As Medication Abortion Becomes Dominant, Red States Restrict Pills

The abortion drug mifepristone was approved by the FDA more than 20 years ago. The FDA recently relaxed some of the rules for dispensing the drug. Now, some legislatures are trying to restrict access.

For most of the almost 50 years since the Roe v Wade Supreme Court decision legalized abortion nationwide, clinics have been the focus of the battle over abortion rights.

Protesters gather outside on sidewalks. And Republican state lawmakers try to regulate what happens inside — through laws restricting which healthcare providers can perform abortions, the kind of counseling required and which procedures are allowed.

But now, more than half of abortions are taking place with pills.

According to data released by Guttmacher earlier this year, abortion pills – not surgical procedures – accounted for 54 percent of abortions in 2020. That makes medication abortion the dominant choice in the United States for the first time since the Food and Drug Administration approved an abortion pill, mifepristone, more than 20 years ago. It’s part of a two-drug protocol approved to terminate pregnancies up to 10 weeks gestation. That protocol also is prescribed to manage some miscarriages.

During the pandemic, the FDA relaxed rules so that the tightly regulated drug mifepristone could be obtained through telehealth appointments and mail-order pharmacies, rather than in person. That made it easier for patients in some states to get a medication abortion at home. The Biden administration recently made those changes permanent.

Now, Republican lawmakers in several states are pushing back. In South Dakota, Gov. Kristi Noem recently signed legislation designed to restrict access to the drugs.

Already, more than a dozen states restrict limit the use of telemedicine to provide abortion pills. And this year, Planned Parenthood says new restrictions have been introduced in two dozen states, some of which would ban the pills altogether if Roe v Wade is overturned.

In Georgia, Republican state Sen. Bruce Thompson sponsored SB 456, a bill banning abortion pill delivery by mail and requiring doctors to examine patients in person before prescribing them. During floor debate, Thompson said his bill was intended “to protect the cherished doctor-patient relationship.”

But that position is at odds with that of major medical groups, including the American College of Obstetricians and Gynecologists and the American Medical Association, who’ve long supported easing access to the pills and called for lifting the in-person dispensing requirement.

Thompson opposes abortion rights, but he claims this bill is all about patient safety.

“Why would we not do everything within our power to protect women’s health and safety during this difficult time in their lives?” he said.

But opponents say the bill would make patients less safe. Several lawmakers noted that Georgia is among the states with the highest rates of maternal mortality – and that those death rates are dramatically higher for Black women.

State Sen. Kim Jackson, a Democrat, noted that many people, particularly in rural areas, lack access to pregnancy care.

“What’s really cruel about this bill is that those who are already the most vulnerable are the ones who are most likely to be burned by this injustice,” Jackson said. “People who are poor, people who live in rural communities. People with disabilities, and people of color.”

The bill passed Georgia’s state senate on March 1 and is awaiting a vote in the House.

“As soon as the FDA made medication abortion more accessible, Georgia pretty much turned around and was like, ‘No, we actually want to make it really difficult for people to get one,'” said K. Agbebiyi, a Georgia-based advocate with the reproductive rights group URGE, which is fighting the bill.

Agbebiyi said medication abortion could become the only option for a growing number of people in states where clinics are few and far between because of abortion restrictions.

“We know, and our opponents know, that medication abortion is going to grow in popularity if Roe is overturned,” Agbebiyi said. “And that’s precisely why they’re trying to put as many barriers in place as possible.”

It’s more difficult to put up barriers on the internet, where abortion pills are available through mail-order pharmacies and other groups.

Ushma Upadhyay, a reproductive health researcher at the University of California, San Francisco, warned that if states try to block access to abortion pills, patients will find them online without a doctor’s help.

“That is what I’m concerned about,” she said. “It is extremely safe, but all patients should have the access to clinical support if they need it, if they have questions about how to take it, or whether what’s happening is normal.”

Meanwhile, some states are trying to make access to medication abortion easier. A bill moving forward in Delaware would allow a wider array of healthcare providers to prescribe the pills to their patients.

By:

Source: Republican state lawmakers are working to restrict access to abortion pills. : NPR

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Critics:

By: Shefali Luthra

“Medication abortion is the existential threat of the anti-abortion movement,” said Greer Donley, an assistant professor at the University of Pittsburgh Law School who specializes in laws surrounding medication abortion access. When they’re on the precipice of getting the Supreme Court to overturn Roe v. Wade, there’s a technological advance that has made it impossible to control abortions.” 

