Fears of coronavirus second wave prompt flu push at U.S. pharmacies, drugmakers

By Caroline Humer and Julie Steenhuysen

NEW YORK (Reuters) – U.S. pharmacy chains are preparing a big push for flu vaccinations when the season kicks off in October, hoping to curb tens of thousands of serious cases that could coincide with a second wave of coronavirus infections.

CVS Health Corp, one of the largest U.S. pharmacies, said it is working to ensure it has vaccine doses available for an anticipated surge in customers seeking shots to protect against seasonal influenza.

Rival chain Rite Aid Corp has ordered 40 percent more vaccine doses to meet the expected demand. Walmart Inc and Walgreens Boots Alliance said they also are expecting more Americans to seek these shots.

Drugmakers are ramping up to meet the demand. Australian vaccine maker CSL Ltd’s Seqirus said demand from customers has increased by 10 percent. British-based GlaxoSmithKline said it is ready to increase manufacturing as needed.

A Reuters/Ipsos poll of 4,428 adults conducted May 13-19 found that about 60 percent of U.S. adults plan to get the flu vaccine in the fall. Typically fewer than half of Americans get vaccinated. The U.S. Centers for Disease Control and Prevention (CDC) recommends the vaccine for everyone over age 6 months.

Getting a flu shot does not protect against COVID-19, the respiratory disease caused by the novel coronavirus for which there are no approved vaccines. Public health officials have said vaccination against the flu will be critical to help prevent hospitals from becoming overwhelmed with flu and COVID-19 patients.

“We’re in for a double-barreled assault this fall and winter with flu and COVID. Flu is the one you can do something about,“ Vanderbilt University Medical Center infectious disease expert Dr. William Schaffner said.

Drugmakers last year produced nearly 170 million doses of influenza vaccine, according to the CDC. There were up to 740,000 hospitalizations and 62,000 deaths in the 2019-2020 flu season that ended last month, the CDC said.

While health insurance typically covers the flu shot at a doctor’s office and other groups offer free flu vaccine clinics, the adult vaccine retails for about $40, putting the U.S. market at up to $6.8 billion. The CDC secures some doses at a discount price in its child vaccination program.

Global revenue for influenza vaccines is about $5 billion, according to Wall Street firm Bernstein, and in the United States each additional 1 percentage point of Americans getting the vaccine is worth $75 million in revenues to drugmakers.

HEAVIER TOLL

CDC Director Robert Redfield has said that flu and COVID-19 combined could exact a heavier toll on Americans than the initial coronavirus outbreak that began this winter.

Some experts said creative ways must be developed to ensure that people are vaccinated against flu because patients may be less likely to see their doctors in person out of fear of getting infected with the coronavirus in medical offices.

Pharmacies, public health clinics and other flu shot providers may need to develop drive-up clinics – popular with COVID-19 diagnostic tests – for flu vaccines, said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Disease.

“My goal is that every single vaccine dose that gets made gets into somebody’s arm to protect them. I don’t want any vaccines left on the shelves or in doctors’ offices,” Messonnier said in an interview.

One reason for reluctance among Americans to get the flu shot is that it does not always prevent disease, in part because the flu strains selected as targets of the vaccine months ahead of time are not always a perfect match for the dominant flu strains that actually circulate in any given season. But the shots reliably reduce hospitalizations every year, according to experts.

“Even if it protects 35 to 40 percent of the population, it’s a lot better than zero,” University of Minnesota influenza expert Dr. Michael Osterholm said.

In a survey commissioned by CVS Health between January and May, consumers who said they will definitely or are likely to get a flu shot rose from 34 percent to 65 percent. They also said they would increasingly go to pharmacies and less often to a doctor’s office or healthcare centers.

Rite Aid Chief Pharmacy Officer Jocelyn Konrad said the pharmacy chain, which provided about 2.6 million flu shots last year, upped its order by 40 percent this year.

