Coronavirus Briefing: What Happened Today

Merck shares its Covid pill.,


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ImageDaily reported coronavirus cases in the United States, seven-day average.
Daily reported coronavirus cases in the United States, seven-day average.Credit…The New York Times

Merck announced today that it would license its promising Covid-19 pill, allowing the drug to be manufactured and sold cheaply in 105 developing nations, mostly in Africa and Asia. The move could help millions in poorer countries have access to a potentially lifesaving treatment.

This month, the company reported that its drug, called molnupiravir, halved the rate of hospitalizations and deaths in high-risk Covid patients in a large clinical trial. After the announcement, wealthy countries, including the U.S., negotiated deals to buy large portions of the planned supply, raising concerns that poor countries would be shut out, as they have been with vaccines.

Our colleague Stephanie Nolen, who covers global health, said Merck’s decision to license the drug free made for good public relations, and had its roots in the criticism the company faced during the fight for lifesaving H.I.V. drugs for Africa in the early 2000s.

Back then, Western pharmaceutical companies that produced H.I.V. medications were attacked by governments and activists for not licensing their treatments to drug makers in the developing world who said they could cheaply manufacture generic versions. Eventually, a compromise was reached: Pharmaceutical companies would hold patents and produce for wealthy nations, including the U.S. and European countries, while companies in India and other emerging economies manufactured generic versions.

“It took pharmaceutical companies a long time to do what I would say is the right thing back then,” Stephanie said. “But they learned from that. Now, it’s core to the culture of some pharmaceutical companies to understand that you have to do access right from the beginning with a new drug.”

Merck is partnering with the Medicines Patent Pool, a United-Nations backed organization that helps to make medical treatment globally accessible, which will then sublicense the formulation of the pill to companies in the developing world. Merck will supply wealthy nations, like the U.S., which purchased courses of the drug for $712 each. And companies in the developing world will supply the market there. Some experts said a generic version of molnupiravir could profitably be produced for as little as $8 per course.

More than 50 companies, from all regions of the developing world, have already approached the organization about obtaining a sublicense, said the director of the Medicines Patent Pool.

The move to license the drug also stands in contrast to the fight over vaccine technology.

“Merck’s pill is a straightforward small-molecule drug,” Stephanie said. “Whereas the thing that Moderna and Pfizer are holding on to is something that no one else has managed to successfully make yet — an effective vaccine using an mRNA platform. A lot of companies are looking at mRNA technology for tuberculosis, malaria, H.I.V. and cancer vaccines. It’s a golden ticket. So the stakes in sharing that are totally different.”

Although Merck’s announcement today is positive news, Stephanie said there were some outstanding issues. The drug has not been approved for use by any regulatory agency, and Merck has not shared any clinical trial data. (The company has applied for emergency authorization from the F.D.A. and a decision could come by December.)

The deal with the Patent Pool also leaves out most middle income countries, including China and Russia — the site of a raging Covid outbreak — raising the possibility that citizens in these nations, which often have weak health systems, will not have access to the drug.

And molnupiravir will need to be accompanied by widespread access to fast and easy testing — people can take the pill only after they know they have Covid.

“But if this drug proves safe, and if it’s approved, then it potentially dramatically changes what the pandemic looks like,” Stephanie said. “You can treat people as soon as they start to fall sick, and you can keep them out of hospital, and keep them from dying. Then we start to be able to think about living with Covid in a really different way.”


Josie Taveras tested positive early in the pandemic and continued to have symptoms consistent with “long Covid.”Credit…Sarah Blesener for The New York Times

Thousands of Americans and possibly millions may have “long Covid,” in which they continue to experience symptoms long after an infection.

But although President Biden has said they should qualify for federal disability benefits, survivors can have a hard time getting the assistance.

The American Academy of Physical Medicine and Rehabilitation estimates that three to 10 million Americans may have long Covid. But only about 16,000 applicants have even been able to provide the Social Security Administration with medical evidence supporting Covid-19 as an impairment since December 2020, according to an agency spokeswoman.

There is no widely agreed-on method of diagnosing the ailment.

Josie Cabrera Taveras tested positive in April 2020. Since then, she has been sleeping for up to 15 hours a day, stopping in grocery store aisles to catch her breath, and lapsing in and out of consciousness. She has been unable to return to her job as a nanny.

She’s tried to find medical evidence of her condition, undergoing two brain M.R.I.s, several heart ultrasounds and dozens of lung X-rays, among other procedures. All have returned normal results. Without concrete evidence, she has been turned down for disability coverage twice.

“It’s something doctors can’t explain yet, what’s happening to me,” Taveras said.

We’re parents of a 3- and 5-year-old. I think we’ll come to appreciate all the time we’ve been able to spend with the children in our small apartment together, but for the most part, it’s been all-consuming. We haven’t tried recipes, taken up hobbies, caught up on anything; on the contrary, we’ve lost our personal lives. We even gave up on attempting adult conversation moons ago. The top priority is getting the kids through. When schools and kinders reopen someday, we’ll get to recover, and hopefully see that our sacrifice has given the kids endless family time they’d never have had otherwise.

— David Lazarus, Lima, Peru

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