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Thursday, October 27, 2022

Central bank guns spiked by bank windfall backlash

 Central banks may be forced to rethink and even undermine one of their prized emergency policy tools as popular resistance mounts against giant cash transfers to commercial banks while interest rates climb, recession deepens and Treasury coffers drain.

The stakes are high as it potentially affects the future use and effectiveness of extraordinary monetary policies such as bond-buying 'quantitative easing' (QE) and questions the wider political independence of central bank policymaking.

The European Central Bank, Bank of England and U.S. Federal Reserve are all - to differing degrees - now facing a backwash from years of policy-driven but lucrative balance sheet expansion. As they lift interest rates, that balance sheet burns a hole in their pockets - or more particularly the pockets of their governments long used to windfalls coming the other way.

It's the flip side of more than a decade of bond-buying QE - introduced to overcome the limits of near-zero policy rates when deflation fears dominated and which offered banks trillions of dollars of interest-bearing reserves in exchange for the bonds.

With rates falling or near zero, central banks made money on that switch as they hoarded higher yielding bonds, paid next to nothing on commercial bank reserves and transferred the resulting accounting profit to governments for spending.

Now that they're forced to raise interest rates sharply before significantly reducing those balance sheets, bloated further by pandemic-related support, a massive pay day for the banks is in store while remittances to Treasuries dry up and even reverse.

The optics of those payments to banks while taxpayers go on the hook may prove politically toxic.

"Paying billions to banks for holding the safest possible form of liquidity may trigger criticisms from the public," Axa Group Chief Economist Gilles Moec wrote, adding that it could be seen as "undue support" when rising rates already lift banks' net margins and when the public purse is pressured by serial shocks.

Britain has been battling this issue all year. read more read more read more

After channelling some 120 billion pounds in profit to the Treasury over 13 years, the Bank of England last month incurred its first loss for the public finance since it launched its QE programme in 2009 - a 156 million pound monthly loss from its bond portfolio versus interest paid on reserves.

That will surely climb as the BoE is expected to at least double its policy rate, the rate paid on bank reserves, by May. Paul Tucker, the BoE's former deputy governor, called on the central bank this month to limit the rate it pays on those reserves, and estimated it could save about 40 billion pounds the government is now desperately seeking elsewhere for its Nov. 17 revised budget statement.

And after more than $100 billion of transfers to the Treasury last year alone, the Fed's net income also turned negative in September and will continue that way for some time as reserve payments rise.

The ECB on Thursday may well reveal how it plans to run the gauntlet.

Axa chart on ECB reserves and euro zone debt
Axa chart on ECB reserves and euro zone debt
Reuters Graphics
Reuters Graphics

WAR AND PEACE

With a total of almost 5 trillion euros in excess reserves, the ECB is expected to address how its rising deposit rate allows commercial banks to use the central bank like an ATM, 'round tripping' emergency funding facilities with rates now lower than those earned from simply depositing the cash back at the ECB.

ECB-watchers think a solution could be some form of 'reverse tiering' of the payment of reserves related to amounts taken in so-called Targeted Long-Term Refinancing Operations (TLTROs) - which make up about a quarter of the ECB balance sheet.

While that may well end up being the least worst option, it's laced with multiple problems - not least the precedent of retrospectively altering the original terms and conditions of the TLTRO loans and potentially muddying their take-up and effectiveness if needed in a future downturn or another shock.

Unicredit economic adviser Erik Nielsen described that option as "a seriously troublesome road".

Goldman Sachs rates strategist Simon Freycenet reckons adjustment of TLTRO terms in order to lift that funding rate closer to the ECB deposit rates was probably the "least complicated solution" - but it had "clear disadvantages with regards to future policy and legal risks."

The cost of doing nothing is barely an option. Axa models show that ECB rates rising to an expected peak of 3% next year would involve an excess reserves shock that depresses the euro zone fiscal balance by 1% in one shot.

All of which underlines the direct fiscal effect of QE monetary policy that many feared would complicate full exit from QE when policy rates need to spike hard to cool inflation - threatening central banks' independence and their mandate to solely focus on price stability as governments' political and budget pressures demand otherwise.

Kenneth Rogoff, the International Monetary Fund's former chief economist, this week restated his argument that the Fed should have considered negative interest rates rather than doubling down on a QE program that's now politically more difficult to reverse.

