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Coronavirus outbreak: Your paracetamol supply depends a lot on China

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Coronavirus outbreak: Your paracetamol supply depends a lot on China
India spooked the world this week by announcing curbs on exports of common drugs including paracetamol.
Bloomberg|
Last Updated: Mar 07, 2020, 08.25 AM IST

You would expect the coronavirus outbreak to have focused the minds of Europe’s politicians and drugmakers on finding a vaccine.

But it’s the continent’s fragile dependence on Asia for raw generic drug ingredients like paracetamol that’s proving a more immediate headache.

European Union health ministers are due to discuss the security of medical supplies on Friday, after warnings that the bloc faces potentially significant shortages of crucial components imported from China as the country attempts to get back to work after virusrelated shutdowns.

France has openly called for more manufacturing “sovereignty” from foreign suppliers, as it scrambles to guarantee the supply of masks and control the price of hand-gel to try to reassure the public.

It may seem pretty insensitive to point the finger at China and politicize medical-supply issues, given the country’s own tally of infections and deaths from the Covid-19 disease. Yet the scale of pharmaceutical dependence on Asia clearly deserves more attention than, say, textiles.

The data is patchy but France’s National Pharmaceutical Academy estimates the EU imports 80% of its “active pharmaceutical ingredients,” mostly from China and India. The U.K. medicines regulator estimates Chinese manufacturers make around 40% of all APIs used worldwide.

What makes Covid-19 so dangerous for imports is that it combines Chinese factory shutdowns with domestic political pressure to act aggressively.

India, itself very reliant on China for pharmaceutical ingredients, spooked the world this week by announcing curbs on exports of common drugs including paracetamol.

French laboratories have warned of possible medicine shortages later this year, according to Les Echos. Over in the U.S., which has similar supply issues when it comes to China, the Food and Drug Administration has said one drug is in short supply because of the coronavirus outbreak without naming it.

Short-term ideas such as stockpiling or resource sharing will probably be examined today in Brussels. But supply risks have been known for a long time and will require deeper fixes, according to Philippe Luscan, an executive who oversees French drugmaker Sanofi’s industrial footprint.

In an interview in his Paris office — where handshakes are now discouraged, obviously — he outlines Sanofi’s own push to get pharmaceutical production re-shored back in Europe. The company aims to spin off six European factories (in the U.K., France, Germany, Italy and Hungary) into a new listed entity by 2022, representing 1 billion euros ($1.1 billion) of revenue.

That entity will strike deals with firms that want to expand EU production. The Covid-19 crisis serves as one “salutary” incentive to do so, says Luscan. There are others, he adds: Quality issues that have forced products off the shelves, rising labor costs in China, and a pollution crackdown that’s temporarily shuttered factories.

This alone is probably unlikely to reverse the forces of globalization. If so many generic ingredients are manufactured in Asia, it’s because the plunging price of off-patent drugs using them and the rising cost of building lucrative new drug pipelines have pushed drugmakers to seek out cheap bases abroad.

The head of Swiss company Novartis AG’s generics business, Richard Saynor, said last month that some antibiotics were being sold in Europe for “less than the price of chewing gum.” Even Sanofi’s own initiative looks like an elegant way to free up capital from a low-margin business. But Luscan’s initiative should also prod policy makers into doing their part to boost production.

Viewing medicines as a strategic asset rather than a cheap commodity — one of the recommendations of Rosemary Gibson’s 2018 book “China Rx” — would be a good start, as would thinking up financial incentives to encourage local production. EU initiatives designed to boost new medical research are a good thing, but the security of generics shouldn’t be ignored.

The big unknown is how bad the current crisis could get. Bloomberg Intelligence pharma analyst Sam Fazeli warns that if Chinese factory production bounces back while the virus spreads in the EU, it’s possible that European manufacturing will become a bigger source of disruption. Officials in Brussels should bear that in mind when mapping out emergency scenarios.

Still, it's a good thing overall that the EU is finally waking up to drug supply risks. It shouldn't miss the opportunity to do something about it — or seed the makings of an even bigger headache when the next pandemic threat strikes.

https://economictimes.indiatimes.co...pends-a-lot-on-china/articleshow/74521467.cms
 
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How Are People Dying From The Coronavirus?
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Photo by Anthony Kwan/Getty Images

ALLISON CALLCONTRIBUTOR
March 06, 202012:29 PM ETFONT SIZE:
The U.S. death toll of the novel coronavirus rose Wednesday to 11, heightening concerns about how the virus works and, more importantly, how it kills.

