Covid-19: why is treatment against BA.4 and BA.5 reserved for the United States?

To date, there is only one effective treatment for severe Covid cases: bebtelovimab.

Covid-19: why is treatment against BA.4 and BA.5 reserved for the United States?

To date, there is only one effective treatment for severe Covid cases: bebtelovimab. According to a recent study conducted by a team from Columbia University and published in pre-publication on the BioRxiv site, this monoclonal antibody developed by the American pharmaceutical company Lilly retains a powerful neutralizing activity against the BA.4 and BA subvariants .5 from Omicron. But if the Lilly laboratory has signed an agreement with the American government providing for the delivery of 600,000 doses for March 31, 2022, with an option of 500,000 additional doses for July 31, 2022, it refuses to market its treatment outside the UNITED STATES.

"A scandal", for epidemiologist Antoine Flahault, director of the Institute of Global Health at the University of Geneva, who denounces the company's decision on Twitter. The pharmaceutical company defends itself by explaining that it "continued to assess the need and the demand for [its] treatment in other markets", underlines Le Temps. What interest does the laboratory have in limiting its market if the demand is present in Europe? “Lilly had launched a first generation of monoclonal antibodies directed against SARS-CoV-2, but this treatment very quickly lost effectiveness against new variants. Is it possible that the company was burned by this experience and does not want to invest as much in this therapeutic field?” asks Alexandra Calmy, infectious disease specialist at the University Hospitals of Geneva (HUG) to the Swiss daily. "It is very difficult for us as physicians not to have a drug that appears to retain efficacy against BA.4 and BA.5."

And for good reason, according to a study by the University of Tokyo, which evaluated the characteristics of the sub-variants, BA.4 and BA.5, the latter would replicate more efficiently in human lung cells than BA.2. In hamsters, the lung lesions would in any case be more severe during an infection. Having an effective treatment for immunocompromised patients and people at high risk of developing serious forms is therefore not a luxury.

On June 14, the European Center for Disease Prevention and Control (ECDC) warned of the possibility of an increase in the number of daily cases in Europe in the coming weeks "carried" by BA.4 and BA.5. Both subvariants are already dominant in the United States, in South Africa where they were first spotted, but also in Portugal, which is currently seeing an increase in the number of cases, hospitalizations and deaths linked to the Covid-19. In France, the BA.2 sub-variant remains dominant but it is beginning to be overtaken by the last two, which are gradually taking over in all contaminations.

While they were respectively at 0.8% for BA.4 and 5% for BA.5 in all the contaminations listed in the data of June 2, they have now risen to 3.7% and 24.2% , explains Public Health France in its last weekly update of June 16. At the same time, the number of cases recorded daily in the territory is also increasing. Public Health France thus explains that “the circulation of SARS-CoV-2 has accelerated throughout the metropolitan territory with a strong increase in virological indicators.” A trend of increasing hospital admissions was also observed. The incidence rate thus increased by 53% in one week (between the week of June 30 and June 5 and June 6 to 12) according to health authorities.

If the epidemic therefore seems to spread, epidemiologists, who call for caution, believe however that these new sub-variants will not necessarily cause more deaths. "In South Africa, BA.4/5 were much, much less deadly than all the previous waves", reassured at the start of the week Tulio de Oliveira, director of the CERI (Centre for Epidemic Response

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