Coronavirus in the United States - news and thoughts

My daughter 18 just tested positive the second time (last Aug likely delta). We started her on the paxlovid within 3 hours of a positive test. It hasn't bothered her gut, just a medicine taste. You still will mount an immune response the med slows viral replication, and the "rebound" cases were not a huge percentage(based on the trials).

 

Dr. Anthony Fauci confirmed on Tuesday that he is suffering from 'Covid rebound' symptoms after being treated with Paxlovid.

Paxlovid, a drug that was anointed as America's silver bullet against COVID-19 by some health officials and even President Joe Biden, may not have any effectiveness for people that are already vaccinated, according its manufacturer Pfizer's own data.

Fauci, 81, broke the news while speaking remotely at the Foreign Policy Global Health Forum.



Anthony Fauci says that he's experienced a rebound in Covid symptoms after Paxlovid course | Daily Mail Online

 

Just to be clear, what the media (and I guess the president) were suppsedly touting as a "silver bullet" was NEVER what the medical community was saying.

Rather than read just headline non-sense, if one would just follow the data, one would be much better served. Pfizer recently abandoned its trial of Paxlovid for treating those patients who had COVID but fell into the low risk for severe disease progression because there was no statistically significant benefit.

Paxlovid continues to show 80+% efficacy against severe disease progression, hospitalization and death, especially in those who are at high risk. People should read the EUA....it is targeted for those with high risk for severe disease progression.

Again, all we care about is preventing development of severe disease, needing hospitalization and/or leading to death.

 

Well, to be clear, the Medical community(Fauci and Walensky) did say vaccinated people almost never carry the virus. That was not close to a true statement.

CDC director says data 'suggests that vaccinated people do not carry the virus'

 

The study by Pfizer was on unvaccinated high risk only.

 

That article was from 15 months ago. Do you not think things change? Especially a virus like COVID, that mutates very quickly?

 

The study that the EUA was issued on. Correct. Text from the EUA fact sheet sent to providers shown below (not sure how else you would have deconvoluted the factors for non-naive immune system responses by people who were vaccinated or had anti-bodies from previous infection???)

There are currently being tracked 9 other trials involving Paxlovid. Everything from general investigation in a real world setting to specific impact on pregnant women.

 

Like many of the drugs through this. It will not turn out to be a big hit. Pfizer will make a lot of money off it at the taxpayers expense. But if it worked for some that is fantastic. Just not sure this is a drug that needs to be touted for every single case. I do not see the need for it in a healthy person at all. But that does not mean someone should not take it if they are healthy. Just not needed based on what we know and where the disease is at right now for most imo.

 

It is not currently authorized for a healthy person. Just like primary care doctors are throwing z-packs and vitamin D at people for no reason, some are just handing out scripts for Paxlovid too. If you are hypertensive and diabetic, absolutely this will be beneficial. However, there is a large percentage of people who simply do not need to take this. 100% agree with that.

 

seniors are high risk so the doctors are automatically offering paxlovid if you are a senior and test positive. i usually go to Fast Track Urgent Care for the test (tampa area). they keep it in stock and if you decide you want to take paxlovid you walk out with your result and the drug

 

Which is unfortunate since most seniors have some kind of decline in kidney performance.

So many ignorant, under educated, primary care doctors. It is stunning how poor our health care system is.

 

Pfizer to apply for full approval of Paxlovid, despite not hitting all goals and desired end points for standard risk, vaccinated patients in their two EPIC (Evaluation of Protease Inhibitor for COVID) studies. EPIC-HR (high risk patients) and EPIC-SR (standard risk patients). Some key results from the release are presented below. Data shows that there may be some benefit for vaccinated patients with risk factors or unvaccinated without risk factors, but much lower than for people who were unvaccinated with risk factors.

Pfizer Announces Submission of New Drug Application to the U.S. FDA for PAXLOVID™

 

Yes

 

It doesn’t cause rebound. A percentage of patients do get a rebound.

 

I haven’t been following this drug, but i think you are hitting the point. How would one prove it’s causing a rebound vs. simply failing to eradicate the virus and then the virus coming back once the drug leaves the system? Those aren’t the same thing.

I’d say in such a scenario what would matter for the drugs usefulness (just like any other drug) would be it’s ultimate numbers on hospitalizations and deaths vs. control group. What do the numbers show. The “rebound” sounds like an unfortunate phenomenon and probably needs study, but obviously secondary to the bigger picture.

 

Layman's explanation of this phenomenon:
The drug (Paxlovid) inhibits the release of the enzyme protease by your body. This is an enzyme that the virus infected cells need to mature, ultimately allowing the virus to copy itself within the infected cell. The drug does not directly damage, destroy or otherwise attack the virus. So, during the course of the 5 day treatment, viral replication is suppressed in the body by the drug, not stopped. During this time, it is hoped your immune system can move faster than the muted virus and eliminate the virus and virus infected cells. However, in some percentage of people, viral load gets so high prior to the introduction of Paxlovid (protease inhibitor) or the immune sysmtem produces an insufficiently rapid response during the 5 day course of the drug that your body cannot fully clear the virus. In some of those people, the virus again starts replicating after the 5 day treatment course and symptoms return. However, those symptoms are almost always mild and eventually your bodies defenses "catch up" and overwhelm the virus ending the disease disease and (likely) ending the infection.

 

My wife had a tele med with her PA at TGMG today and the PA mentioned that she was smart not to take it because of the kidneys and also she mentioned the vomitting and stomach pain possibility. Im sure some at risk seniors benefit from it but it's not for everyone.

My wife and I are both out of quarantine and recovered from Covid.

 

Sadly, primary care providers are too lazy, or too political to read the recommendations. There is an entire checklist to follow now:

1. Paxlovid - should have data/testing on renal function
2. Remdesivir - not sure why it took over a year to use this in week #1 vs week#2 - but 80% with fewer side effects.
3. Monoclonals - harder to keep up with which ones are effective due to variation in Omicron
4. Molnupiravir - trials only showed 40% efficacy; real-world data showing 65% though, with none of the side effects of a protease inhibitor (Paxlovid).

And, these are only if you really should be treated based on known medical history. Our primary care providers in this country are terrible.