Thursday, November 30, 2023

What's the latest on COVID antiviral drugs, and who is eligible in Australia?

Australia is experiencing a fresh wave of COVID, seeing increasing cases, more hospitalisations and a greater number of prescriptions for COVID antivirals dispensed over recent months.

In the early days of the pandemic, the only medicines available were those that treated the symptoms of the virus. These included steroids and analgesics such as paracetamol and ibuprofen to treat pain and fever.

We now have two drugs called Paxlovid and Lagevrio that treat the virus itself.

But are these drugs effective against current variants? And who is eligible to receive them? Here's what to know about COVID antivirals as we navigate this eighth COVID wave.

What antivirals are available?

Paxlovid is a combination of two different drug molecules, nirmatrelvir and ritonavir. The nirmatrelvir works by blocking an enzyme called a protease that the virus needs to replicate. The ritonavir is included in the medicine to protect the nirmatrelvir, stopping the body from breaking it down.

Molnupiravir, marketed as Lagevrio, works by forcing errors into the RNA of SARS-CoV-2 (the virus that causes COVID) as it replicates. As these errors build up, the virus becomes less effective.

This year in Australia, the XBB COVID strains have dominated, and acquired a couple of key mutations. When COVID mutates into new variants, it doesn't affect the ability of either Paxlovid or Lagevrio to work because the parts of the virus that change from the mutations aren't those targeted by these two drugs.

This is different to the monoclonal antibody-based medicines that were developed against specific strains of the virus. These drugs are not thought to be effective for any variant of the virus from omicron XBB.1.5 onwards, which includes the current wave. This is because these drugs recognise certain proteins expressed on the surface of SARS-CoV-2, which have changed over time.

What does the evidence say?
As Lagevrio and Paxlovid are relatively new medicines, we're still learning how well they work and which patients should use them.

The latest evidence suggests Paxlovid decreases the risk of hospitalisation if taken early by those at highest risk of severe disease.

Results from a previous trial suggested Lagevrio might reduce COVID deaths. But a more recent, larger trial indicated Lagevrio doesn't significantly reduce hospitalisations or deaths from the virus.

Australia is riding another COVID wave — and the most vulnerable are the least vaccinated
As a new wave of COVID-19 hits Australia, why are so few aged care residents up-to-date with their COVID-19 vaccinations?

However, few people at highest risk from COVID were included in this trial. So it could offer some benefit for patients in this group.

In Australia, Lagevrio is not routinely recommended and Paxlovid is preferred. However, not all patients can take Paxlovid. For example, people with medical conditions such as severe kidney or liver impairment shouldn't take it because these issues can affect how well the body metabolises the medication, which increases the risk of side effects.

Paxlovid also can't be taken alongside some other medications such as those for certain heart conditions, mental health conditions and cancers. For high-risk patients in these cases, Lagevrio can be considered.

Some people who take COVID antivirals will experience side effects. Mostly these are not serious and will go away with time.

Both Paxlovid and Lagevrio can cause diarrhoea, nausea and dizziness. Paxlovid can also cause side effects including muscle aches and weakness, changes in taste, loss of appetite and abdominal pain. If you experience any of these, you should contact your doctor.

More serious side effects of both medicines are allergic reactions, such as shortness of breath, swelling of the face, lips or tongue and a severe rash, itching or hives. If you experience any of these, call 000 immediately or go straight to the nearest emergency department.

Be prepared

Most people will be able to manage COVID safely at home without needing antivirals. However, those at higher risk of severe COVID and therefore eligible for antivirals should seek them. This includes people aged 70 or older, people aged 50 or older or Aboriginal people aged 30 or older with one additional risk factor for severe illness, and people 18 or older who are immunocompromised.

A COVID infection now could spell trouble in three decades
Genes, environment and lifestyle are some of the risk factors for serious diseases like Parkinson's and Alzheimer's. This is why scientists believe COVID-19 infection should be added to the list.

If you are in any of these groups, it's important you plan ahead. Speak to your health-care team now so you know what to do if you get COVID symptoms.

If needed, this will ensure you can start treatment as soon as possible. It's important antivirals are started within five days of symptom onset.

If you're a high-risk patient and you test positive, contact your doctor straight away. If you are eligible for antivirals, your doctor will organise a prescription (either an electronic or paper script).

These medicines are available under the Pharmaceutical Benefits Scheme (PBS) and subsidised for people with a Medicare card. The cost for each course is the standard PBS co-payment amount: $30 for general patients and $7.30 for people with a concession card.

