Many have made the observation that if you had told people two years ago that we would have a cure (not a vaccine, but a cure!) for Covid-19 that was free, safe and effective, but that no one wanted to take it, and Congress wasn’t willing to fund further purchases, people would not have believed you.
It's incredibly hard for an average person to find who qualifies. It's in a footnote of the EUA and nowhere else. It's also incredibly hard to get a prescription. I attempted to solve both of those with my infographic.
I'm not surprised public health hasn't been able to create the same infographic. The amount of asterisks and sources and side effects would mandate a 15 page infographic. It's still sad though, and I wouldn't mind a signal boost.
Second, I have been alerted and lived through myself, that a "rebound" of covid after paxlovid is common. I haven't heard that in circles before. I suspect I took paxlovid too early, and "my body didn't develop an immune response because it didn't need to". For this reason, I'd recommend people wait until at least day 2 of covid to take it if they are otherwise healthy. I took it 3 hours after my first positive test, had almost no symptoms until day 7 (after paxlovid course), and now am on day 11 and coming down from some more severe symptoms, and still testing positive. There are a few articles posted by news outlets on this topic in the last few days, see here: https://www.cnn.com/2022/04/27/health/paxlovid-covid-rebound/index.html
I'm curious to see expert takes on this effect. I wonder if a lower dose of paxlovid could titrate the amount of actual covid in your body, such that your body has an immune response, but to still prevent major symptoms.
Last, paxlovid gives a bitter taste in your mouth. Two people I've talked to say it's like walking into a cloud of hairspray with your mouth open. During the day, it's easy to counteract with candy, but it did taste bad enough (on top of some acid reflux from covid) that it made it difficult to sleep. My partner stopped taking paxlovid on day 3 of the course due to this. It's something I wish I included in my infographic.
That is a nice infographic, good on you for making it.
I wonder how many people are actually, in practice, not eligible to get Paxlovid based on that. ADHD, physically inactive, obese, depression, I mean those four alone have to be something like 50% of the adult population. Throw in smoker, overweight and any learning disability, and who isn't on that list?
If everyone is eligible, what's the point of listing those things? Who are they singling out? "Sorry, no Paxlovid for you, you are simply too abnormally normal to be allowed treatment. Get diagnosed with some interesting mental illness and we will talk."
That's the general idea. I've heard >80%. That's why it's especially a shame that there isn't more use of the drug. Though - some of my friends say they don't qualify.
My mother is in a nursing care facility which did a great job of boosting its residents in time for the omicron wave. So I emailed them recently to ask what they are doing about Paxlovid for future cases and they just said it was one option among a few others that it is up to doctors to prescribe. While that is technically true, it seems like they should be encouraging it and making sure their residents know about it.
I did read that Paxlovid has many potentially worrisome drug "interactions", but wasn't able to look into it more. Maybe this is a problem for elderly who often take many different kinds of medications?
Yes, there are interactions with a bunch of drugs. But from what I have read, most of the interactions can be avoided by stopping the drug during treatment and resuming afterwards with minimal risk. It's something the prescriber can manage pretty well.
The standard vaccine test cycle before normal FDA approval is, I believe, 3-5 years, if not 7. The current approvals are "emergency authorizations", not normal approvals. Which can only be done in an emergency.
Now that we're not in one, maybe FDA not rushing to approve vaccines for kids (longest expected life spans, most potential vax risk, least actual risk from virus), maybe that's FDA working exactly as it should?
The explanation is the strange part. It is like when my kid is in the kitchen and I ask "Hey, what's happening, kiddo?" and they say "Uhm well I had to use the potty but then a squirrel ran by the window and I thought mommy wanted to know but mommy isn't here so I thought she was at the table but she wasn't so I came to the kitchen but I wanted a glass of water and then I wanted to go watch a show. Don't look at me."
The next question I have is always "What are you holding behind your back?" at that point.
In the case of the FDA what is behind their back is probably a bribe of some sort to not let the first vaccine out before the other is ready, as that would be worth quite a bit. Sadly, that notion is so unsurprising to me at this point that I can't even get angry about it. The FDA working exactly as it usually does, apparently.
As in any large organization, the professionals and the messaging people are different people. While in theory they should come up with a coherent message, in practice the PR people are much more concerned with political pressures and what not.
I'd rather a correctly functioning but badly messaging FDA than the other way around.
That might be true, but the decision to pass/fail and when to do so is done by management, not the professionals working in the lab or the PR folks. Particularly the WHEN part of the decision is under the control of management, not the PR folks. So the question is "Why is one being delayed after having passed?" If the best the PR people can come up with is confusion, that implies that there wasn't a better answer readily available; if there was, they would have used that instead. One doesn't use obviously stupid reasons when there is a perfectly good reason just lying there. The PR people (and management to whom they answer) thought that the confusion story was the least bad story available.
That tells you a lot about how the FDA functions. Whether or not that function is "correct" depends on where your desk is located I suspect, but for most of us it doesn't bode well.
I could see how the perfectly good reason could have been "there's no emergency", but the politically astute management then foresaw answering a lot of unpleasant questions, so that answer was not given. And the PR people were left to come up with the best they could.
Trying to second guess the internal workings of a big org is even less reliable than trying to second guess individual decision making. We don't know what happened during the decision making. We only know what decision came out, and it's not an unreasonable one.
We seem to be understanding the situation differently. I read that the FDA is ready to approve one now, all the ducks are in a row, everything stamped etc. such that they could just pull the trigger now, but have decided to postpone the approval till they are done approving the second vaccine. Is that not your reading of what is written?
Wife got Covid this week. Home test. Called doc's office to figure out quarantine protocols.
I had to cut in at the end and ask for paxlovid. Half hour on hold. Told we could have a prescription filled tomorrow (it was before 7pm). Oh but the person picking it up can't be from her home. And they need her physical insurance card.
1% of those surveyed Never Heard Of Kamala Harris. I guess I am not surprised but, damn, this is the likely electorate and ~10 people of 1,001 Never Heard Of the sitting vice president? I suppose I should be glad that everyone surveyed had apparently head of the past two presidents, at least.
Only 17% hadn't heard of Ketanji Brown Jackson. That actually seems like a relatively well-informed sample of the population. (I feel like I've barely heard of her myself.)
That's true... I would have to think pretty hard to remember. For some reason her name doesn't stick, I suppose because I have never really heard anyone saying it out loud.
Caution: I now can't remember who it was that was forced to take off their P100 and then got COVID. If anyone has heard the same story and remembers who it is about, please do say.
Aside from immunocompromised kiddos, are parents really so concerned about vaccinating their children to go about their lives? Is it a worry about the child getting sick, or them passing it on to a family-member that's more at risk?
No one in my social circle is remotely concerned about vaccinating their children, so I can't tell what the norm is outside of it.
First, I did my part by making a shitty infographic about paxlovid. It is here: https://imgur.com/a/Nu5HVYP
It's incredibly hard for an average person to find who qualifies. It's in a footnote of the EUA and nowhere else. It's also incredibly hard to get a prescription. I attempted to solve both of those with my infographic.
I'm not surprised public health hasn't been able to create the same infographic. The amount of asterisks and sources and side effects would mandate a 15 page infographic. It's still sad though, and I wouldn't mind a signal boost.
Second, I have been alerted and lived through myself, that a "rebound" of covid after paxlovid is common. I haven't heard that in circles before. I suspect I took paxlovid too early, and "my body didn't develop an immune response because it didn't need to". For this reason, I'd recommend people wait until at least day 2 of covid to take it if they are otherwise healthy. I took it 3 hours after my first positive test, had almost no symptoms until day 7 (after paxlovid course), and now am on day 11 and coming down from some more severe symptoms, and still testing positive. There are a few articles posted by news outlets on this topic in the last few days, see here: https://www.cnn.com/2022/04/27/health/paxlovid-covid-rebound/index.html
I'm curious to see expert takes on this effect. I wonder if a lower dose of paxlovid could titrate the amount of actual covid in your body, such that your body has an immune response, but to still prevent major symptoms.
Last, paxlovid gives a bitter taste in your mouth. Two people I've talked to say it's like walking into a cloud of hairspray with your mouth open. During the day, it's easy to counteract with candy, but it did taste bad enough (on top of some acid reflux from covid) that it made it difficult to sleep. My partner stopped taking paxlovid on day 3 of the course due to this. It's something I wish I included in my infographic.
Awesome, thanks! Just shared your infographic with my parents!
That is a nice infographic, good on you for making it.
I wonder how many people are actually, in practice, not eligible to get Paxlovid based on that. ADHD, physically inactive, obese, depression, I mean those four alone have to be something like 50% of the adult population. Throw in smoker, overweight and any learning disability, and who isn't on that list?
If everyone is eligible, what's the point of listing those things? Who are they singling out? "Sorry, no Paxlovid for you, you are simply too abnormally normal to be allowed treatment. Get diagnosed with some interesting mental illness and we will talk."
That's the general idea. I've heard >80%. That's why it's especially a shame that there isn't more use of the drug. Though - some of my friends say they don't qualify.
Your infographic is great but trying to get an e-clinic visit for a minor from CVS is a nightmare
My mother is in a nursing care facility which did a great job of boosting its residents in time for the omicron wave. So I emailed them recently to ask what they are doing about Paxlovid for future cases and they just said it was one option among a few others that it is up to doctors to prescribe. While that is technically true, it seems like they should be encouraging it and making sure their residents know about it.
I did read that Paxlovid has many potentially worrisome drug "interactions", but wasn't able to look into it more. Maybe this is a problem for elderly who often take many different kinds of medications?