"For all their complaints about inflation, one wonders how prepared voters are for yet another deep recession," Rogoff wrote in Foreign Affairs. "The changes in the political and economic landscape have become so profound that it seems unlikely for the foreseeable future that the Fed will choose to bring inflation down to pre-pandemic levels and keep it there."

For Nobel laureate Joseph Stiglitz, the political imperatives of the war triggered by Russia's invasion of Ukraine - at least partly responsible for the surge in inflation and interest rates this year - should reasonably dominate narrower market objectives and override opposition to the use of windfall taxes, as they have done in all previous major wars.

"It is a mistake to think that the war can be won with a peacetime economy," he wrote in a Project Syndicate blog. "No country has ever prevailed in a serious war by leaving markets alone."

G4 central bank balance sheets
G4 central bank balance sheets
The easy-money era is over
The easy-money era is over
Reuters Graphics Reuters Graphics
Reuters Graphics Reuters Graphics

https://www.reuters.com/business/finance/central-bank-guns-spiked-by-bank-windfall-backlash-mike-dolan-2022-10-27/

Multiple lineages of monkeypox virus detected in the United States, 2021–2022

 CRYSTAL M. GIGANTE HTTPS://ORCID.ORG/0000-0002-2169-7156BETTE KORBER HTTPS://ORCID.ORG/0000-0002-2026-5757MATTHEW H. SEABOLT HTTPS://ORCID.ORG/0000-0002-0336-5545KIMBERLY WILKINS HTTPS://ORCID.ORG/0000-0002-0346-7656WHITNI DAVIDSON HTTPS://ORCID.ORG/0000-0003-3372-7903AGAM K. RAOHUI ZHAO HTTPS://ORCID.ORG/0000-0002-3816-7733TODD G. SMITHCHRISTINE M. HUGHES HTTPS://ORCID.ORG/0000-0002-0177-2454[...]YU LI 

DOI: 10.1126/science.add4153


Abstract

Monkeypox is a viral zoonotic disease endemic in Central and West Africa. In May 2022, dozens of non-endemic countries reported hundreds of monkeypox cases, most with no epidemiological link to Africa. We identified two lineages of monkeypox virus (MPXV) among two 2021 and seven 2022 U.S. monkeypox cases: the major 2022 outbreak variant, B.1, and a minor contemporaneously sampled variant called A.2. Analyses of mutations among these two variants revealed an extreme preference for GA-to-AA mutations indicative of human APOBEC3 cytosine deaminase activity among Clade IIb MPXV (previously West African, Nigeria) sampled since 2017. Such mutations were not enriched within other MPXV clades. These findings suggest that APOBEC3 editing may be a recurrent and a dominant driver of MPXV evolution within the current outbreak.

Circulating subset of iNKT cells mediates antitumor and antiviral immunity

 GUANGWEI CUI HTTPS://ORCID.ORG/0000-0002-3276-1926 AKIHIRO SHIMBAJIANSHI JIN HTTPS://ORCID.ORG/0000-0003-4697-8760TAISAKU OGAWAYUKIKO MURAMOTO HTTPS://ORCID.ORG/0000-0002-8706-3113HITOSHI MIYACHI HTTPS://ORCID.ORG/0000-0002-4855-3857SHINYA ABE HTTPS://ORCID.ORG/0000-0002-2707-1947TAKUMA ASAHI HTTPS://ORCID.ORG/0000-0001-6372-7563SHIZUE TANI-ICHI HTTPS://ORCID.ORG/0000-0003-2388-776X[...]KOICHI IKUTA HTTPS://ORCID.ORG/0000-0003-1319-1021 

DOI: 10.1126/sciimmunol.abj8760


Circulating iNKT cells protect

Invariant natural killer T (iNKT) cells are tissue-resident, innate-like T cells that recognize lipid antigens and are involved in immune regulation. The heterogeneity and development of iNKT cell populations has not been well defined; thus, Cui et al. used various mouse models, transcriptomics, flow cytometry, and histology to better understand iNKT subpopulations. The authors uncovered a circulating population of iNKT cells that expressed CD244 and CXCR6 and were distinct from conventional iNKT cells in mice and humans. This iNKT subset depended on IL-15+ medullary thymic epithelial cells for development and maturation. The circulating iNKT cells were highly cytotoxic and protected mice from melanoma metastasis and influenza infection. Thus, the authors uncovered a population of circulating iNKT cells that were highly cytotoxic and protective against various insults.

