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Evusheld injection, a new COVID treatment people can take before they become symptomatic, on Friday February 4, 2022 in Chicago.

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The Omicron subvariants that have become dominant in recent months pose a serious threat to the effectiveness of the new boosters, render antibody treatments ineffective and could cause a rise in breakthrough infections, according to a new study.

Omicron subvariants BQ.1, BQ.1.1, XBB, and XBB.1 are the most immune-avoidable variants of Covid-19 to date, according to scientists at Columbia University and the University of Michigan. These variants combined currently cause 72% of new infections in the United States, according to data from the Centers for Disease Control and Prevention.

The scientists noted in a study published online Tuesday in the journal Cell that these subvariants are “hardly susceptible to neutralization” by the vaccines, including the new Omicron boosters. Also, the immune response of people vaccinated with earlier Omicron variants who had breakthrough infections was weaker than the subvariants.

“Taken together, our results suggest that BQ and XBB subvariants pose a serious threat to current COVID-19 vaccines, render all approved antibodies inactive and may have gained population dominance due to their advantage in antibody evasion.” , the scientists wrote.

Although these subvariants are more likely to cause breakthrough infections, the vaccines have been shown to be effective in preventing Omicron-related hospitalizations and serious illness, the scientists wrote.

The study looked at blood samples from people who received three or four shots of the original vaccines, people who received the new Omicron booster shots after three shots of the original vaccines, and people who were vaccinated with the original vaccines and also had breakthrough infections caused by BA.2 or BA.5 subvariants.

In people who received the omicron boosters, antibodies that block infection were 24-fold lower against BQ.1, 41-fold lower against BQ.1.1, 66-fold lower against XBB, and 85-fold lower against XBB. 1 compared to their performance against the Ancestral Tribe which emerged in 2019 in Wuhan, China.

However, according to the study, people who received the Omicron boosters had slightly higher antibody levels against all of these subvariants compared to people who received three or four shots of the original vaccines.

People who were vaccinated and had breakthrough infections had the highest antibody levels of any group in the study, although neutralization was also much lower against the subvariants than the ancestor strain.

The subvariants have evolved dramatically from earlier versions of omicron. BQ.1.1, for example, is about as different from omicron BA.5 as the latter subvariant is from the ancestral Covid strain, according to the study.

“Therefore, it is alarming that these newly emerging subvariants could further impair the effectiveness of current COVID-19 vaccines and lead to a surge in breakthrough infections as well as reinfections,” the scientists wrote.

However, XBB.1 poses the greatest challenge. According to the study, it is about 49 times more resistant to antibody neutralization than the BA.5 subvariant. Fortunately, XBB.1 currently causes no more than 1% of infections in the US, according to CDC data.

BQ.1.1 and BQ.1 account for 37% and 31% of new infections, respectively, while XBB causes 4.7% of new infections, according to CDC data.

Antibodies ineffective

According to the study, the main antibody drugs Evusheld and Bebtelovimab were “completely inactive” against the new subvariants. These antibodies are mainly used by people with weak immune systems.

Evusheld is an antibody cocktail used to prevent Covid in people with weak immune systems who don’t respond strongly to the vaccines. Bebtelovimab is used to prevent Covid from progressing to serious illness in organ transplant patients and others who cannot receive other treatments.

“This poses a serious problem for millions of immunocompromised individuals who do not respond robustly to COVID-19 vaccines,” the scientists wrote. “The urgent need to develop active monoclonal antibodies for clinical use is evident.”

The Food and Drug Administration has already withdrawn approval of bebtelovimab nationwide because it is no longer effective against the dominant Omicron variants in the US. Evusheld remains approved as the only option for pre-exposure prophylaxis.

New Covid infections rose about 50% to 459,000 in the week ended December 7, according to CDC data. The number of deaths from Covid rose by 61% to nearly 3,000 in the same week. Hospital admissions have leveled off at an average of 4,700 per day after a spike in November, according to the data.

White House Medical Advisor Dr. Anthony Fauci, in a news conference last month, said US health officials hope the population has enough immunity to vaccination, infection, or both to prevent the massive spike in infections and hospitalizations that the US suffered last winter omicron arrived first.

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Drugstores warn of major shortages of key antibiotics used to treat Strep A as cases rise in the UK

Marco Geber | digital vision | Getty Images

LONDON – Drugstores in the UK are warning of shortages of essential antibiotics to treat Strep A as cases rise and the death toll in children reaches 15.

A surge in group A streptococci, particularly among schoolchildren, has increased demand for the main antibiotic treatments, amoxicillin and penicillin, over the past week.

Where stocks are, drugstores say they’re “flying off the shelves,” and some say they’re now selling drugs at a loss due to rising wholesale prices.

In some cases, pharmacists say wholesale prices for the drugs have increased by as much as 850%.

At least 15 children have died from severe cases of Strep A in the UK this winter season, according to health officials in England, Wales and Northern Ireland. Another death from suspected infection was reported on Saturday but has not yet been confirmed.

