marlborough, MA) has estimated the coronavirus outbreak will cost the company from $10 million to $40 million in sales. Boston Scientific expects $12 billion in sales this year, but it’s a sign of how the effects of coronavirus are beginning to be felt across the global economy. The virus outbreak hit airline and oil stocks in late January, and the impact on much of the rest of the corporate landscape is building slowly. Boston Scientific says it expects to absorb revenue hits from canceled surgeries in areas where the virus is prevalent, and from disruptions in its supply chain. Read more on Boston Scientific and other companies bracing for the impact of coronavirus here.