Pharmacists are going to be allowed to prescribe Paxlovid, while doctors continue to be confused by the guideline of ‘you can give this life-saving medicine that cures disease to the people who are sick with that disease.’ The news on the vaccine update front is good.
I am not an American, and in my actual political opinions I am quite leftwing, but isn’t increasing chances of De Santis being elected president a GOOD thing, given that likely alternative is Trump? (feel free to purge me, if this sort of comment isn’t welcome)
I am more interested in actions that reliably backfire than in defining outcomes as good or bad. Certainly it is possible to be left-leaning and think helping DeSantis improves expected outcomes (it's also very possible to think the opposite), but that's not what's happening here.
No one knows who will be a contender 2 1/2 years before a presidential election. No one saw Trump coming. Hillary Clinton was the favorite in 2008 and Obama came from nowhere to win.
Trump is done. He exploited a weak field with a single issue that no one else was addressing. That's not true anymore. The fact is he lost and most Republicans will realize that almost anyone else has a better chance of winning the general election.
Also, Trump has betrayed everyone who ever had anything to do with him, from his ex-wives to his cabinet to his donors to his voters. Polls show more support than he will have because there aren't any known alternatives yet.
Oh, and Biden is not going to run in 2024. It's obvious. Harris might, but she'll lose. He's too old, and everyone realizes he's a mediocre leader, even if they won't admit it.
Pro tip: stop nominating anyone but governors of large states for the presidency. Quit voting for people who have intentionally avoided having a record. We haven't elected a governor since 2004, and of the 8 major party candidates since, 7 were not governors. This is a big reason why things are so bad.
(BTW Reagan was a two-term governor of California, the largest state. For some reason this was conveniently forgotten by his critics.)
It's not a perfect criteria, but I think anyone would agree that Bill Clinton, a seriously flawed person and president, was more effective than Biden. He was also governor of Arkansas.
Executive skills are not the same as legislative skills. Stop nominating Senators.
> The good news is that we are not at any risk of losing control of Monkeypox. The bad news is that this is because we were never at any risk of being in control in the first place.
It seems to be starting as another debacle of extreme risk-aversion regarding making the vaccine available. I see news reports by my city's public health department confirming community spread, and a proud detail-free announcement that they're part of the emergency vaccine distribution plan. So I called the department to try to get details. It turns out there is still actually no way to request the vaccine here yet.
IIUC, the current national strategy is to hoard the vaccines until the supply increases. But... isn't that the exact opposite of what should be done when there's exponential spread? Giving out all the vaccines to the relevant demographic ASAP would start slowing the transmission *before* numbers have already grown high.
In 'fairness' to the relevant Serious People, hoarding a limited supply until 'everyone' can get shields them from 'criticism' from other Serious People, which is probably the most important consideration for them.
This is disingenuous. Unless the vaccine is, in fact, capable of preventing spread, then the benefits of vaccination primarily accrue to the individual (as with the Covid vaccine). For a vaccine that cannot prevent spread, the net good that a vaccination program can do is a function of giving the finite vaccine resources to the right set of people. There is no time dependence or benefit to giving early unless you really do wait so long that the total number of doses administered decreases because you have an excess. The cost of rushing is that you potentially distribute the constrained vaccine resources to a suboptimal set of people.
So really, you're pricing the mere possibility that the disease may be containable against achieving a better selection of the set of people who receive the vaccine. So, while saving the vaccine until there is a surplus is stupid, saving it until we know who needs it is not.
I'm assuming here that the cost non-linearity of medical systems being overwhelmed does not apply to Monkeypox.
OK. This is anecdotal. This is a bit hearsay. This is almost certainly confined to my particular city.
…but I can't tell if the local public health plan to distribute the ”good” Jynneos vaccine (of which there are very limited supplies, because of a plant shutdown) is secretly brilliant or secretly insane.