Texas, which is so far the only state that has ended access to abortions after six weeks of pregnancy, provides some insight. The number of Texans receiving abortions has only fallen somewhat — a far larger number of people are now making journeys out of state or ordering medication abortion pills online from the European nonprofit Aid Access, which operates outside the U.S. health care system but has worked to provide Americans with telemedicine-based medication abortions since 2018.

In a post-Roe world, the options would likely look different. With more states banning or severely restricting abortion access, travel likely poses a greater burden, especially for people who live where neighboring states also have legislatures that have restricted access. But health care providers in states where abortion rights are protected could, under the new FDA guidance, could potentially prescribe pills through a phone call or video-chat and mail them to people in other states.

There are accessibility questions. Not everyone has sufficient internet access to find a virtual provider, noted Abigail Aiken, an associate professor at the University of Texas at Austin who has studied the Texas law’s impact on medication abortion requests. And not everyone knows about services like Aid Access or other ways to navigate the health care system and find an out-of-state provider.

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The Coronavirus Crisis

More Patients Seek Abortion Pills Online During Pandemic, But Face Restrictions

Consider This from NPR

The New Texas Abortion Law Is Putting Some Patients In Danger

National

With Abortion Restrictions On The Rise, Some Women Induce Their Own

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Welcome To The Vice Age: How Sex, Drugs And Gambling Help Americans Cope With Covid

The pandemic caused millions to lean in to good old-fashioned bad behavior. Two years later, business has never been better for cannabis, gaming and porn—and the high times are here to stay.


On March 13, 2020, everything changed for Doug, a 35-year-old manager at a supply chain logistics company in Chicago. He was told his offices were closed until further notice. Then the stock market took a dive, his 401K plunged, and several family members fell ill with Covid-19. As a father of four, in a house he recently bought, he was afraid for his family’s future.

For Doug, the glass of wine he usually had every night to unwind turned into a whole bottle. “My alcohol consumption turned into a seven-day affair,” he says. He’d usually top it off with some THC-infused gummies. And when sporting events returned, gambling helped him assuage his fear of an uncertain future.

Doug was not alone. As stay-at-home orders swept across the country in March 2020, Americans got high, got drunk, and turned to porn in order to cope with the many fears and anxieties that were symptomatic of the pandemic. Alcohol sales in 13 states surged more than 10% that first month of lockdown while wine sales jumped nearly 9%, according to a study conducted by the University of Buffalo. The number of cigarettes sold in the U.S. also increased in 2020, the first time in 20 years, according to the Federal Trade Commission’s Cigarette Report.

Dr. Peter Grinspoon, a primary care physician at Massachusetts General Hospital and an instructor in medicine at Harvard Medical School, saw more of his patients turn to drugs and alcohol to “blot out reality” after the start of the pandemic than the years before.

“In a perfect world, when under stress, we do yoga, eat tofu, exercise, talk to our best friend, but in reality, most of us rely on some kind of substance,” says Grinspoon, who has specialized in medical cannabis for more than 25 years. “You don’t have to be a rocket scientist to understand that while people are home, bored and lonely they’re going to drink and get high.”

Covid Lows, Cannabis Highs

As the pandemic took an unimaginable toll on thousands of lives a day and brought the global economy to a standstill, it also helped legitimize the legal marijuana industry. With lockdowns rolling across the country in March 2020, many states deemed cannabis dispensaries “essential businesses,” meaning they could stay open along with pharmacies, grocers and liquor stores.

Cannabis sales in Washington state rose 9% over the same month in 2019 to $99 million while in California, weed sales grew by 53% over March 2019 to $276 million. Several months later, on Election Day 2020, five states passed marijuana legalization laws. Overall, the legal cannabis industry had a sky-high year in 2020: legal sales surpassed $17.5 billion, a 46% increase in sales over pre-pandemic 2019.

With Covid attacking respiratory systems, many longtime pot smokers made the switch to edibles. According to Headset, the Seattle-based cannabis analytics firm, sales of edibles grew by 54% across six states—California, Colorado, Michigan, Nevada, Oregon and Washington—during 2020.