Abstract

Invariant natural killer T (iNKT) cells are a group of innate-like T lymphocytes that recognize lipid antigens. They are supposed to be tissue resident and important for systemic and local immune regulation. To investigate the heterogeneity of iNKT cells, we recharacterized iNKT cells in the thymus and peripheral tissues. iNKT cells in the thymus were divided into three subpopulations by the expression of the natural killer cell receptor CD244 and the chemokine receptor CXCR6 and designated as C0 (CD244CXCR6), C1 (CD244CXCR6+), or C2 (CD244+CXCR6+) iNKT cells. The development and maturation of C2 iNKT cells from C0 iNKT cells strictly depended on IL-15 produced by thymic epithelial cells. C2 iNKT cells expressed high levels of IFN-γ and granzymes and exhibited more NK cell–like features, whereas C1 iNKT cells showed more T cell–like characteristics. C2 iNKT cells were influenced by the microbiome and aging and suppressed the expression of the autoimmune regulator AIRE in the thymus. In peripheral tissues, C2 iNKT cells were circulating that were distinct from conventional tissue-resident C1 iNKT cells. Functionally, C2 iNKT cells protected mice from the tumor metastasis of melanoma cells by enhancing antitumor immunity and promoted antiviral immune responses against influenza virus infection. Furthermore, we identified human CD244+CXCR6+ iNKT cells with high cytotoxic properties as a counterpart of mouse C2 iNKT cells. Thus, this study reveals a circulating subset of iNKT cells with NK cell–like properties distinct from conventional tissue-resident iNKT cells.

US Ready To Protect Asian Allies With Nukes, Biden Official Says In Tokyo

 It's a hugely alarming scenario when world leaders and government officials representing nuclear-armed superpowers appear to increasingly be spouting nuclear rhetoric and warnings in an almost casual manner.

US Deputy Secretary of State Wendy Sherman on Tuesday said Washington is ready to protect its Asian allies using nukes if they came under attack, spelling out the US would deploy its "nuclear, conventional and missile defense."

Washington "will use the full range of US defense capabilities to defend our allies, including nuclear, conventional and missile defense capabilities," the deputy secretary told a Tuesday meeting with South Korean and Japanese officials, ahead of a series of talks this week. She hailed America's commitment to defense of Seoul and Tokyo as "ironclad".

The region is currently on edge after early this week South Korea announced that its intelligence concluded Pyongyang has finalized preparations for what will be its first nuclear test in a half-decade. These warnings of an imminent North Korean nuclear test have been growing louder since early August, with the US backing Seoul's assessment. 

Sherman in her comments condemned the recent series of ballistic missile launches by North Korea, calling the record number of tests over the course of the year "deeply irresponsible, dangerous, and destabilizing."

One of the more provocative among the latest tests saw a ballistic missile soar over Japan itself. The Asian officials meeting with Sherman in Tokyo agreed that Pyongyang is "creating serious tension on the Korean Peninsula.”

Patrol ships from the north and south exchanged warning fire along the shared marine-time border on Monday in but the latest sign tensions are at boiling point. The north is meanwhile angry that the US military has in the last month stepped up its presence in waters off the peninsula, while participating in joint military drills with South Korea.

https://www.zerohedge.com/geopolitical/us-ready-protect-asian-allies-nukes-top-biden-official-says-tokyo

Amazon Pharmacy inks deal with Florida Blue for home drug delivery

 Amazon Pharmacy has inked a deal with another Blue Cross and Blue Shield plan as it works to carve out a piece of the retail pharmacy market.

Starting next year, Florida Blue will use Amazon Pharmacy as its exclusive home delivery service provider for its more than 2 million members covered under individual and employer group-insured plans. Earlier this year, Florida Blue also began making the service available to self-insured employers, according to a press release.

At the ViVE 2022 digital health conference in March, Amazon Pharmacy announced it was partnering with Blues plans in five states and Prime Therapeutics to launch a prescription discount savings card for some Blue Plans members.

Prime Therapeutics' MedsYourWay discount card, administered by InsideRx, offers an ordering and delivery experience through Amazon Pharmacy that enables customers to apply purchases for eligible medications to the out-of-pocket maximums and deductibles associated with their insurance plan.

The Blues plans that signed on for that drug discount coupon program include Horizon Blue Cross Blue Shield of New Jersey, Blue Cross Blue Shield of Nebraska, Blue Cross Blue Shield of Alabama, Florida Blue, Blue Cross and Blue Shield of Kansas, Blue Cross and Blue Shield of North Carolina, Blue Cross Blue Shield of North Dakota and Blue Cross and Blue Shield of Minnesota. Many of those Blues plans have also inked home delivery contracts with Amazon's pharmacy arm, according to information on their websites.