Rite Aid said social distancing policies may cut into workplace flu clinics but that it may offer voucher programs to employers and is considering setting up drive-through clinics. In Australia, where the winter flu season is underway, such sites are already in use.

Some U.S. doctors are also considering clinics in parks and community centers and even home visits for vulnerable patients, said David Ross, vice president of commercial operations for North America at Seqirus.

“As we look at immunization this coming fall, it will play an enormous role in this battle against COVID-19,” Ross said.

(Reporting by Caroline Humer in New York and Julie Steenhuysen in Chicago; Additional reporting by Grant Smith in New York; Editing by Michele Gershberg and Will Dunham)

U.S. could face 200,000 coronavirus deaths, millions of cases, Fauci warns

By Doina Chiacu and Tom Polansek

WASHINGTON/CHICAGO (Reuters) – U.S. deaths from coronavirus could reach 200,000 with millions of cases, the government’s top infectious diseases expert warned on Sunday as New York, New Orleans and other major cities pleaded for more medical supplies.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, estimated in an interview with CNN that the pandemic could cause between 100,000 and 200,000 deaths in the United States.

Since 2010, the flu has killed between 12,000 and 61,000 Americans a year, according to the U.S. Centers for Disease Control and Prevention. The 1918-19 flu pandemic killed 675,000 in the United States, according to the CDC https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/pandemic-preparedness.htm.

The U.S. coronavirus death toll topped 2,400 on Sunday, after deaths on Saturday more than doubled from the level two days prior. The United States has now recorded more than 137,000 cases of COVID-19, the disease caused by the virus, the most of any country in the world.

Click https://graphics.reuters.com/HEALTH-CORONAVIRUS-USA/0100B5K8423/index.html for a GRAPHIC on U.S. coronavirus cases

Jason Brown, who was laid off from his job in digital media due to the pandemic, said Fauci’s estimate was scary.

“I feel like it’s just growing, growing, growing,” said Brown, who is 27 and lives in Los Angeles, one of the epicenters of the outbreak. “There’s no vaccine. It seems like a lot of people don’t take it seriously in the U.S. so it makes me believe that this would become more drastic and drastic.”

Erika Andrade, a teacher who lives in Trumbull, Connecticut, said she was already expecting widespread deaths from the virus before Fauci’s estimate on Sunday.

“I wasn’t surprised that he said the numbers were coming. They were lower than what I actually expected,” said Andrade, 49. “I’m worried for my mother. I’m worried for the people I love.”

In New York, the usually bustling city was quiet except for the sound of ambulance sirens.

“It feels very apocalyptic,” said Quentin Hill, 27, of New York City, who works for a Jewish nonprofit. “It almost feels like we’re in wartime.”

New York state reported nearly 60,000 cases and a total of 965 deaths on Sunday, up 237 in the past 24 hours with one person dying in the state every six minutes. The number of patients hospitalized is slowing, doubling every six days instead of every four, Governor Andrew Cuomo said.

Stephanie Garrido, 36, a tech worker from Manhattan, said she has not left her home in 15 days, receiving her groceries by delivery. Too many New Yorkers have underestimated the aggressiveness of the virus as many people continue to socialize and congregate, Garrido said.

“Those people are in denial or just don’t think it will affect them. It’s extremely inconsiderate,” Garrido said. “People need to consider that this will be much longer term.”

The governors of at least 21 states, representing more than half the U.S. population of 330 million, have told residents to stay home and closed non-essential businesses.

Maryland arrested a man who repeatedly violated the ban on large gatherings by hosting a bonfire party with 60 guests, Governor Larry Hogan said on Sunday.

One bright spot on Sunday was Florida reporting about 200 more cases but no new deaths, with its toll staying at 56.

President Donald Trump has talked about reopening the country by Easter Sunday, April 12, despite many states such as New York ordering residents to stay home past that date. On Saturday, he seemed to play down those expectations, saying only “We’ll see what happens.”

Tests to track the disease’s progress also remain in short supply, despite repeated White House promises that they would be widely available.