Cannabis Laws By State


“In a lot of ways, Covid accelerated the cannabis industry 10 years,” says Aaron Morris, the co-founder of Clackamas, Oregon-based edibles manufacturer Wyld. “It legitimized it in a way as a mainstream coping mechanism along with alcohol.” For Wyld, one of the country’s best-selling edibles brands, the pandemic put the company into overdrive. “Sales got crazy,” says Morris. “It was like toilet paper—edibles flew off the shelves.”

Morris says the pandemic spiked Wyld sales by 20%, but the uptick never slowed. Instead, sales were “boosted permanently,” he says. As a new normal took hold, the only fluctuations Wyld saw in sales were when stimulus checks went out. “Every time the government sent out checks, sales went on steroids for 30 days,” says Morris.

In 2019, Wyld generated $25 million in sales and by the end of 2020, it sold $64 million of its natural fruit gummies. By the end of last year, the company nearly topped $110 million in sales.

Morris is obviously pleased with how the company performed, but not surprised. “Everyone loves cannabis, everyone’s at home, you aren’t socializing, so what are you going to do on a Tuesday night or a Friday night?” says Morris. “Everyone just got lit.”


Higher and Higher

Annual state cannabis sales have grown rapidly and consistently since 2019.


In the United States, annual cannabis sales hit $25 billion in 2021, a 43% increase over 2020. Sales in Florida, where only medical marijuana is legal, and sales in Illinois, which has both medical and adult-use, jumped 70% from 2020 to 2021. In Massachusetts, sales increased 85% during the same period.

Despite the growth of edibles, marijuana flower sales didn’t slow down either. For Emily Paxhia, cofounder of cannabis investment fund Poseidon, what sticks out to her from the past two years is the rise in pre-roll sales. Joint sales shot up 47% from April 2020 to October 2021 in California, Colorado, Michigan, Nevada, Oregon and Washington.

Paxhia believes a touch of nihilism is driving this statistic. “I think the pandemic shortened the timeline of how we view and how we live our lives to be focused on today, tomorrow versus what’s happening in five to 10 years,” she says. “Why not just live now and live well now?”

Betting Against Covid

The start of the pandemic hit the gaming industry hard, and as travel restrictions expanded globally, Covid looked like a losing proposition for the house. Casinos across the U.S. shuttered for months due to stay-at-home orders. In Nevada, the country’s gambling mecca, gross gaming revenue dropped from $12 billion in 2019 to $7.8 billion in 2020.

But when vaccines became available and Covid restrictions eased, Americans flocked to Sin City and regional state casinos as gambling became a way for the country to let loose after the height of the pandemic. By the end of 2021, Nevada reported a 10-month winning streak of more than $1 billion in monthly gambling revenue and an annual record of $13.4 billion, an 11.6% increase over pre-pandemic levels.

“People were cooped up for, depending on their risk tolerance, six months to two years,” says Colin Mansfield, an analyst who covers gaming and leisure at Fitch Ratings. “There was a time when there was not much to do from an entertainment perspective except go to a casino. After the shutdown people wanted to go out and have a good time and spend some money.”


The Money Lines

Annual state gambling revenue has recovered from the pandemic thanks to pent-up demand and the rise in mobile betting and iGaming.


And as states were eager for more tax revenue, many pushed through laws to get mobile sports betting programs off the ground. In 2018, there were eight states with legal sports betting and by the end of 2021, 31 states had legal markets with 18 launching mobile sports gambling.

New York, which launched its mobile sports betting program in early January 2022, surpassed $1 billion in wagers in the first two weeks of legalization, double the amount sportsbooks took in on The Las Vegas Strip in all of December. By the last week of February, New York bettors had wagered a total of $3.1 billion since the program launched, translating into $204.6 million in gross gaming revenue and $104.3 million in tax revenue.

Mansfield says the pandemic gambling boom is far from over. The industry is growing as more states are legalizing sports betting and the broader casino market is also expanding. “We’re not forecasting any strong pullback in gaming revenues,” he says. “People like to gamble. I don’t think that’s really going away at all.”

Over time, gambling has made the leap from a vice that cities and states wanted to hide on riverboats and away from big cities to placing it in the center of major entertainment districts. The combination of the pandemic and the expansion of mobile sports betting brought gambling to the “mainstream conversation,” says Mansfield. “You can’t watch a game anymore without hearing about gambling.”