There is a public health imperative to not cast this as strictly a “gay” disease, partly out of fear of homophobia, but also because it’s not strictly confined to the gays. But as one of the gays: it’s totally being spread by the gays. I can tell you the events where it spread. I can tell you people who went to those events. I can tell you people who got monkeypox. I can tell you I went to one of the events…but was occupied doing paid photography, and not partaking. This is spread by circuit queens and leather daddies, though I guess we have to maintain the polite fiction it’s not.
All that is a preamble to how my local city has distributed the quite limited supplies of vaccines it got. The public health department relied on a whisper network. It quietly told a few local clinics, who told a few key people, and decided to do a major distribution event of the vaccine at Steamworks. A bathhouse. (I am not making this up.) 12:30 on a Friday afternoon before Pride. First come, first serve…and there was a line down the block. They put every single dose they had into arms, on the second floor of a bathhouse, right outside the gym area.
Is this a sane plan? I have no idea. Superficially, it seems nuts to tell some key people in the community and rely on word of mouth…but as a result, everyone in that party gay network knew what was going on IMMEDIATELY. The initial word got out on Wednesday night, and they reached maximum capacity on Friday afternoon, and you had people proudly sporting their bandages for Pride. So, the people who are absolutely most at risk got their jabs ASAP.
Regarding Netheralnds and cutting down on emissions - I'm not familiar with this particular case but cutting down nitrogen emissions from animal agriculture is more than welcome. it deos not have to mean less calories produced but rather more - as we move from growing feed for animals to actually grow food for humans. Also there is a huge waste connected to the food industry whatsoever, so states can do better in terms of controlling this part of the equation.
Got COVID, took Paxlovid on day 1 of symptoms, and recovered by day 3.
It worked great. I had to blatantly lie to the doc on the phone because of supposed drug interactions. I decided the risk of serious COVID far outweighed low-probability side effects. I had none.
Other family members were sick for 7-14 days. My initial symptoms were not mild, either. 101 degree fever, cough, extreme fatigue.
I've gotten shit from friends about it, because I cheated. I was going to have a rebound infection. I didn't. I'd be sick for longer even if I didn't go to the hospital. I wasn't, but got better fast. They said I wouldn't gain immunity and that the drug wouldn't work next year. I said who cares about immunity if I'm well now, and there will be new drugs next year. I told them to read Zvi and stop being idiots.
I am a moderately at-risk person (40yo with T1 diabetes, 3 shots). I had COVID in late December just before Paxlovid became available, it was about 4-5 days of discomfort followed by another week or so not being 100%. I'm sure I would have taken it if it were available at the time. Side note - I was offered molnupravir which I declined and am glad I did.
My parents both had COVID in March, both took Paxlovid which seemed to help, but my dad had the now well-known, though seemingly uncommon, Paxlovid rebound which resulted in him being varying stages of ill for over 3 weeks. Of course it's possible he could have been much worse without it. Both are happy they took it given their age and risk profile.
I think your implication that Paxlovid is a no-brainer for everyone (including young/healthy/boosted) is a bit flippant, even though it is probably true that it has been vastly underprescribed. Do you have a framework for weighing the costs vs. benefits for someone not at high risk?
You have a good idea of the risks of Covid, and Paxlovid takes care of most of those. So the question is whether you want to take a not-so-fun drug instead, basically. I haven't quantified the cost of Paxlovid side effects but it seems very manageable.
+1 to just including arbitrary links in a 'weekly update' post; seems a good way to batch them up when they don't individually warrant their own posts.
> It’s as if they are worried someone will notice someone is optimizing for good outcomes in this hive of scum and villainy, and so they must be cautious.
Who's responsible for the 'Paxlovid via pharmacy' change? Can we 'bomb' them with 'love and support' and maybe flip their expectations about 'good things being good'?