Trump, who is due to hold a news conference at 5 p.m. ET (2100 GMT), bragged on Twitter about the millions of Americans tuning in to watch the daily briefings.

VENTILATOR SHORTAGE

Michigan Governor Gretchen Whitmer, whose state has become one the fastest growing areas for the virus, especially in the county that includes Detroit, called the rapid spread “gut-wrenching.”

“We have nurses wearing the same mask from the beginning of their shift until the end, masks that are supposed to for one patient at one point in your shift. We need some assistance and we’re going to need thousands of ventilators,” Whitmer told CNN.

New York City will need hundreds more ventilators in a few days and more masks, gowns and other supplies by April 5, Mayor Bill de Blasio said to CNN.

New Orleans will run out of ventilators around April 4, John Bel Edwards told CBS.

Ventilators are breathing machines needed by many of those suffering from the pneumonia-like respiratory ailment and many hospitals fear they will not have enough.

Dr. Arabia Mollette, an emergency medicine physician at Brookdale and St. Barnabas Hospital in the Bronx, say she now works in a “medical warzone.”

“We’re trying to keep our heads above water without drowning,” Mollette said. “We are scared. We’re trying to fight for everyone else’s life, but we also fight for our lives as well.”

Click https://graphics.reuters.com/CHINA-HEALTH-MAP/0100B59S39E/index.html for a GRAPHIC tracking the spread of the global coronavirus

(Reporting by Sarah N. Lynch, Doina Chiacu and Chris Sanders in Washington, Karen Freifeld in New York, Tom Polansek in Chicago and Dan Trotta; Writing by Lisa Shumaker; Editing by Daniel Wallis)

Bird flu hits another U.S. farm that supplies Tyson Foods

quarantine researcher checking chickens on poultry farm for bird flu

By Tom Polansek

CHICAGO (Reuters) – Bird flu that is highly lethal to poultry has infected a second commercial chicken farm in Tennessee that supplies Tyson Foods Inc, company and state officials said on Thursday.

The finding expands an outbreak near the major chicken-producing states of Alabama and Georgia, and is the second in the type of breeder flock crucial for keeping the chicken-meat industry supplied with birds. A case of less dangerous bird flu was confirmed in Alabama on Thursday.

In Tennessee, authorities have started to cull the infected flock of 55,000 chickens in Lincoln County, to contain the highly pathogenic H7N9 flu, according to the U.S. Department of Agriculture.

The farm was in a quarantine zone established after authorities this month found the same strain of the disease in a flock of about 73,500 chickens less than 2 miles (3.2 km) away, the Tennessee Department of Agriculture said. That farm also supplied Tyson, the world’s biggest chicken company.

“I’m sure on the part of the company they’re quite concerned and going back and reviewing all of their information and data to determine how in the world this got into the buildings,” said Bret Marsh, state veterinarian in Indiana, which had the nation’s only highly pathogenic bird flu case in poultry in 2016.

The initial case in Tennessee was the nation’s first infection of highly pathogenic bird flu at a commercial operation in more than a year. Tennessee also recently detected a less-dangerous case of low-pathogenic flu in another chicken flock.

On Thursday, Alabama said the USDA confirmed a suspected case of low-pathogenic flu in a guinea fowl at a flea market as H7N9. Aviagen, the world’s largest poultry breeding company, has culled chickens in the state over concerns about the disease.

Highly pathogenic bird flu led to the deaths of about 50 million birds, mostly egg-laying hens, in the United States in 2014 and 2015.

Another widespread outbreak could represent a financial blow for poultry operators because it could kill more birds or require flocks to be culled. It also would likely trigger more import bans from trading partners, after South Korea, Japan and other countries limited imports after the first highly pathogenic case in Tennessee.

China has also been grappling with an outbreak of H7N9, which has killed 161 people since October. U.S. authorities have said that strain is genetically distinct from the H7N9 in Tennessee and that the risk of the disease spreading to people from poultry or making food unsafe is low.