Gaming may be on a serious roll right now, but few are thinking about the long-term consequences. Bill Krackomberger, a veteran professional sports gambler, grew up in the seedier edges of the industry among loan sharks and underground bookies. Legalization of sports betting is a good thing, no doubt, but Krackomberger feels uneasy about how quickly an addictive pastime has gone mainstream.

“We’re going to see a fallout in about 10 years, not just among regular degenerates,” says Krackomberger. “I’m talking with doctors, lawyers, professionals, Wall Street guys, you’ll see—you won’t be able to get into a Gamblers Anonymous meeting.”


Legal Sports Betting in the the U.S.


Porn This Way

When the pandemic hit in March 2020, Maya Morena, an adult film performer and sex worker living in New York, knew she had to stop meeting clients. The respectable and polite ones disappeared, and it seemed like the only johns willing to pay for sex and risk getting Covid were the “scummy ones.” So, Morena, like millions of other workers in America, started doing business online—she began treating her OnlyFans page like a full-time job.

By the end of that first month, Morena says she made $4,800 producing and selling erotic videos on the U.K.-based streaming platform best known as the billion-dollar tech company that porn built. By January 2021, Morena, who is originally from Honduras, was making $6,000 a month on OnlyFans. As the pandemic wore on and she advertised her page and recruited new customers, she saw her business boom again. By September of last year, she hit $12,000 for the month.

Of course, the idea that anyone can launch an OnlyFans page and start reeling in money by showing a little skin is a lie, Morena says. It requires a lot of hard work. The number of paying users and content creators joining adult streaming platforms like OnlyFans, FanCentro, IsMyGirl, ManyVids, and others, is exploding but only the most dedicated creators can make a living. “It’s a thriving economy that’s ruthlessly competitive,” says Morena.

For OnlyFans, the pandemic helped it become one of the biggest social media platforms seemingly overnight with more than 180 million users and more than 2 million content creators who have earned a collective $5 billion by selling subscriptions to content. In 2019, it had 348,000 creators and 13.5 million users. In 2020, OnlyFans grew revenue by 540%, hitting $400 million.

The popularity of OnlyFans, which has attracted a diverse group of creators from a former pastor to porn stars like Sophie Dee to celebrities like Cardi B, has given birth to a whole new adult-rated streaming economy.


Naked Ambition

Since 2019, the number of content creators on OnlyFans has increased nearly sixfold, while the number of users has expanded by a factor of 13.


Evan Seinfeld, the Brooklyn-born second cousin of comedian Jerry Seinfeld, who launched the online adult content platform IsMyGirl in 2017, says the pandemic turbocharged his business. In 2019, Seinfeld had 500,000 users on his platform and 8,000 creators. By the end of 2020, 25,000 creators signed up and 1.5 million users joined. Today, the site hosts 2.5 million users and 50,000 creators, who collectively make millions of dollars a month.

“Everybody’s business is booming and growing,” says Seinfeld. “When people are alone in the house, people crave stimulus, they crave stimulation, they crave sexual excitement.”

While many sex workers and performers may have first joined a site out of desperation, he says, many eventually realized that selling erotic content to lonesome people stuck at home was a sustainable business.

Adds Seinfeld: “A lot of people needed a pandemic to realize that people who aren’t paying your bills don’t really have a right to have an opinion about how you earn your living.”

Or enjoy life.

Two years into the pandemic, Doug from Chicago is doing better financially—no other industry was in more demand than supply chain logistics—but he held onto some of his new vices, which he describes as “comforts.” Before the pandemic, he was trying to live a healthier life and moderate his food, drug, and alcohol intake. But his perspective has changed—happiness, not moderation, is part of his new approach.

“I’m enjoying the comfortability of my life,” says Doug. “Does it come with a few asterisks? Yes. But we’re not going to live forever.”

Follow me on Twitter. Send me a secure tip.

I am a staff writer on the vices beat, covering cannabis, gambling and more. I believe in the many virtues of vices. Previously at Forbes, I covered the world’s richest people as a member….

