COVID hospitalizations on the rise, but fewer people needing intensive care, vents

For the first time during the COVID-19 pandemic, we are seeing an increase in hospitalizations without a corresponding spike in intensive care and ventilator use.

Experts say the decoupling is likely because antiviral treatments like Paxlovid and Molnupiravir are more widely available and preventing people from getting seriously ill. In fact, the state is “currently experiencing the lowest percentage of hospitalizations requiring intensive care or a ventilator since September 2020,” according to state health officials.

That’s likely thanks “in part to vaccinations and therapeutics,” like monoclonal antibodies and oral antiviral drugs, the Michigan Department of Health and Human Services said in its latest COVID Weekly. updating of data and modeling. While the FDA’s emergency use authorization for Paxlovid only extends to people at high risk of becoming seriously ill from COVID, Michigan patients can now get the drug at pharmacies like Walgreens and Meijer.

“I’ve prescribed it to a few people, and they’ve done really well with it,” said Dr. Dennis Cunningham, director of infection control and prevention at Henry Ford Health. “I think it’s incredibly effective, incredibly safe. I wish we did more.

MDHHS

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Michigan Department of Health and Human Services

A graph of trends in hospitalizations and critical illnesses for COVID, showing that in previous surges, when Michigan had affected about 1,000 adults hospitalized with COVID (that’s where the state is now), a higher a large proportion of these patients were critically ill in intensive care or on ventilators.

While initially the problem with Paxlovid was a limited supply, Cunningham said they are now pushing doctors to take advantage of the increased availability. “It’s getting better, but I’d like to see it used a lot more,” he said. “One thing that would make life easier for everyone is that we don’t have a lot of prescribed antivirals in the state. So we send messages to our suppliers to make sure that they are aware that we have a small number of doses of monoclonal antibodies, but that the two antivirals that exist are very effective.

“Unfortunately, the better of the two is Paxlovid, but it has a lot of drug interactions. So clinicians may have to be creative in keeping other drugs or decreasing doses, but it’s worth it, because Paxlovid will prevent hospitalizations in people at high risk for severe COVID disease by 80%, if you start it within the first five days of symptoms,” Cunningham said.

But that doesn’t mean people should let their guard down. Michigan’s surge in cases in recent weeks comes just as we get a better idea of ​​who gets long COVID and what those health issues may look like in the weeks, months, and even years after an infection. initial.

“I think people are watching [rising case rates] and say, ‘Most of us are fine. We’re not going to end up in the hospital,” Cunningham said. “But this long-haul COVID is very real, where people can be affected for quite a while. So that should really fit into people’s equation. It’s not just the short illness you’re going to go through. You don’t want that fatigue, brain fog, other symptoms [that can last far longer.]”

On Tuesday, the CDC released a new study suggesting that up to 1 in 5 adults who survive COVID will continue to have health problems possibly related to the virus for weeks, months, and sometimes even years after infection. initial. Overall, the risks for COVID survivors, compared to people who were never infected, were highest for acute pulmonary embolism (blockage of a pulmonary artery) and respiratory symptoms.

The picture is even bleaker for people over 65, nearly half of whom experienced “incident conditions” that could be part of a long COVID, the study found. These include neurological issues that could last beyond a year, such as “mood disorders, other mental disorders, anxiety and substance abuse disorders”.

“People’s lives are really affected,” Cunningham said. “And you know, you hear fatigue and brain fog, that’s bad, but [you think] “I’ll manage to deal with that.” There are people who are going to struggle to get out of bed, to go to work, to do their daily living activities, to take care of their children, all the things that we all have to do.”

“I’m really worried about the impact that the long COVID is going to have. Not that people are going to die, but it’s going to be pretty miserable,” he said.

And while vaccination may offer some protection against the long COVID, a major new study from the Department of Veterans Affairs released on Wednesday found that while vaccination seemed to offer better protection against lung and blood clot problems in long COVID, it did not offer as much protection against other long COVID symptoms as experts. had hoped.

“Vaccines are miraculous for doing what they were designed to do. [in terms of preventing hospitalization and death,]said lead author Dr Ziyad Al-Aly BNC News. But they “offer very modest protection against the long Covid,” he said.

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