Monoclonal, only one is effective on Omicron: it is produced in Parma but ends up in the USA. Thus hospitals and Italian patients remain dry

It is the only monoclonal effective against Omicron, they produce it in Parma but it ends up in American hospitals while ours remain dry, just when the strain becomes prevalent. Our fault: we bought a few doses and late, to the point that many regions have out of stock, and Italy’s demand for supplies is now discounting the effects of the global hoarding race. “We are at the national shortage“, Admit the leaders of regional pharmaceutical services who yesterday participated in the national table with Aifa which monitors dispensations and needs. Let’s talk about Sotrovimab, the last of the four drugs with synthetic proteins authorized in emergency in Italy against Covid, the only one to have demonstrated efficacy against the variant landed in Italy at the end of November, which then made Delta shoes, becoming today – according to ISS data – prevalent for the81% of cases.

The neutralizing capacity against the variant was announced by the pharmaceutical company Gsk il Last December 2nd, based on a pre-clinical study: would reduce the risk of hospitalization or death by 85%. In Italy it is confirmed by the clinic: on 18 December the Spallanzani of Rome, for example, reports of a patient treated for which an improvement in symptoms was immediately observed, after four days a sudden drop in viral load, after eight the complete negativization . Aifa had indicated the treatment on 4 August 2021, again with the specifications common to monoclonals: adults and adolescents 12 years of age and older who do not require supplemental oxygen therapy for COVID-19 and who are at high risk of progression to severe COVID-19.

From what appears to the of that drug our country bought just 2 thousand doses in December and used 1,542: today there are therefore less than 500 throughout Italy, so much so that a region like Liguria has some for 20 treatments only while others, especially in the south, not even one. “The few who got there, 12 in all, we have all run out, I understand that there is not one in all of Piedmont, we really hope they will arrive on Monday”, says the head of the pharmaceutical service of the Ospedale Maggiore in Novara that it serves all of North Eastern Piedmont, with 4 local health authorities (Novara, Vercelli, Biella, Verbano). But there are those who have had / dispensed less. These are the premises of the perfect storm: while the peak of the fourth wave branded Omicron approaches, the employment of intensive care rises to 18%, in the refrigerators of hospital pharmacies the drugs effective against the variant are practically out of stock, and the regions that have a supply, however minimal, divert it to those that have remained completely dry.

A very delicate situation. So much so that in the last national coordination meeting with Aifa at the regional pharmaceutical services, which took place just yesterday, the absolute need to administer the few remaining doses was reiterated. high-risk patients, avoiding the dispersion of the few remaining available to the health system. On January 17, from what has been learned, further delivery will take place 5 thousand doses, a number that to insiders already seems undersized to the needs dictated by the trend of the curve, by the number of infected and resuscitating people, by the expected peak of infections by Omicron. In short, many more would be needed, but there won’t be more. Why never?

Because while the Ministry of Health, which purchases centrally and then distributes to the regions, made orders at a snail’s pace and with a dropper, someone was making the lion’s share. In particular the United States which, as far as is known, al, they ordered at the GSK plant 500 thousand doses, thus conditioning it stock of the drug on a global scale, starting from Italy which in theory would have it at home, but in practice sees it leave for abroad. It is a joke that is repeated: even the first monoclonals, those against Covid of the first waves, were bought late and among many resistors, with the paradox that those produced in Latina were loaded on refrigerated trucks to fly to other countries, not to Italian hospitals. In short, we have not learned from experience.

The hope, according to the most unmanned regional dispensers, is in the combined between the few stocks being transferred, the doses arriving, however modest, and the antivirals such as Molnupiuravid, the so-called “Covid pill” of Merck authorized for distribution on December 22nd and effectively available to the regions from January 4th. The effectiveness of which has decreased in recent months (from 50 to 30%), with limits also in the choice of treatment (patients at risk and frail) and in the administration (within 5 days of symptoms). But with this, in the fourth wave, it’s time to get by.

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