Tyson said it worked with Tennessee and federal officials to quickly euthanize birds in the infected flock and did not expect disruptions to its chicken supply.

“Our business is diversified and scaled across multiple states, so we plan to meet our customers’ needs,” spokesman Worth Sparkman said.

Tyson shares fell 1.7 percent to close at $62.00 on Thursday.

The company has said it tests all the birds it owns for the virus and flocks diagnosed with highly pathogenic flu are not processed.

Wild birds can carry the disease without showing signs of sickness and transmit it to poultry through feces, feathers or other forms of contract.

(Editing by Chizu Nomiyama and Matthew Lewis)

Poultry breeder Aviagen culls U.S. flock over bird flu fears

FILE PHOTO: The Avian influenza virus is harvested from a chicken egg as part of a diagnostic process in this undated U.S. Department of Agriculture (USDA) handout image. Erica Spackman/USDA/Handout/File Photo via REUTERS

By Tom Polansek

CHICAGO (Reuters) – Aviagen [EWESJA.UL], the world’s leading poultry breeding company, has euthanized chickens at a farm in Alabama over concerns about bird flu, the company said on Tuesday, as likely cases of the disease emerged in a top chicken-producing state.

Alabama officials said they suspected that poultry at three sites in the state were infected with the virus, about a week after some 90,500 chickens were culled over infections at two commercial operations across the border in Tennessee.

Aviagen detected the presence of antibodies for the flu virus in a flock in Alabama that showed “no evidence of clinical disease,” company spokeswoman Marla Robinson said in an email. The company is based in Alabama.

The company euthanized the flock and “all eggs which were collected from that farm in the production system were traced and removed,” she said. Aviagen did not respond to a question about how many birds were killed.

Tony Frazier, Alabama’s state veterinarian, said the company chose to cull about 15,000 birds. The U.S. Department of Agriculture (USDA) said the farm had 153,000 birds.

A national USDA lab is testing samples from poultry in Alabama to identify the strain of the virus and how lethal it is for birds, after another agency-approved lab identified the H7 subtype of the disease in samples, USDA spokeswoman Lyndsay Cole said.

The birds in Alabama did not show clinical signs of sickness, which indicates they did not have a highly lethal, or pathogenic, form of the virus, Cole said.

In Tennessee, both cases were identified as H7N9. The USDA on March 5 confirmed that one was the United States’ first infection of highly pathogenic flu in commercial poultry in a year. Days later, the state said it had found the other case nearby and it was low pathogenic.

Highly pathogenic bird flu led to the deaths of about 50 million birds, mostly egg-laying hens, in the United States in 2014 and 2015.

Another highly pathogenic outbreak would likely represent a financial blow for poultry operators such as Tyson Foods Inc and Pilgrim’s Pride Corp because it would kill more birds or require flocks to be culled.

It also would likely trigger more import bans from trading partners, after South Korea, Japan and other countries limited imports after the highly pathogenic case in Tennessee.

Health officials have said the risk of bird flu spreading to people from poultry or making food unsafe was low.

Separately, Frazier said the owner of a backyard flock suspected of having the virus chose to cull about 70 birds. No poultry linked to the third suspected case, which involved birds at a flea market, have been culled, he said.

Frazier said the cases were still only suspected flu infections and needed to be confirmed by the USDA. Earlier, the Alabama Department of Agriculture and Industries called a news conference to discuss what it said were three findings of avian influenza.

Alabama raised more than 1 billion chickens for meat in 2015, making it the country’s third largest producer, according to the USDA.

The national USDA laboratory, to which samples from the state were sent, is the only one in the United States that officially confirms cases.

The World Organization for Animal Health requires that all confirmed low-pathogenic H5 and H7 bird flu subtypes be reported because of their potential to mutate into highly pathogenic strains. Highly pathogenic cases also must be reported.