Source: Welcome To The Vice Age: How Sex, Drugs And Gambling Help Americans Cope With Covid

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More Contents:

Alcohol Addiction 101 – What You Should Know For most adults, moderate or social alcohol use is not problematic, however, approximately 18 million American adults have an alcohol addiction. Here is some basic information to help individuals navigate problematic alcohol use.

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Vaccine To Have Marginal Impact On Winter Pressures As Rollout Work Continues

The UK’s chief medical officers have warned the coronavirus vaccine will only have a “marginal impact” on hospital numbers over the winter as each of the four nations prepares to start administering the first doses next week.

Festive gatherings are likely to put additional pressure on healthcare services, with a tough few months still ahead, experts said.

It comes as preparations are continuing to roll out the Pfizer/BioNTech vaccine from as early as Tuesday in what has been described as “one of the greatest challenges the NHS has ever faced”.

GP surgeries in England have also been told to be ready to start staffing Covid-19 vaccination centres by December 14.

In a letter to colleagues, the four chief medical officers said this winter would be “especially hard” for the health service due to coronavirus.

“Although the very welcome news about vaccines means that we can look forward to 2021 with greater optimism, vaccine deployment will have only a marginal impact in reducing numbers coming into the health service with Covid over the next three months,” they said.

“The actions and self-discipline of the whole population during lockdowns and other restrictions have helped reduce the peak and in most parts of the four nations hospital numbers are likely to fall over the next few weeks, but not everywhere.

“The social mixing which occurs around Christmas may well put additional pressure on hospitals and general practice in the New Year and we need to be ready for that.”

The letter, signed by chief medical officer of England, Professor Chris Whitty; of Scotland, Dr Gregor Smith; of Wales, Dr Frank Atherton; and of Northern Ireland, Dr Michael McBride, said they did not expect the virus to “disappear” even once full vaccination had occurred.

The first jabs will be administered in each of the UK nations on Tuesday. In Northern Ireland it will be administered at a mass vaccination centre at the Royal Victoria Hospital in Belfast, while in Wales frontline NHS and social care staff will receive the country’s first coronavirus vaccine.

The first vaccinations will also take place in Scotland next week, while jabs will be administered at hospital hubs in England.

Meanwhile, in a letter sent out across England’s primary care networks, NHS England and NHS Improvement said GP-led vaccination centres would start administering doses from December 14.

The letter said centres would be set up with the necessary IT equipment and a fridge, while staff would be given training to ensure they are ready to administer 975 doses of the vaccine to priority patients within three-and-a-half days of delivery.

The first to receive the vaccine in these centres will be those aged 80 and over, as long as other risk factors, “clinical or otherwise”, have been taken into account.

There remain issues around how to ensure elderly residents in care homes, who have been recommended as the top priority, get access to a jab due to difficulties in storing and transporting the Pfizer/BioNTech version as its cold temperature – minus 70C – limits how often it can be moved.

HEALTH Coronavirus Oxford
(PA Graphics) Credit: PA Graphics

NHS England has not yet committed to a date to roll the vaccine out in English care homes, but Dr June Raine, chief executive of the Medicines and Healthcare products Regulatory Agency, told the BBC on Friday that she estimated the vaccine would begin to be delivered to care homes “within the next two weeks”.

In total, some 40 million doses of Pfizer’s inoculation are on order – enough to administer it to 20 million people, with two jabs required 21 days apart.


By: https://www.itv.com

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Healthy Lifestyle

Vaccines will only have ‘marginal impact’ on NHS winter pressures, chief medical officers warn COVID-19 will keep hospitals under continued strain in the coming months as new vaccines will only have a “marginal impact” on patient numbers over winter, the UK’s chief medical officers have warned. In a letter written to healthcare colleagues, the group – which includes England’s Professor Chris … Home remedies refer to “practical cure or treatment that cures, heals or relieves” using certain common substances such as spices, vegetables, fruit, herbs and modern materials. Click Here: https://remediesnew.com

Expert Pharmacist GEMMA FROMAGE Reveals How To Save £200-a-Year On Everyday Essentials

For every condition, there is often a branded over-the-counter remedy we instinctively reach for. And yet there will be a cheaper version with identical contents that could save you a small fortune. Pharmacist GEMMA FROMAGE reveals the definitive guide to the best buys to fill your medicine cabinet.

