“A researcher had a good idea. Good trials were designed and implemented. After an auspicious start, the end results were disappointing. That’s just how it goes.”
Just an observation--somewhat off topic: I met with my primary care --who is also trained in ID yesterday--and she's expressing skepticism about Paxlovid. This is from a good physician in practice. Can you address that at some point? I'm a physician and prescribe it in a health center setting. She's in a private primary care office and is concerned about lack of efficacy and rebound.
Hi--In fairness, I have also expressed skepticism about the drug, for various populations. I think it worked extremely well for the unvaccinated and those who had never been infected before. For the vaccinated and those who have already had Covid, I suspect the benefit still exists for some (primarily older but also younger populations with substantial health burdens), but it's a lot less. For some populations, there is likely not benefit.
Overall, there are some docs who are *too skeptical of everything and some who are not skeptical enough. The former may dissuade patients who need a therapy (or vaccine) from getting it, which is very, very bad. The latter may take pharma (or whoever else) at their word a little too uncritically, leading to over treatment (or false hope). So, I think a doctor who is balanced and open on this is to be applauded, provided that they are not ideologically driven in a manner that really denies patients treatments that would help them.
I think rebound remains a concern. There are some people who are so at risk from Covid, though, that rebound would be a small price to pay, if it happened, making paxlovid "worth it." For others, no. For example, I am 43 and I have a mild seasonal asthma. But if I got Covid today, I'd be unlikely to take Paxlovid. But I have many older relatives for whom I would recommend it.
So...it's not cut-and-dry and it is a spectrum.
By the way, a big clinical trial on Pax will be out later this year, looking at vaccinated people. That'll be important.
Thank you for your incredibly thoughtful response. At 64+, I have a moderate primary immune deficiency--see at great doc at Brigham--and have so far, not been infected. I told her I'd ask her for it, and she was telling me her thoughts. She's not even sure about the bivalent booster at this point. Thank you!
Thanks for your efficiency in updating us.
“A researcher had a good idea. Good trials were designed and implemented. After an auspicious start, the end results were disappointing. That’s just how it goes.”
That sums it up it!
Just an observation--somewhat off topic: I met with my primary care --who is also trained in ID yesterday--and she's expressing skepticism about Paxlovid. This is from a good physician in practice. Can you address that at some point? I'm a physician and prescribe it in a health center setting. She's in a private primary care office and is concerned about lack of efficacy and rebound.
Hi--In fairness, I have also expressed skepticism about the drug, for various populations. I think it worked extremely well for the unvaccinated and those who had never been infected before. For the vaccinated and those who have already had Covid, I suspect the benefit still exists for some (primarily older but also younger populations with substantial health burdens), but it's a lot less. For some populations, there is likely not benefit.
Overall, there are some docs who are *too skeptical of everything and some who are not skeptical enough. The former may dissuade patients who need a therapy (or vaccine) from getting it, which is very, very bad. The latter may take pharma (or whoever else) at their word a little too uncritically, leading to over treatment (or false hope). So, I think a doctor who is balanced and open on this is to be applauded, provided that they are not ideologically driven in a manner that really denies patients treatments that would help them.
I think rebound remains a concern. There are some people who are so at risk from Covid, though, that rebound would be a small price to pay, if it happened, making paxlovid "worth it." For others, no. For example, I am 43 and I have a mild seasonal asthma. But if I got Covid today, I'd be unlikely to take Paxlovid. But I have many older relatives for whom I would recommend it.
So...it's not cut-and-dry and it is a spectrum.
By the way, a big clinical trial on Pax will be out later this year, looking at vaccinated people. That'll be important.
Thank you for your incredibly thoughtful response. At 64+, I have a moderate primary immune deficiency--see at great doc at Brigham--and have so far, not been infected. I told her I'd ask her for it, and she was telling me her thoughts. She's not even sure about the bivalent booster at this point. Thank you!