So you can rest and reduce the risk of spreading the virus to others, ask your pharmacy to deliver the medication to your home, or ask someone to collect it for you.

***************************************************

Former Labor cabinet minister lashes government over green litigant funding

Former Labor cabinet minister Joel Fitzgibbon has lashed the Albanese government over its decision to hand millions of dollars to help green litigants, accusing Labor of “financing job destroying legal challenges”.

In a speech to forestry industry leaders, the former Hunter MP said Labor had “handed taxpayers’ money to activists”.

The attacks come after Labor fulfilled its election promise to reverse funding cuts to the Environmental Defenders Office, providing $10m in funding to the community legal centre over the forward estimates.

The EDO is an legal organisation well known for its environmental advocacy, running high-profile cases against coal and gas developments.

Mr Fitzgibbon, the chair of the Australian Forest Products Association, said it made no sense for the government to fund activists to take legal action “against the very government that gave them the money”.

“Activists funded by rich donors - and indeed governments through the Environmental Defenders Office - are challenging value-creating projects in the law courts,” Mr Fitzgibbon said, in a speech delivered earlier this month that has been obtained by The Australian.

“In a wealthy, liberal democracy it makes sense to use taxpayers money to ensure all Australians have legal representation when they face a criminal conviction. But it makes no sense to hand taxpayers’ money to activists so they can take legal action against the very government that gave them the money.

“To challenge in the courts approvals processes the government rightly argues are as robust as any in the world.”

Labor pledged to reinstate funding for the EDO ahead of the last election in order to enable Australians to have access to the law.

Environment Minister Tanya Plibersek told The Australian Labor was “proud to be restoring funding to the Environmental Defenders Office, reversing cuts made by the Abbott government.”

“Every section of our community deserves legal advocacy. As does our previous environment. Unlike the Liberals and Nationals, we are not afraid of scrutiny and accountability,” Ms Plibersek said.

Government officials pointed out that the EDO was also funded under the Rudd and Gillard governments of which Mr Fitzgibbon was a Cabinet minister.

The Abbott government cut funding to the organisation following allegations of activist lawfare.

The EDO, first established in NSW in 1985, has used the courts to delay or squash major projects including the Adani coalmine in central Queensland, Santos’ Barossa gas proposad and forestry developments in Tasmania.

The body has received grants from groups including the Myer Foundation.

In a wide-ranging speech, Mr Fitzgibbon also attacked “extreme environmental activists” who he said “would destroy our sovereign capability in this country and destroy the jobs of the people who provide it”.

“AFPA provides me with an opportunity to do another thing I did for many years in politics – to take on the extreme environmental activists who, given the chance, would destroy our sovereign capability in this country and destroy the jobs of the people who provide it,” he said.

The EDO was contacted for comment.

*****************************************************

Mandate madness: What will it take to allow Victoria’s firefighters back to work?

The 2019-2020 Australian bushfire season was one of the worst in recorded history with fires burning across Australia for over six months. No state or territory was left unscathed with an estimated 24.3 million hectares burned, including 34 deaths, 3,000 buildings, and decimation of wildlife and habitat.

During such times we rely on our first responders to bravely step into the breech, and our firefighters are first to respond to the call. The courage of Australia’s firefighters is well-known and with the approaching fire season we once again turn to these everyday heroes knowing that for them, this personal risk is something they shoulder with pride.

It seems, therefore, unthinkable that almost 4 years since Covid arrived on our shores we would still have up to 50 Victorian firefighters sidelined by vaccine mandates.

Fire Rescue Victoria (FRV) has been the stalwart of mandates, continuing with these ridiculous measures – despite all other states and territories removing them – and no one seems to know why.

Some of this confusion is apparent as recently highlighted in state estimates when Victoria’s newly appointed Emergency Management Commissioner, Rick Nugent, confirmed the only vaccine mandate still in place is with Fire Rescue Victoria (FRV). When asked why these mandates were remaining, Deputy Secretary of the Department of Justice, Ryan Phillips answered, ‘That’s ultimately an operational matter for FRV… [and] something that organisation has decided.’ But when Bev McArthur MLC asked if the Department ultimately had responsibility for the organisation, she was told they were ‘not responsible for internal policies in relation to vaccines’.

This begs the question, who is responsible for the ongoing mandates at FRV?