Centene's Wellcare announced that Amazon Pharmacy will become its preferred retail pharmacy for its 1.5 million Medicare Advantage members starting next year.

"Florida Blue hopes the savings and the familiarity of ordering through Amazon will make it easier for our members to get their daily medications and better manage their health," said Chuck Divita, Florida Blue executive vice president of commercial markets, in a statement. "Medication adherence is a major factor in the health and well-being of Floridians."

Amazon shook up the retail drugstore market when it acquired PillPack in 2018 and then again when it rolled out Amazon Pharmacy in 2020. The online retail giant has been rapidly expanding its reach in the healthcare space, most notably with its recent deal to buy One Medical for $3.9 billion.

Florida Blue executives said the Amazon Pharmacy shopping experience includes transparent, real-time pricing information and allows members to compare and choose the option that works best for their needs—either their insurance copay price or the price from the Prime Therapeutics MedsYourWay discount. All covered and eligible drug purchases, whether using the copay or discount card pricing, may count toward out-of-pocket maximums and deductibles, the insurer said.

As many as one-third of prescriptions are never filled. A study published in the Annals of Internal Medicine estimates that a lack of drug adherence causes nearly 125,000 deaths and 10% of hospitalizations a year, while potentially costing the healthcare system as much as $289 billion annually. 

"Each year more than $500 billion is spent on avoidable health care costs in the U.S. due to individuals not taking their medications properly—often due to lack of access or affordability," Divita said, noting that home delivery provides members with a cost-effective and simplified way to get medications.

https://www.fiercehealthcare.com/payers/amazon-pharmacy-inks-deal-florida-blue-home-pharmacy-delivery-2m-members

Search for a one-and-done, all-purpose COVID-19 vaccine

 As the uptake of the bivalent COVID-19 vaccine sputters and stalls—with just 8.5% of eligible Americans getting it, according to the Centers for Disease Control and Prevention—experts and researchers look to find ways to make inoculation against the ever-expanding roster of COVID-19 variants manageable.

They also search to find ways to coexist with other coronaviruses that will almost certainly be coming at us. As a subtitle in an article accompanying the release of one of two preprint studies dealing with vaccines that landed this week put it: “next threat not if but when.”

The research comes at a time when the Biden administration is looking to shift the costs of COVID-19 vaccines, tests and treatments to commercial health insurers.

One of the studies unveiled this week, from researchers with Columbia University and the University of Michigan and published on the website bioRxiv, focuses on what might be holding some individuals back from getting not only the bivalent shot, but any COVID-19 vaccine: Why get it if it doesn’t work?

BioRxiv is an open-access repository for preprint studies; its prominence rose during the fast-moving and mutating pandemic, because, often by the time peer-reviewed studies came out, the information and conclusions would be dated (e.g., studies that focused on the original COVID-19 strain as delta rampaged through the world).

The bivalent COVID-19 vaccine manufactured and sold specifically on the premise that it targets the BA.4 and BA.5 iterations of the omicron variant doesn’t really boost the body’s immune system to fight off those any more than does the original monovalent vaccine, the study by the Columbia University and University of Michigan researchers found.

“When given as a fourth dose, a bivalent mRNA vaccine targeting Omicron BA.4/BA.5 and an ancestral SARS-CoV-2 strain did not induce superior neutralizing antibody responses in humans … compared to the original monovalent vaccine formulation,” the study states.

As a rationale for doing the study, the researchers note that “despite their widespread use, the impact of a booster shot with a new bivalent vaccine on SARS-CoV-2-neutralizing antibody responses in humans remains unknown.”

The other preprint study, by researchers with the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), states that research and development must focus on the creation of a COVID-19 vaccine that works against any possible variant that might be thrown at us. A one-and-done vaccine, at least on a yearly basis.

“Advancing a global R&D agenda for broadly protective coronavirus vaccines is a large and complex endeavor that will require ongoing investment, communication, and coordination among researchers; representatives from governments, industry, multilateral and nongovernmental organizations; regulators; and public health policymakers,” the study states. “The purpose of this roadmap is to provide a framework and timeline to align coordination, leadership, and investment to achieve these ambitious goals.”

The study notes that pharmaceutical companies have very little incentive to develop new vaccines. “Unless opportunity costs are absorbed by governments or other funding bodies, companies face a high opportunity cost when it comes to focusing on vaccines rather than other pharmaceuticals with a likely higher per-unit profit, on-going use, and stable demand,” the CIDRAP study states.

The observation comes on the heels of the Biden administration's effort to shift costs for COVID-19 vaccines, treatments and tests to commercial insurance companies, and think tanks such as the Commonwealth Fund start crunching numbers about how much cost payers will have to take on relative to public uptake of vaccines.

In the article on the CIDRAP website, Michael T. Osterholm, Ph.D., CIDRAP’s director, stressed that “the current vaccines should be used. But we need to look at vaccines that address more robust immunity, with a broad breadth of protection.”

The current crop of vaccines will not suffice as society hopefully eases out of the pandemic crisis stage and into one of coexistence not only with the coronaviruses that we know but also the ones that we will come to know. Three coronaviruses have jumped from animal hosts to humans in the last 20 years: COVID-19, or SARS-CoV-2; SARS-CoV-1; and MERS (Middle East respiratory syndrome).

Though COVID-19 is much more infectious than the other two, its case fatality rate stands at about 1%, as opposed to SARS-CoV-1 and MERS, with CFRs of 10% and 35% respectively. “The bigger threat is a future coronavirus that has a case fatality ratio (CFR) approaching that of SARS or MERS, but is as transmissible as COVID-19,” the CIDRAP article states.

Osterholm: “The current vaccines we have for COVID-19 have played a critical role in reducing morbidity and mortality, but they are not the vaccines that will sustain us in the future with coronavirus infections.”

He likened the current vaccines to the first bulky mobile phones that needed to be improved.

In their study, researchers with Columbia University and the University of Michigan collected sera from individuals who’d had three or four doses of the original vaccines, individuals who’d gotten the bivalent vaccine as a fourth dose and individuals infected by the BA.4 or BA.5 subvariants of omicron.

“Boosting with a new bivalent mRNA vaccine targeting both BA.4/BA.5 and an ancestral SARS76 CoV-2 strain did not elicit a discernibly superior virus-neutralizing antibody response compared [to] boosting with an original monovalent vaccine,” the study states. “These findings may be indicative of immunological imprinting, although follow-up studies are needed to determine if the antibody responses will deviate in time, including the impact of a second bivalent booster.”

https://www.fiercehealthcare.com/payers/experts-call-one-umbrella-covid-19-vaccine-handle-all-known-and-unknown-variants

Wednesday, October 26, 2022

Sleep apnea device recall drags on, stoking frustration

 A massive recall of millions of sleep apnea machines has stoked anger and frustration among patients, and U.S. officials are weighing unprecedented legal action to speed a replacement effort that is set to drag into next year.

Sound-dampening foam in the pressurized breathing machines can break down over time, leading users to potentially inhale tiny black particles or hazardous chemicals while they sleep, manufacturer Philips warned in June 2021.

Philips initially estimated it could repair or replace the units within a year. But with the recall expanding to more than 5 million devices worldwide, the Dutch company now says the effort will stretch into 2023.

That’s left many patients to choose between using a potentially harmful device or trying risky remedies, including removing the foam themselves, buying second-hand machines online or simply going without the therapy.

The devices are called continuous positive airway pressure, or CPAP, machines. They force air through a mask to keep passageways open during sleep.

Untreated sleep apnea can cause people to stop breathing hundreds of times per night, leading to dangerous drowsiness and increased heart attack risk. The problem is more common in men than women, with estimates ranging from 10% to 30% of adults affected.

Most patients are better off using a recalled device because the risks of untreated sleep apnea still outweigh the potential harms of the disintegrating foam, physicians say. But doctors have been hard pressed to help patients find new machines, which generally cost between $500 and $1,000, and were already in short supply due to supply chain problems.

“What happened is the company just said, ‘Talk to your doctor.’ But doctors can’t manufacture new machines out of the blue,” said Dr. John Saito, a respiratory specialist near Los Angeles.

Risks from the foam include headache, asthma, allergic reactions and cancer-causing effects on internal organs, according to the Food and Drug Administration. The recalled devices include Dreamstation and SystemOne CPAP models and several other Philips machines, including Trilogy ventilators.

Last March, the FDA took the rare step of ordering Philips to expand its communication effort, including “clearer information about the health risks of its products.” Regulators estimated then that only half of U.S. consumers affected had registered with the company.