I am not an American, and in my actual political opinions I am quite leftwing, but isn’t increasing chances of De Santis being elected president a GOOD thing, given that likely alternative is Trump? (feel free to purge me, if this sort of comment isn’t welcome)
I am more interested in actions that reliably backfire than in defining outcomes as good or bad. Certainly it is possible to be left-leaning and think helping DeSantis improves expected outcomes (it's also very possible to think the opposite), but that's not what's happening here.
Liberals thought helping Trump in the primary would help Hillary Clinton win. Oops.
No one knows who will be a contender 2 1/2 years before a presidential election. No one saw Trump coming. Hillary Clinton was the favorite in 2008 and Obama came from nowhere to win.
Trump is done. He exploited a weak field with a single issue that no one else was addressing. That's not true anymore. The fact is he lost and most Republicans will realize that almost anyone else has a better chance of winning the general election.
Also, Trump has betrayed everyone who ever had anything to do with him, from his ex-wives to his cabinet to his donors to his voters. Polls show more support than he will have because there aren't any known alternatives yet.
Oh, and Biden is not going to run in 2024. It's obvious. Harris might, but she'll lose. He's too old, and everyone realizes he's a mediocre leader, even if they won't admit it.
Pro tip: stop nominating anyone but governors of large states for the presidency. Quit voting for people who have intentionally avoided having a record. We haven't elected a governor since 2004, and of the 8 major party candidates since, 7 were not governors. This is a big reason why things are so bad.
(BTW Reagan was a two-term governor of California, the largest state. For some reason this was conveniently forgotten by his critics.)
It's not a perfect criteria, but I think anyone would agree that Bill Clinton, a seriously flawed person and president, was more effective than Biden. He was also governor of Arkansas.
Executive skills are not the same as legislative skills. Stop nominating Senators.
> No one knows who will be a contender 2 1/2 years before a presidential election.
I think this is the only correct take on Presidential elections.
> The good news is that we are not at any risk of losing control of Monkeypox. The bad news is that this is because we were never at any risk of being in control in the first place.
It seems to be starting as another debacle of extreme risk-aversion regarding making the vaccine available. I see news reports by my city's public health department confirming community spread, and a proud detail-free announcement that they're part of the emergency vaccine distribution plan. So I called the department to try to get details. It turns out there is still actually no way to request the vaccine here yet.
IIUC, the current national strategy is to hoard the vaccines until the supply increases. But... isn't that the exact opposite of what should be done when there's exponential spread? Giving out all the vaccines to the relevant demographic ASAP would start slowing the transmission *before* numbers have already grown high.
There is no circumstance in which 'save the vaccine for later when we have ample supply' makes any sense.
In 'fairness' to the relevant Serious People, hoarding a limited supply until 'everyone' can get shields them from 'criticism' from other Serious People, which is probably the most important consideration for them.
This is disingenuous. Unless the vaccine is, in fact, capable of preventing spread, then the benefits of vaccination primarily accrue to the individual (as with the Covid vaccine). For a vaccine that cannot prevent spread, the net good that a vaccination program can do is a function of giving the finite vaccine resources to the right set of people. There is no time dependence or benefit to giving early unless you really do wait so long that the total number of doses administered decreases because you have an excess. The cost of rushing is that you potentially distribute the constrained vaccine resources to a suboptimal set of people.
So really, you're pricing the mere possibility that the disease may be containable against achieving a better selection of the set of people who receive the vaccine. So, while saving the vaccine until there is a surplus is stupid, saving it until we know who needs it is not.
I'm assuming here that the cost non-linearity of medical systems being overwhelmed does not apply to Monkeypox.
OK. This is anecdotal. This is a bit hearsay. This is almost certainly confined to my particular city.
…but I can't tell if the local public health plan to distribute the ”good” Jynneos vaccine (of which there are very limited supplies, because of a plant shutdown) is secretly brilliant or secretly insane.