The Victorian state government revoked the Pandemic Order on October 12, 2022. In June 2023, the former Chief Medical Officer Brendan Murphy admitted there was ‘little justification’ for ongoing mandates, and on October 20, 2023, Australia’s Chief Medical Officer announced the official end of the Covid emergency response, declaring Covid was no longer a Communicable Disease Incidence of National Significance.

With the pandemic officially over and mandates no longer ‘justified’ (if they ever were), what exactly is Fire Rescue Victoria holding out for?

This question is also being asked by The Australian Firefighters Alliance (AFA). Formed in 2021, under threat of the mandates, this organisation is committed to ‘protecting the freedoms and democratic rights of firefighters and workers throughout the nation’. They are staunchly pro-choice, not anti-vaccination. Co-founder, Josh Hawkes, has been relentless in seeking answers from FRV regarding their continued stance on preventing unvaccinated firefighters from returning to work. The situation has become incomprehensible as he and around 30 AFA colleagues – with an estimated further 20 outside of the organisation – are kept on the sidelines purely due to their vaccination status.

Hawkes contends the lawfulness of the continuing policy which seems to be continuing under a workplace policy. ‘Literally, at 5 pm on the day they rescinded the pandemic orders, Fire Rescue Victoria came up with an interim measure under the Commissioner’s directions,’ he tells me. ‘The union comes out immediately after and says there’s no lawfulness to this. It’s not pinned to anything. The commissioner doesn’t have the statutory authority to enforce it because it references all the pandemic orders. So essentially, they’re continuing a Minister or Chief Health Officer order under a workplace policy, but the Commissioner doesn’t have the power to do that and not neither does FRV.’

So, are the mandates continuing under a workplace policy? It would seem so. But wait, there’s more.

Hawkes and his colleagues are prevented from entering their workplace in a professional capacity however they could enter the same station and work as a volunteer. This seems completely illogical and somewhat hypocritical. As if the same workplace is only ‘safe’ for an unvaccinated firefighter if they are a volunteer.

But wait, there’s more.

FRV produced a Covid-19 Controls Risk Assessment. This document was obtained by Hawkes under freedom of information. The risk assessment identifies potential serious side effects from the jab including myocarditis, pericarditis, blood clots, and even death!

I ask, does Fire Rescue Commissioner Gavin Freeman know about this risk assessment? And if so, what is the justification for continuing to mandate an experimental jab, that doesn’t stop infection or transmission and has very real and significant risks of injury – no matter how rare? Just ask those vaccine-injured firefighters who are now unable to work and on Work Cover.

But wait, there’s more.

There are reports of serious shortages of firefighting crews on multiple occasions, involving multiple stations in Victoria. According to Hawkes, FRV may have instances that slip under minimum staffing numbers, citing emails that call for the ‘backfilling’ of shifts. ‘FRV are failing to fill the gaps while up to 50 firefighters remain sidelined,’ he tells me. ‘On Grand Final day this year, there were thirteen vehicles in the Metropolitan Fire Districts that were each running one firefighter down.’ That’s a tremendous shortage.

But wait, there is even more.

According to Hawkes, the last known mandated dose at FRV was in March 2022. They haven’t forced anyone in the workplace to have a jab – a second booster – since then. This would technically mean that all employees who had not received their second booster and beyond would officially be considered ‘not up to date’ according to official ATAGI guidelines. It appears, on paper, FRV are still mandating the jab and preventing those who are unvaccinated from returning to work, while not enforcing the policy in the workplace.

This mandate madness hasn’t gone unnoticed by elected members including federal MP Russell Broadbent. The long-standing member for Monash has held his seat continuously for almost 20 years, and recently lost pre-selection by the Liberal Party. Broadbent has been outspoken against mandates since 2021, at that time urging the government not to proceed and acknowledges his stance over the Covid years may have contributed to the lost pre-selection bid. Despite platform censorship and push-back, Broadbent has continued to advocate for those injured by the vaccine or continuing to be mandated, including Victoria’s firefighters. ‘The (FRV) risk assessment 100 per cent vindicates the firies still being threatened and punished for speaking out against the mandates,’ says Broadbent. ‘But it’s also a chilling admission for the colleagues who took the vaccine especially those who are now on WorkCover after suffering severe injuries following the jab. This is a blight on our nation. It’s unjust and an absolute disgrace.’

I couldn’t agree more.

As we head into another long hot summer, and the third Christmas for these sidelined firefighters, let’s hope and pray common sense prevails before it’s too late.