Yes, there are interactions with a bunch of drugs. But from what I have read, most of the interactions can be avoided by stopping the drug during treatment and resuming afterwards with minimal risk. It's something the prescriber can manage pretty well.
Please read
@michaelmina_lab on rapid tests. They work, detect infectiousness, which is often after symptoms develop for the vaccinated
The standard vaccine test cycle before normal FDA approval is, I believe, 3-5 years, if not 7. The current approvals are "emergency authorizations", not normal approvals. Which can only be done in an emergency.
Now that we're not in one, maybe FDA not rushing to approve vaccines for kids (longest expected life spans, most potential vax risk, least actual risk from virus), maybe that's FDA working exactly as it should?
The explanation is the strange part. It is like when my kid is in the kitchen and I ask "Hey, what's happening, kiddo?" and they say "Uhm well I had to use the potty but then a squirrel ran by the window and I thought mommy wanted to know but mommy isn't here so I thought she was at the table but she wasn't so I came to the kitchen but I wanted a glass of water and then I wanted to go watch a show. Don't look at me."
The next question I have is always "What are you holding behind your back?" at that point.
In the case of the FDA what is behind their back is probably a bribe of some sort to not let the first vaccine out before the other is ready, as that would be worth quite a bit. Sadly, that notion is so unsurprising to me at this point that I can't even get angry about it. The FDA working exactly as it usually does, apparently.
As in any large organization, the professionals and the messaging people are different people. While in theory they should come up with a coherent message, in practice the PR people are much more concerned with political pressures and what not.
I'd rather a correctly functioning but badly messaging FDA than the other way around.
That might be true, but the decision to pass/fail and when to do so is done by management, not the professionals working in the lab or the PR folks. Particularly the WHEN part of the decision is under the control of management, not the PR folks. So the question is "Why is one being delayed after having passed?" If the best the PR people can come up with is confusion, that implies that there wasn't a better answer readily available; if there was, they would have used that instead. One doesn't use obviously stupid reasons when there is a perfectly good reason just lying there. The PR people (and management to whom they answer) thought that the confusion story was the least bad story available.
That tells you a lot about how the FDA functions. Whether or not that function is "correct" depends on where your desk is located I suspect, but for most of us it doesn't bode well.
I could see how the perfectly good reason could have been "there's no emergency", but the politically astute management then foresaw answering a lot of unpleasant questions, so that answer was not given. And the PR people were left to come up with the best they could.
Trying to second guess the internal workings of a big org is even less reliable than trying to second guess individual decision making. We don't know what happened during the decision making. We only know what decision came out, and it's not an unreasonable one.
I am confused how the decision could be viewed as reasonable.
Are we in an emergency wrt Covid and kids less than 5 years old?
Is FDA considering an emergency authorization?
We seem to be understanding the situation differently. I read that the FDA is ready to approve one now, all the ducks are in a row, everything stamped etc. such that they could just pull the trigger now, but have decided to postpone the approval till they are done approving the second vaccine. Is that not your reading of what is written?
Are they ready to "approve" as per standard protocol, or "emergency authorize"? Probably I read it incorrectly.
Re: Musk approval rate, would be interesting to see a Right leaning (or a 50/50?) audience answering the same poll.
Pfizer is paying for this ad to run on TV. I saw it first during an NBA playoff game.
https://www.ispot.tv/ad/bAea/pfizer-inc-move-fast-oral-treatment
Wife got Covid this week. Home test. Called doc's office to figure out quarantine protocols.
I had to cut in at the end and ask for paxlovid. Half hour on hold. Told we could have a prescription filled tomorrow (it was before 7pm). Oh but the person picking it up can't be from her home. And they need her physical insurance card.
These are the professionals folks.
Now that I think about it, this is probably the sub population that would be confused by the two stage kiddy vaccine approval.
1% of those surveyed Never Heard Of Kamala Harris. I guess I am not surprised but, damn, this is the likely electorate and ~10 people of 1,001 Never Heard Of the sitting vice president? I suppose I should be glad that everyone surveyed had apparently head of the past two presidents, at least.
Only 17% hadn't heard of Ketanji Brown Jackson. That actually seems like a relatively well-informed sample of the population. (I feel like I've barely heard of her myself.)
That's true... I would have to think pretty hard to remember. For some reason her name doesn't stick, I suppose because I have never really heard anyone saying it out loud.
Caution: I now can't remember who it was that was forced to take off their P100 and then got COVID. If anyone has heard the same story and remembers who it is about, please do say.
In Australia (NSW anyway, might differ by state) you need to be over 65 and have 2 underlying conditions to be eligible for Paxlovid.
Aside from immunocompromised kiddos, are parents really so concerned about vaccinating their children to go about their lives? Is it a worry about the child getting sick, or them passing it on to a family-member that's more at risk?
No one in my social circle is remotely concerned about vaccinating their children, so I can't tell what the norm is outside of it.