(Reporting by Tom Polansek; Editing by Frances Kerry, Toni Reinhold)

Bird flu strikes Tennessee chickens again, in a less-dangerous form

The Avian influenza virus is harvested from a chicken egg as part of a diagnostic process in this undated U.S. Department of Agriculture (USDA) handout image. REUTERS / Erica Spackman / USDA / Handout via Reuters

By Tom Polansek

CHICAGO (Reuters) – A commercial flock of 17,000 chickens in Tennessee has been culled after becoming infected with low-pathogenic bird flu, state agricultural officials said on Thursday, days after a more dangerous form of the disease killed poultry in a neighboring county.

Authorities killed and buried chickens at the site in Giles County, Tennessee, “as a precaution” after a case of highly pathogenic flu in Lincoln County led to the deaths of about 73,500 chickens over the weekend, according to the Tennessee Department of Agriculture. It said officials did not believe birds at one premise sickened those at the other.

Highly pathogenic bird flu is often fatal for domesticated poultry and led to the deaths of about 50 million birds, mostly egg-laying hens, in the United States in 2014 and 2015. Low-pathogenic flu is less serious and can cause coughing, depression and other symptoms in birds.

The highly pathogenic case in Tennessee was the first such infection in a commercial U.S. operation in more than a year and heightened fears among chicken producers that the disease may return.

The spread of highly pathogenic flu could represent a financial blow for poultry operators, such as Tyson Foods Inc and Pilgrim’s Pride Corp, because it would kill more birds or require flocks to be culled. It also would trigger more import bans from other countries, after South Korea, Japan and other nations limited imports because of the case in Lincoln County.

Jack Shere, chief veterinary officer for the U.S. Department of Agriculture, said in an interview that there was speculation the highly pathogenic virus found in Tennessee shared similar characteristics with a low-pathogenic virus that circulated in Tennessee, Kentucky, Minnesota and Illinois in 2009.

Wild migratory birds can carry the flu without showing symptoms and spread it to poultry through feces, feathers or other contact.

“This virus can mutate very easily, so low-pathogenic issues are just as important – when they are circulating among the wild birds – as the high-pathogenic issues,” Shere said.

Both cases in Tennessee were located along the state’s southern border with Alabama, one of the country’s top producers of “broiler” chickens for meat. They also were both in facilities for chickens that bred broiler birds and involved the same strain, H7N9, according to Tennessee’s agriculture department.

The state said it was testing poultry within a 10-kilometer radius of the Giles County site for the flu and so far had not found any other sick flocks.

“When routine testing showed a problem at this facility, the operators immediately took action and notified our lab,” said Charles Hatcher, Tennessee’s state veterinarian.

H7N9 is the same name as a strain of the virus that has killed people in China, but U.S. authorities said the Tennessee virus was genetically distinct.

U.S. officials have said the risk of bird flu spreading to people from poultry or making food unsafe was low.

Low-pathogenic bird flu also was recently detected on a turkey farm in Wisconsin. Authorities there decided to keep the birds under quarantine until they tested negative for the virus, rather than to cull them, according to the state.

(Additional reporting by Mark Weinraub in Washington, D.C.; Editing by G Crosse, Richard Chang and Bernard Orr)

Woman’s Holiday Trip Leaves Her Quadruple Amputee

A woman’s 4th of July trip to Grand Lake has left her without parts of her arms and legs thanks to one tick bite.

Jo Rogers, a mother of two, took her family for a holiday getaway to Grand Lake in northeast Oklahoma.  When she returned home, she mentioned to family members she was not feeling well, thinking that she had picked up the flu during her trip.

The following day, family members rushed her to the hospital when Rogers said her hands and feet hurt.  Within hours Rogers was placed into a medically induced coma as her limbs began to turn black and blue at the tips and then spread up her arms and legs.

Doctors finally noticed a tick bite and discovered she had an aggressive form of Rocky Mountain Spotted Fever (RMSF).  While there is treatment for RMSF, it must be started in the early days of infection and doctors say that Rogers missed that initial time frame.

The initial symptoms of RMSF mimic that of a cold or flu with headache, fever, vomiting and muscle pain.  Oklahoma is one of five states where the rate of infection from the disease is three to 10 times the national average according to the Centers for Disease Control.

“She is still on a ventilator and being kept sedated to help with pain.  Although she will have insurance for a couple more months, her medical bills are mounting daily and will continue as she will be in the hospital for many more months with rehab, prosthetics and home and car renovation to accommodate her needs,” her family wrote on a GoFundMe page.

CDC Says Flu Vaccine Just 23 Percent Effective

Early estimates of the flu vaccine show that it has been just 23 percent effective at preventing doctor visits for all ages.

The flu vaccine is not the worst ever, as one vaccine this decade has been as low at 10 percent effective, but the low totals are enough for the Centers for Disease Control to urge doctors to increase antiviral prescriptions should a patient show signs of flu.

The weakness of the vaccine is blamed on the prevalence of the H3N2 strain of flu that is circulating most among citizens.

“Physicians should be aware that all hospitalized patients and all outpatients at high risk for serious complications should be treated as soon as possible with one of three available influenza antiviral medications if influenza is suspected, regardless of a patient’s vaccination status and without waiting for confirmatory testing,” said Joe Bresee, branch chief in the CDC’s Influenza Division.

The vaccine was showing 26 percent effectiveness in children six months through 17 years but only 14 percent for adults over 50.

The flu season is being called “moderately severe” by the CDC.

CDC Declares National Flu Epidemic

The Centers for Disease Control has officially declared a flu epidemic.

The number of states reporting high levels of flu jumped from 13 to 22 last week and the CDC says there are now flu outbreaks in every region of the country.

The CDC also said that 15 children have died as a result of this year’s flu outbreak, 6 of them in Tennessee alone.  East Tennessee Children’s Hospital has reported 442 children with flu already this year.

ABC Chief Medical Editor Dr. Richard Besser said on Good Morning America that about a hundred children a year die from the flu.  He said that children, the elderly and anyone with a compromised immune system are at highest danger for death.

The CDC says the H3N2 subtype is the strain in 90 percent of confirmed flu cases.

Dr. Besser said that the flu season has been striking earlier during the last few years and he called it a “worrying trend.”

He advised anyone in a high risk category to get a flu shot.

CDC: Too Late To Make Flu Vaccine

The Centers for Disease Control says that it’s too late in the flu season to create a vaccine to fight the predominant strain of flu virus in the United States.

The strain, influenza A (H3N2) has mutated since the current flu shots were created and the current shots are only partially effective in containing the virus.

CDC Director Dr. Thomas Frieden said it would take up to four months to create a new flu vaccine even if newer technologies are used in creation.

Doctors say that the H3N2 strain has been especially severe when dominant and that without good match in a vaccine the likelihood of increased hospitalizations and deaths significantly increases.

The CDC is still recommending a flu shot because they say it could provide partial protection against H3N2.  They also say that if someone comes seriously ill with the flu it’s vital they be taken to a hospital for treatment.

Flu Growing Among Younger People

The Centers for Disease Control is noticing a disturbing trend in the current flu season.

The CDC says that significantly more adults between 18 and 64 have been hospitalized because of the flu than in previous years.  According to their weekly survey of the flu, more than 61.5 percent of hospitalized patients were between the 18 to 64 age group, an 80 percent increase from last year.

Almost 2,500 specimens sent to the CDC for testing that showed positive for the flu. Of that group, almost 96% tested positive for the H1N1 swine flu.

The alarm from the CDC is echoing among medical providers who are seeing deaths among previously healthy young adults. Last week a 29-year-old mother of three died just a few days after exhibiting flu symptoms.  A 41-year-old man also died from the flu.

The CDC says the country has not yet reached epidemic level but the number of states showing widespread influenza rose from 25 to 35 last week.