***************************************************

The Right wing of the Labor party came to the rescue on detaineee releases

Last week’s immigration omnishambles has panned out to be a masterclass in what not to do for the Albanese government – so much so that this time it was actually a good thing the PM was out of the country.

In fact, Albo’s absence turned out to be critical to the crisis being resolved, but we will come back to that intriguing little titbit later.

First let’s get to the heart of the issue. As we all know, 93 foreign detainees, including some with appalling criminal backgrounds, have been released from indefinite detention by the High Court.

That decision is the fault of the court, which is obliged to uphold the letter of the law — if not, as it would seem in this case, the spirit.

Home Affairs Minister Clare O’Neil made this point in noting that the decision was unexpected and overturned 20 years of legal precedent. She was also correct in observing that the government is obliged to follow the law.

Fair enough.

But we are all obliged to follow the law. The difference between the government and the rest of us is that the government has the power to change the law.

Indeed, that is ultimately the government’s only purpose. If laws are never going to change, why have governments? If there is no need to produce new legislation, why have legislators? If the system simply exists in perpetuity, why have elections?

These fundamental questions seem to have eluded the otherwise intelligent O’Neil as she seemed to fight a scrappy defensive day-to-day war against the obvious.

As for Immigration Minister Andrew Giles, one has to wonder what the point of his role is at all if not to prevent outcomes such as this.

Thus the vibe of the government’s response to a clearly ballooning debacle was the standard kneejerk and utterly wrong response of the besieged – that it wasn’t so bad, that it wasn’t their fault, that there isn’t anything they can do and that everything will be OK.

The first two defences are a form of gaslighting – telling the electorate that their concerns are imaginary and thus by implication that they are foolish to have them.

The second two simply render the defendant impotent – like the sort of thing you’d say to the person sitting next to you as a plane went down.

Again, if there is nothing the government can do, then what is the point of it?

And indeed every time a government or organisation attempts this type of defence against an obvious problem, it always ends up in disaster. Think Qantas. Think Optus.

A week ago chief executive Kelly Bayer Rosmarin was untroubled enough by the Optus outage that she was doing a photoshoot – one of the few cameras she faced on the day.

Literally in the middle of writing this, I was interrupted by a news alert that she had resigned.

Instead, governments should heed the advice of the godfather of the Labor right Graham Richardson, who says that at the first sign of an error – at least the first public one – ministers should immediately own it, apologise for it and fix it.

Thus it was telling that after days of the government swinging in the breeze on this issue, it was Acting PM Richard Marles, the senior figure of the resurgent Victorian Right, who swept in and cleaned up the mess by hurriedly doing a deal with Peter Dutton and pushing through a raft of security measures.

Even more tellingly, he pointedly brushed aside all the tangled and tokenistic semantics and legalese that had crippled the response until that point and said that it was clear the government needed to address community concerns.

Well yes, quite. That is effectively the government’s entire job definition.

After the listing directionlessness of the Voice campaign and deer-in-headlights haplessness of the immigration fiasco, this was a sharp relief example of the Right of the Labor Party at its best.

Whereas the Left is typically obsessed by pet issues that transcend all rules and boundaries while being crippled by systemic inertia in all other areas, the Right, when it’s working as it should, lives in the real world, responds to mainstream concerns and has a default position of just getting things done.

Indeed, it was jarring to contrast the initial government response that there was nothing it could do but wait for the High Court reasons with the incandescent comments of Treasurer Jim Chalmers – another leading Right figure and prime ministerial heir apparent – published in the Good Weekend on Saturday: “Even if you are here for a relatively long time, you still don’t have any time to waste. I am petrified of that. I’m petrified of getting to the end of the day and not having made the most of it.”

Or indeed the bombshell report on the front page of the News Corp Sunday papers that Bill Shorten – once the king of the Right – was going to wholly overhaul the NDIS, one of the most vital and fraught reforms facing the country.

For all of these reasons, it was probably good for everyone that Albo was out of the country, including Albo himself.

To the nominally Left PM’s credit, he has already been acting in the tradition of Labor Right leaders before him. He has now received a masterclass in how to act like those alongside him.

************************************

Also see my other blogs. Main ones below:

http://dissectleft.blogspot.com (DISSECTING LEFTISM -- daily)

http://antigreen.blogspot.com (GREENIE WATCH)

http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)

http://edwatch.blogspot.com (EDUCATION WATCH)

http://snorphty.blogspot.com/ (TONGUE-TIED)

http://jonjayray.com/blogall.html More blogs

***************************************

No comments: