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"You don't always need a plan. Sometimes you just need to breathe, trust, let go and see what happens." — Mandy Hale

The Daily Tonic is a two to five minute read sharing science backed health news and tips, all while getting you to crack a smile or even lol on occasion.

Thursday. Two decades ago, nothing was cooler than owning a fancy flip phone like the Razr. Today, owning a flip phone means you are either in the CIA or trying to hide something from your spouse. But yesterday, Google announced the launch of its first FOLDABLE phone. So basically, a flip phone that you fold instead of flip. Maybe this will make having a flip phone cool again. Maybe it won’t. Speaking of things coming full circle, today marks the official end of the U.S. Covid-19 emergency. So what does the post-pandemic era have in store for us? Let’s dive in.

The Pressure Is On! 

The pandemic was a strange time for all of us. Some people lost loved ones, some people lost friendships, some lost jobs, and some lost their businesses. But there were also a handful of winners that came out of this strange time.  

The pandemic provided a significant boost to Big Pharma’s revenues over the past two years. However, with the Covid-19 emergency officially behind us, Big Pharma companies are bracing themselves for a steep decline in pandemic-related pharma revenues. This puts immense pressure on pharmaceutical companies to develop new drugs, treatments, and vaccines because when you run a large publicly-traded company, the revenue graphs need to constantly point up. As the companies that made billions from the pandemic now face a steep COVID cliff, investor pressure is mounting on pharmaceutical companies to spend their windfalls wisely.

AstraZeneca, one of the largest pharmaceutical companies in the world by revenue, has set some lofty goals as it anticipates a steep decline in Covid-19 pharma revenues for 2023. The company is now redirecting its Covid strategy to focus on "protecting the most vulnerable population" with antibody therapy.

Looking beyond Covid, AstraZeneca plans to launch 30 Phase 3 clinical trials this year and introduce 15 new drugs to the market by 2030. The company expects at least 10 of those drugs to become blockbusters, meaning they will make at least $1 billion in revenue annually. The drugs pending trials are designed to treat all disease areas in the company's portfolio.

Naturally, this begs the question — are all these new drugs absolutely necessary? Or is this more a result of AstraZeneca’s need to show continuous revenue growth year over year? And if it is the latter, are we rushing unnecessary treatments onto the market to increase revenue at the expense of our health? 

Only time will tell. 

Pharmaceutical companies, including Pfizer, BioNTech, Moderna, Gilead Sciences, AstraZeneca, and Merck, are estimated to have brought about $100 billion in revenue from Covid vaccines and treatments in 2022 alone. However, these sales could fall by nearly two-thirds this year due to built-up product inventories around the world, including in the countries that pay the most. Population immunity from high rates of vaccination and previous infections means that demand for treatments could dip as well. 

So what will Big Pharma do to make up for all those losses? 

Pharmaceutical companies are used to steep revenue drops known as patent cliffs that occur when their exclusivities on big-selling drugs expire and generic rivals move in. But usually, they strategize to prepare for those revenue swings for years. The type of revenue cliff coming post-pandemic is unprecedented, and the pressure to act now and make up for those losses is huge.

The key takeaway? The pressure to keep profits growing despite the pandemic being over puts our healthcare system in a precarious situation we should all be aware of. I am not saying we should all put on our tin foil hats and assume every drug that comes out over the next few years was rushed onto the market to make a few bucks. But the likelihood of Big Pharma playing fast and loose with the rules at the expense of our health might just be higher than ever before.

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The Reinforcements Are Delayed

We have a serious nursing shortage in the U.S., and one of the solutions has been to hire from abroad. Unfortunately, nothing is ever that simple or that easy. 

U.S. healthcare facilities that have hired international nurses to fill staffing shortages caused by Covid-19 may have to wait up to 18 months for the workers to arrive due to new federal visa rules. 

The State Department announced that only nurses who filed employment-based green card petitions before June 1, 2022, can proceed with green card interviews. This freeze is expected to impact thousands of international nurses and exacerbate staffing shortages at hospitals and health systems across the US. 

Organizations will now need to rely on travel nurses, who command high pay, while they wait for the visa process to move forward, putting further strain on a system that is already struggling.   

Healthcare experts are calling on Congress to pass legislation allowing federal immigration officials to "recapture and reallocate 25,000 previously issued but unused immigrant visas" for international nurses. 

I am sure Congress will get right on that. Solving problems effectively and efficiently is what they do best. 

Tonic Shots

• Do you have a teenager at home? Understanding how their brain is developing during those years might just help you understand them a bit better. Check it out. 

• Curious about meditation? Here are some books to check out that could help you start your mindfulness journey. Check out the list.