Painkillers 

Best buys: Aspar Paracetamol 500mg, 16 caplets, 25p, sainsburys.co.uk; Bell’s Ibuprofen 200mg, 16 tablets, 45p, lloydspharmacy.comAnnual saving: £55.20* (Based on the average person buying eight packs of paracetamol a year, and for women, 12 packs of ibuprofen — one for each menstrual period.)

Some branded versions have special coatings, or are contained in soft capsules, and may dissolve more quickly in the body — however, the difference in speed of pain relief will be minimal

Some branded versions have special coatings, or are contained in soft capsules, and may dissolve more quickly in the body — however, the difference in speed of pain relief will be minimal

Expert says: The price of painkillers can vary hugely, yet the own-brand or cheaper versions will contain the same active ingredient in the exact same doses. As a result, they will do the exact same job as any expensive, branded options despite being up to ten times cheaper in some cases.

Some branded versions have special coatings, or are contained in soft capsules, and may dissolve more quickly in the body — however, the difference in speed of pain relief will be minimal.

Also, despite some products claiming to be designed for a specific type of pain, such as migraine or back pain, oral painkillers do not target one type alone, they work throughout the body so it won’t be targeted relief (but gels may offer this, see below).

Paracetamol and ibuprofen work differently: paracetamol can reduce a fever and ease cold and flu symptoms, whereas ibuprofen (which may also ease some of these problems) is an anti-inflammatory and so is beneficial for muscle aches and period pain. 

Antibacterial mouthwash 

Wisdom Chlorhexidine Antibacterial Mouthwash fresh mint

Best buy: Wisdom Chlorhexidine Antibacterial Mouthwash fresh mint, 300ml, £1.49, groceries.asda.com Annual saving: £35.10 (Based on going through ten bottles a year.)

Expert says: Studies have shown that chlorhexidine is the most effective mouthwash ingredient for killing bacteria that cause plaque and lead to gum disease (specifically gingivitis).

Despite the difference of more than £3.50 for the same size bottle of the branded version, the cheapest product contains the same active ingredient and will be just as effective in easing inflammation, swelling and bleeding associated with gum disease.

As with all mouthwash, use at a different time from brushing, as slooshing straight after will wash away most of the protective fluoride in toothpaste.

Allergy tablets

Best buys: Galpharm Cetirizine Hayfever And Allergy Relief, 30 tablets, £1.45, cooppharmacy.coop

Annual saving: £34.20 (Based on getting through four boxes over a year.)

Expert says: With an astounding £8.55 difference in price compared to the leading brand, it is hard to believe that the products contain the exact same 30 tablets of cetirizine at the same dose.

This medicine blocks the effects of histamine in your body, which immune cells release during an allergic response to a perceived irritant, such as pollen, which in turn causes symptoms such as sneezing and a runny nose. Take one a day.

Rehydration sachets  

Best buy: Asda Rehydration Treatment blackcurrant flavour, six sachets, £2.25, asda.com Annual saving: £6.16 (Based on buying a box four times a year.)

Asda Rehydration Treatment blackcurrant flavour

Asda Rehydration Treatment blackcurrant flavour

Expert says: Rehydration sachets — which you dissolve in a glass of water — contain electrolytes, vital salts such as sodium citrate and potassium chloride which keep the muscles and nervous system functioning properly (as well as sugar for energy). The body loses these as a result of diarrhoea, through dehydration, causing symptoms such as dizziness, headaches and tiredness.

Rehydration salts restore the natural balance of salts and fluid in the body, and help eliminate symptoms of dehydration.

There may be slight differences in the salts themselves, from one more expensive product to the next (and prices can be more than double this Asda option), but the overall effect will be the same.

Adults should mix one sachet with water and drink immediately after a loose bowel motion. (Do not give to children under two unless told to do so by a doctor.) If symptoms persist for more than 48 hours, seek medical advice.

LloydsPharmacy Chloramphenicol Eye Ointment

LloydsPharmacy Chloramphenicol Eye Ointment

Eye ointment

Best buy: LloydsPharmacy Chloramphenicol Eye Ointment, 4g, £4.99, lloydspharmacy.com

Annual saving: £5.22 (Based on buying two tubes a year.)

Expert says: Eye infections such as bacterial conjunctivitis are common, and the ointment used to treat them contains the active ingredient chloramphenicol, an antibiotic which stops the bug from growing and spreading.