There is a public health imperative to not cast this as strictly a “gay” disease, partly out of fear of homophobia, but also because it’s not strictly confined to the gays. But as one of the gays: it’s totally being spread by the gays. I can tell you the events where it spread. I can tell you people who went to those events. I can tell you people who got monkeypox. I can tell you I went to one of the events…but was occupied doing paid photography, and not partaking. This is spread by circuit queens and leather daddies, though I guess we have to maintain the polite fiction it’s not.
All that is a preamble to how my local city has distributed the quite limited supplies of vaccines it got. The public health department relied on a whisper network. It quietly told a few local clinics, who told a few key people, and decided to do a major distribution event of the vaccine at Steamworks. A bathhouse. (I am not making this up.) 12:30 on a Friday afternoon before Pride. First come, first serve…and there was a line down the block. They put every single dose they had into arms, on the second floor of a bathhouse, right outside the gym area.
Is this a sane plan? I have no idea. Superficially, it seems nuts to tell some key people in the community and rely on word of mouth…but as a result, everyone in that party gay network knew what was going on IMMEDIATELY. The initial word got out on Wednesday night, and they reached maximum capacity on Friday afternoon, and you had people proudly sporting their bandages for Pride. So, the people who are absolutely most at risk got their jabs ASAP.
That's actually a pretty brilliant plan – under the circumstances. (The 'circumstances' are insane of course.)
Regarding Netheralnds and cutting down on emissions - I'm not familiar with this particular case but cutting down nitrogen emissions from animal agriculture is more than welcome. it deos not have to mean less calories produced but rather more - as we move from growing feed for animals to actually grow food for humans. Also there is a huge waste connected to the food industry whatsoever, so states can do better in terms of controlling this part of the equation.
Got COVID, took Paxlovid on day 1 of symptoms, and recovered by day 3.
It worked great. I had to blatantly lie to the doc on the phone because of supposed drug interactions. I decided the risk of serious COVID far outweighed low-probability side effects. I had none.
Other family members were sick for 7-14 days. My initial symptoms were not mild, either. 101 degree fever, cough, extreme fatigue.
I've gotten shit from friends about it, because I cheated. I was going to have a rebound infection. I didn't. I'd be sick for longer even if I didn't go to the hospital. I wasn't, but got better fast. They said I wouldn't gain immunity and that the drug wouldn't work next year. I said who cares about immunity if I'm well now, and there will be new drugs next year. I told them to read Zvi and stop being idiots.
Paxlovid is the exploit scrubs won't use.
Yes, but if everyone did what you did, the Paxlovid doses wouldn't go to waste.
I am a moderately at-risk person (40yo with T1 diabetes, 3 shots). I had COVID in late December just before Paxlovid became available, it was about 4-5 days of discomfort followed by another week or so not being 100%. I'm sure I would have taken it if it were available at the time. Side note - I was offered molnupravir which I declined and am glad I did.
My parents both had COVID in March, both took Paxlovid which seemed to help, but my dad had the now well-known, though seemingly uncommon, Paxlovid rebound which resulted in him being varying stages of ill for over 3 weeks. Of course it's possible he could have been much worse without it. Both are happy they took it given their age and risk profile.
I think your implication that Paxlovid is a no-brainer for everyone (including young/healthy/boosted) is a bit flippant, even though it is probably true that it has been vastly underprescribed. Do you have a framework for weighing the costs vs. benefits for someone not at high risk?
You have a good idea of the risks of Covid, and Paxlovid takes care of most of those. So the question is whether you want to take a not-so-fun drug instead, basically. I haven't quantified the cost of Paxlovid side effects but it seems very manageable.
TIL that pharmacists can prescribe drugs at all.
+1 to just including arbitrary links in a 'weekly update' post; seems a good way to batch them up when they don't individually warrant their own posts.
> It’s as if they are worried someone will notice someone is optimizing for good outcomes in this hive of scum and villainy, and so they must be cautious.
Who's responsible for the 'Paxlovid via pharmacy' change? Can we 'bomb' them with 'love and support' and maybe flip their expectations about 'good things being good'?