The first case of the coronavirus disease COVID-19 is believed to have appeared December 2019 in Wuhan, China. Since late February, the virus has spread to 36 other countries and territories and has a global death toll of 3,041, according to the Centers for Disease Control and Prevention (CDC).

“Globally, about 3.4% of reported COVID-19 cases have died,” Tedros Adhanom Ghebreyesus, the director general for the World Health Organization (WHO), told the BBC.

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Health workers wearing protective gear take part in an exercise in handling a suspected patient at Sanglah hopital in Denpasar, Indonesia’s resort island of Bali, on February 12, 2020. – The number of fatalities from China’s COVID-19 coronavirus epidemic jumped to 1,113 nationwide on February 12 after another 97 deaths were reported by the national health commission. (Photo by SONNY TUMBELAKA / AFP) (Photo by SONNY TUMBELAKA/AFP via Getty Images)

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Like similar respiratory diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), the new coronavirus COVID-19 begins by infecting the tissues and airways inside the lungs, causing fever, coughing, and fatigue, which are the most common symptoms, according to the BBC. (RELATED: Worried About ‘Corona Virus’ Or The Flu? Here’s The Best Practices to Avoid Getting Sick)

Once a person is infected, the virus then invades the two kinds of cells in lung tissue including the mucus-producing cells and the cilia, University of Maryland School of Medicine associate professor Matthew B. Frieman, who researches pathogenic coronaviruses, told National Geographic.

Some of the more recent studies on COVID-19 suggested that the novel coronavirus, like SARS, infects and kills those mucus-producing cells, filling patients’ airways with fluid and causing pneumonia in both lungs. As the immune system fights back, scarring occurs, which stiffens the lungs and causes breathing trouble.

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“In severe cases, you basically flood your lungs and you can’t breathe,” Frieman said. “That’s how people are dying.”

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GLASGOW, SCOTLAND – FEBRUARY 19: Clinical support technician Douglas Condie extracts viruses from swab samples so that the genetic structure of a virus can be analysed and identified in the coronavirus testing laboratory at Glasgow Royal Infirmary, on February 19, 2020 in Glasgow, Scotland. (Photo by Jane Barlow – WPA Pool/Getty Images)

While the death rates among confirmed cases don’t reveal a certain cause for the virus, there are patterns that show which groups are most at risk. (RELATED: Stocks Roar Back From Coronavirus Plunge To Biggest Gain Since 2009)

In the first thorough analysis of over 44,000 confirmed coronavirus cases in China, the death rate was ten times higher in elderly individuals compared to middle-aged individuals, young adults and children.

Deaths directly caused by the coronavirus were highest among people over the age of 70 and lowest among people under 30, said the Chinese Center for Disease Control and Prevention (China CDC). In addition, fatality from the virus was approximately five times more common among people with diabetes, high blood pressure or respiratory diseases.

While coronavirus has led to more than 89,000 illnesses and 3,000 deaths globally, the amount of fatalities from the influenza virus are still significantly higher with approximately 32 million confirmed cases, 310,000 hospitalizations and 18,000 deaths this season in the U.S. alone, according to the CDC.

The chances of contracting and dying from the virus depends on certain set of factors, said the China CDC, like age, sex and pre-existing medical conditions. (RELATED: NBA Says Players Should Limit High-Fives Amid Coronavirus Fears)

The elderly are the most likely demographic to die from the virus, according to the China CDC. There was also a slightly higher fatality rate among men than women.

In a study conducted by the Journal of Medical Virology, the average age range of patients was 48-89, and eight of the patients were over the age of 80. Of the first 17 corona-virus-related deaths, 13 were male and only four were female.

The primary symptoms among these initial deaths included fever, found in 11 patients, and cough, found in 9.

The CDC advised that the best defense against the virus is by washing your hands, avoiding people who are coughing or sneezing, and avoiding touching your eyes, nose and mouth.

Tags : centers for disease control and prevention china coronavirus
 
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