There are many versions on pharmacy shelves, but the ointment always contains 1 per cent chloramphenicol (the drops always contain 0.5 per cent).

You apply a small amount to the infected eye three to four times a day for five days. A tube has to be binned 28 days after opening.

Nasal spray

Wilko Decongestant Nasal Spray

Wilko Decongestant Nasal Spray

Best buy: Wilko Decongestant Nasal Spray, 15ml, £1.75, wilko.com

Annual saving: £10.56 (Based on using four a year.)

Expert says: As part of the immune response during a cold, blood vessels swell, membranes become congested, and as a result the nose feels blocked.

Decongestant nasal sprays contain oxymetazoline hydrochloride which can help relieve symptoms by narrowing the small blood vessels in the nose. This brings down the swelling and helps open up the nasal passages to make breathing easier.

All sprays should work within minutes and the effects last for up to 12 hours. Identical sprays can cost up to four times as much.

Cold sore cream

Best buy: Bell’s Lipsore, 2g, £1, wilko.com Annual saving: £20.80 (Based on needing four a year.)

Expert says: At some point an estimated seven in ten of us will be infected with the virus HSV-1 (also known as herpes simplex virus type 1), which causes cold sores.

And once you have the virus, it is always in your body, where it lies dormant and is reactivated by triggers such as sunlight, stress and cold weather.

Treatments can speed up healing or try to halt outbreaks.

One of the most effective over-the-counter remedies is acyclovir, which stops the virus from reproducing, and in turn reduces the duration and severity of blisters.

Some products cost more than six times as much as this cut-price option, for the same size bottle with the same active dose.

Simply apply to the affected area with a cotton bud five times a day. 

Bell’s Lipsore

For cystitis 

Galpharm Cystocalm cystitis relief

Galpharm Cystocalm cystitis relief

Best buy: Galpharm Cystocalm cystitis relief, pack of six, £1.20, wilko.com

Annual saving: £7.40 (Based on using two packets a year.)

Expert says: Cystitis is an inflammation of the bladder, usually caused by a bladder infection, which causes acidic urine, irritation and an unpleasant burning sensation when passing water.

An effective remedy like this contains sodium citrate, which will make the urine less acidic, thus providing relief of the symptoms in a few hours — but some remedies can cost four times as much.

Mix with water and drink three times a day.

If you have no improvement in symptoms in three days, suffer regularly, or have blood in your urine, then see your GP. 

Ibuprofen gel 

Best buy: Tesco Ibuprofen Gel, 35g, £1.85, tesco.com

Annual saving: £12.42 (Based on buying three a year.)

Expert says: This anti-inflammatory gel contains 5 per cent ibuprofen — but identical versions can cost from £1.85 to £6 for the same size tube.

The gels are beneficial for massaging into muscular aches and pains.

Unlike oral painkillers, which get into the bloodstream and travel around the body, the ibuprofen in the gel is locally absorbed into the skin where it is applied.

This means that pain relief can be accurately targeted.

Massage the gel into the skin until fully absorbed, up to a maximum of three times a day.

Expert says: This anti-inflammatory gel contains 5 per cent ibuprofen — but identical versions can cost from £1.85 to £6 for the same size tube

Expert says: This anti-inflammatory gel contains 5 per cent ibuprofen — but identical versions can cost from £1.85 to £6 for the same size tube

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Tesco Health Chesty Cough Relief

Tesco Health Chesty Cough Relief

Cough syrup

Best buy: Tesco Health Chesty Cough Relief, 300ml, £2.25, tesco.com

Annual saving: £11.48 (Based on using two bottles a year.)

Expert says: A common ingredient in cough syrups is guaifenesin, which reduces chest congestion caused by colds or infections. It does this by loosening phlegm and making it easier to cough out.

Differences in these cough mixtures tends to be due to ingredients that make it taste better. However, this has no effect on how the product works, yet can cost four times more. 

Cold and flu remedy 

Asda Max Strength Cold & Flu Relief sachets blackcurrant

Asda Max Strength Cold & Flu Relief sachets blackcurrant

Best buy: Asda Max Strength Cold & Flu Relief sachets blackcurrant, pack of ten, £1.59, asda.com

Annual saving: £10.40 (Based on using four boxes a year.)