While most cases of Strep A are mild and often go unnoticed, it can also lead to more serious conditions and complications, such as scarlet fever. The bacteria can also enter the bloodstream and cause a disease called invasive group A streptococcus (iGAS).

These serious infections can be deadly and are believed to be the cause of the recent wave of deaths.

Cases have risen in the UK this year, with the UK Health Security Agency reporting 6,602 cases of scarlet fever from September 12 to December 4, far more than the 2,538 reported during the last peak in 2017-2018.

Fear of a national shortage

The government and wholesalers have insisted the country is adequately equipped to deal with the outbreak. Prime Minister Rishi Sunak last week dismissed fears of a “national shortage” of antibiotics.

“There is currently no shortage of medicines to treat this and there are established procedures to ensure this remains so,” he told the House of Commons on Wednesday.

However, a letter to NHS England pharmacists, seen by Sky News, acknowledged that local drugstores may be experiencing a “temporary halt to the supply of some relevant antibiotics due to increased demand”.

dr Leyla Hannbeck, executive director of the Association of Independent Multiple Pharmacies (AIMP), which represents drugstore owners nationwide, told CNBC the reality on the ground was becoming desperate.

That just shows the incompetence of those responsible. This isn’t the first time this has happened.

dr Leyla Hannbeck

Managing Director, Association of Independent Multiple Pharmacies

“Clearly there isn’t (enough supply) because it doesn’t find its way into pharmacies,” she said. “And where there are gaps in stock, they fly off the shelves.”

“This is of great concern to us, especially when we have parents who come into pharmacies and unfortunately don’t have the stock,” she added.

Parents were advised to call drugstores beforehand to check prescription availability after Hannbeck noticed reports of families traveling miles between stores.

She said the government shouldn’t be surprised by the shortages earlier this year, given similar shortages of medicines for other outbreaks like monkeypox.

“It only shows the incompetence of those responsible,” she said. “This is not the first time this has happened. Since the beginning of this year I have been speaking to community pharmacies about what is wrong with the UK pharmaceutical supply chains.”

When asked by CNBC, the British Department of Health did not comment on the allegations of incompetence.

Drugstores “foot the bill”

Pharmaceutical supply chains have been severely disrupted this year due to a combination of factors including Russia’s invasion of Ukraine, inflation, Covid-19 and Brexit.

It has resulted in drugstores spending more time – and money – on sourcing drugs.

Under the UK National Health Service (NHS) drug tariff system, drugstores receive a fixed fee for drugs. There is also a discount list of drugs for which higher prices can be paid.

Despite this, When wholesale prices rise, drugstores can end up making losses.

The Government’s Department of Health and Social Care has warned that while prices can fluctuate, “no company should use this as an opportunity to exploit the NHS”.

Streptococcus A – or Group A Strep (GAS) – is a bacterial infection of the throat or skin that typically occurs during the winter months.

Halfpoint Images | moment | Getty Images

However, in the past week wholesale prices for amoxicillin and penicillin liquid solutions – which are an alternative to children’s tablets and are particularly scarce – have risen in some places from around £2 to between £15 and £19, AIMP’s Hannbeck says.

London-based drug wholesaler Sigma Pharmaceuticals reportedly increased the price of its amoxicillin liquid solution by more than 10-fold to £19 on Thursday, but later told CNBC the increase was due to an “IT error”.

Martin Sawer, executive director of the Healthcare Distribution Association, which represents drug wholesalers, said higher prices “directly” reflect increased costs for manufacturers. He dismissed claims of supply shortages, instead pointing to a “huge surge in demand.”

“Right now there is too much demand for products and there aren’t enough competitive products available for purchase from manufacturers,” Sawer said.

If the government doesn’t step in soon to protect pharmacies, patients will face increasing problems getting their medicines.

Janet Morrison

Chief Executive, Pharmaceutical Services Negotiation Committee

Drugstore owners are now calling on the government to update their preferential pricing for amoxicillin and penicillin to ensure they are reimbursed fairly even if prices continue to rise.

Janet Morrison, executive director of the pharmaceutical services negotiation committee, which is negotiating the list of concessions with the Department of Health, said help on pricing was “urgently” needed.

“Pharmacy teams are at breaking point,” she said. “They are helpless against the market forces working against them and desperately need government assurances that all medicines will be available and not at grossly inflated prices.”

A total of 158 medicines were on the NHS’s concession list in November, compared with 135 in October. Morrison said she expects a “record number” of drugs to be added to the list in December as supply shortages exacerbate shortages and drive drug prices even higher.

“For months, pharmacies have been footing the bill for NHS medicines themselves when they should be covered by the government,” said Morrison.

“It can’t go on like this,” she added. “If the government doesn’t step in soon to protect pharmacies, patients can expect increasing problems getting their medicines. The Government and the NHS need to fix this, and fast.”