The agency hadn’t issued such an order in decades.

In a statement, Philips said ongoing testing on the recalled devices is “encouraging” and shows low levels of particles and chemical byproducts emitted by its leading brand of machine. Philips said its initial communication about the dangers posed by the foam was “a worst-case scenario for the possible health risks.” The deterioration appears to worsen with unauthorized cleaning methods, the company noted.

The FDA has received more than 70,000 reports of problems attributed to the devices, including pneumonia, infection, headache and cancer. Such reports aren’t independently confirmed and can’t prove a causal connection. They can be filed by manufacturers, patients, physicians or attorneys.

Jeffrey Reed, of Marysville, Ohio, had been using his Philips machine for about a year when he began seeing black specks in the tubing and mask. His equipment supplier said the debris was caused by improper cleaning, so he continued using it.

Over the next seven years, Reed says he experienced persistent sinus infections, including two bouts of pneumonia, that didn’t resolve with antibiotics. After hearing about the recall, he suspected the foam particles might be playing a role.

“Once I got off their machine, all of that cleared right up,” said Reed, 62, who obtained a competitor’s device after several months. Like other users, Reed can’t definitively prove his problems were caused by Philips’ device.

More than 340 personal injury lawsuits against Philips have been consolidated in a Pennsylvania federal court and thousands more are expected in coming months. Reed isn’t part of the litigation.

Like the vast majority of U.S. CPAP users, Reed got his device through a medical equipment supplier contracted by his insurer. The company went out of business before the recall and he never heard from them about a replacement.

Even in normal circumstances, those companies typically don’t track patients long term.

“After a couple years, you’re just forgotten in the system,” said Ismael Cordero, a biomedical engineer and CPAP user. “I stopped hearing from my supplier about three years after I got my machine.”

Cordero learned that his Philips machine had been recalled through his work at ECRI, a nonprofit that reviews medical device safety.

In May, the FDA put Philips on notice that it was considering a second order that would force the company to improve and accelerate its repair-and-replace program.

Medical device companies typically conduct recalls voluntarily, and former FDA officials say the agency has never actually used its authority to force additional steps.

“The FDA shares the frustrations expressed by patients who are awaiting a resolution for this recall,” the agency said in a statement. Philips still hasn’t provided “all information we requested to evaluate the risks from the chemicals released from the foam.”

Philips disclosed earlier this year that it received a Department of Justice subpoena over the recall. The agency hasn’t publicly commented on the matter, per federal rules.

But an FDA inspection of Philips’ Pennsylvania offices uncovered a spate of red flags last fall, including emails suggesting the company was warned of the problem six years before the recall. In an October 2015 email, one customer appeared to warn Philips that the polyester polyurethane foam could degrade, according to FDA.

Between 2016 and early 2021, FDA found 14 instances where Philips was made aware of the issue or was analyzing the problem internally. “No further design change, corrective action or field correction was conducted,” the FDA inspectors repeatedly note.

In a May 2018 email, foam supplier William T. Burnett wrote to Philips in an email: “We would not recommend use of polyester foam in such an environment. ... It will eventually decompose to a sticky powder,” according to an affidavit filed as part of a lawsuit over the foam.

Since the recall, Philips has been using a new type of foam made from silicone to refurbish machines.

But FDA alerted consumers last November that the new material had failed one safety test. And regulators asked the company to perform more testing to clarify any health risks with both the new foam and the recalled material. Philips says independent testing has not identified any safety issues.

The company says it has replaced or repaired about 69% of recalled devices globally and aims to ship 90% of those requested by year’s end. On average, the company produces about 1 million sleep devices annually.

“We have scaled up by more than a factor of three, but inevitably it still takes time to remediate 5.5 million devices globally,” the company said. About half are in the U.S.

Jeffrey Reed is among those still waiting.

Reed registered for a replacement device in June 2021 — within a week of the recall. This month, he received an email from Philips indicating that his device has been discontinued and isn’t available for immediate replacement. Instead, the company offered him $50 to return the machine or an option of providing additional information to get a newer one.

“For them to wait until October to tell me that my machine is too old, when they’ve known exactly what device I have since the day I registered — that’s frustrating,” Reed said. “It’s disappointing that a provider of life-saving equipment treats people like this.”

https://apnews.com/article/sleep-apnea-machines-recall-1c0b269dbda55fb6f42c3b33939abdaa