Expert says: There are several cold and flu sachets on the market and the most effective — such as this Asda option — will contain the painkiller paracetamol and decongestant phenylephrine, which reduces inflammation of the nasal tissue to open the airway. 

Yet some can cost up to four times as much for the same effect. Mix with boiling water and drink every six hours. Don’t use with other medicines containing paracetamol.

Arjun Olive Oil Ear Drops

Arjun Olive Oil Ear Drops

Ear drops

Best buy: Arjun Olive Oil Ear Drops, 10ml, £1.99, weldricks.co.uk

Annual saving: £7.08 (Based on needing three bottles a year.)

Expert says: Ear drops can contain medical-grade olive oil (which, unlike that in your kitchen, is licensed for use in the body) to soften hardened ear wax gently and make it easier to remove via syringing. 

Despite containing just this basic ingredient, some cost up to four times as much.

✱ Annual savings based on a comparison with the most expensive branded products at time of writing. Advertisement Read more:

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Here’s Why Hydroxychloroquine Doesn’t Block The Coronavirus in Human Lung Cells

1

A paper came out in Nature on July 22 that further underscores earlier studies that show that neither the malaria drug hydroxychloroquine nor chloroquine prevents SARS-CoV-2 – the virus that causes COVID-19 – from replicating in lung cells.

Most Americans probably remember that hydroxychloroquine became the focus of numerous clinical trials following the president’s statement that it could be a “game changer.” At the time, he appeared to base this statement on anecdotal stories, as well as a few early and very limited studies that hydroxychloroquine seemed to help patients with COVID-19 recover.

Many in the antiviral field, including myself, questioned the validity of both, and in fact, one of the papers was later disparaged by the scientific society and the editor of the journal that published it.

Since then, HQC has had a bumpy ride. It was initially approved by the FDA for emergency use. The FDA then quickly reversed its decision when numerous reports of deaths caused by heart arrhythmias emerged. That news brought many clinical trials to a halt.

Regardless, some scientists continued to study it in hopes of finding a cure for this deadly virus.

How the work was done

The new study was carried out by scientists in Germany who tested HQC on a collection of different cell types to figure out why this drug doesn’t prevent the virus from infecting humans.

Their findings clearly show that that HQC can block the coronavirus from infecting kidney cells from the African green monkey. But it does not inhibit the virus in human lung cells – the primary site of infection for the SARS-CoV-2 virus.

In order for the virus to enter a cell, it can do so by two mechanisms – one, when the SARS-CoV-2 spike protein attaches to the ACE2 receptor and inserts its genetic material into the cell. In the second mechanism, the virus is absorbed into some special compartments in cells called endosomes.

Depending on the cell type, some, like kidney cells, need an enzyme called cathepsin L for the virus to successfully infect them. In lung cells, however, an enzyme called TMPRSS2 (on the cell surface) is necessary. Cathepsin L requires an acidic environment to function and allow the virus to infect the cell, while TMPRSS2 does not.

In the green monkey kidney cells, both hydroxychloroquine and chloroquine decrease the acidity, which then disables the cathepsin L enzyme, blocking the virus from infecting the monkey cells. In human lung cells, which have very low levels of cathepsin L enzyme, the virus uses the enzyme TMPRSS2 to enter the cell.

But because that enzyme is not controlled by acidity, neither HCQ and CQ can block the SARS-CoV-2 from infecting the lungs or stop the virus from replicating.

Why it matters

This matters for several reasons. One, much time and money has been spent studying a drug that many scientists said from the very beginning was not going to be effective in killing the virus.

The second reason is that the studies that have reported antiviral activity for hydroxychloroquine were not in epithelial lung cells. Thus, their results are not relevant to properly studying SARS-CoV-2 infections in humans.

What’s next?

As scientists proceed with investigating new drugs as well as trying to repurpose old ones, like hydroxychloroquine, it is critical that researchers take the time to think about their study design.

In short, those of us involved in antiviral drug development should all take a lesson from this study. It is important not only to focus our efforts on pursuing drugs that will directly shut down viral replication, but also to study the virus in the primary site of infection.The Conversation

By: Katherine Seley-Radtke

Katherine Seley-Radtke, Professor of Chemistry and Biochemistry and President-Elect of the International Society for Antiviral Research, University of Maryland, Baltimore County.

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