The Oxford English Dictionary says that preventative is the “corrupt form” of preventive. Would have liked to have seen Kate Middleton use the more proper term, even if she didn’t say “adjuvant.”
I'm more worried that people might think that they need chemo for prevention, rather than treatment. Example: some biopsy looks indeterminate. The wise thing to do is to watch and wait. But someone might think "preventative chemo" is needed. Nope.
Dr. Faust, I really look forward to Inside Medicine and appreciate your perspective and the topics discussed. And just wanted to say, "thank you!"
With respect to sunsetting Covid-19 guidelines, where will we look for treatment guidance? Will another group take it over? It's not like Covid is going to go away anytime soon, how do those of us interested keep up with current or changing recommendations? While I get we aren't in the crisis times of 2020, will accepting, "we're in a much different place now" and "we have the tools," set us up for unmitigated gamble?
Will you help me better understand, "most people have some degree of immunity to Covid-19." Honestly, it's confusing to me when the consensus of research I've seen agrees that after vaccination or infection, the immunity wanes and the risk of reinfection returns. Wastewater is currently showing infections are decreasing, but most places are still "medium," not "low." And Easter and Spring Break are here. What are cases going to look like in a few weeks? Covid appears to be evolving to no distinct seasonality, and people are still definitely developing re-infections. Are NIH and CDC moving toward a "herd immunity" approach? That seems impossible to achieve given a constantly adapting, mutating virus like Covid-19. Taking away guidelines, dropping isolation and no masking in healthcare... It's making it harder not easier to protect myself and leaves me feeling more vulnerable and less safe.
What I mean by "most people have some degree of immunity" what I mean is that the risk of a severe outcome is nowhere near as high as it was in 2020 when nobody had any immunity. The risk of infection is close to zero after a time, but we forget that the vaccines were meant to prevent severe covid19 pneumonia. They do that exceedingly well. Today, the hopsitalizations we see are mainly the tip-over I always talk about.
Obviously I have no idea what case counts will be at any time. But two things are true at the same time: 1. Getting infected now is less dangerous for most people than it ever has been. 2. each infection carries some risk.
We can't do herd immunity. This virus really won't permit that. But we can keep the herd "protected," for example, by having high risk folks stay up to date on immunizations so that when they do get an infection, it is less bad.
I estimate that Infection Fatality Rate dropped from about 1% in 2020 to 0.04% summer 2023 and now about 0.025% but that's for the whole population and is obviously higher for high risk individuals.
Messaging and outreach should focus really really hard on getting those at high risk to get booster shots at least twice a year.
It should also be dramatically easier for high risk individuals to get serology tests and additional shots if serology shows a weak response to a shot.
“Adjuvant chemotherapy” is exactly what my doctors are calling what I am getting right now: in late October I had a routine colonoscopy at which they found something that had to be removed, which it was in December. Now I'm getting chemotherapy in case some cells remain; they got everything they know about in the procedure but they say outcomes are much better if surgery is followed up promptly by chemo.
So far it's going OK, side effects pretty manageable. Of course I won't really know until future years: did it come back and could it be treated if it did...
Oh, I see that medpage article mentions ondansetron to alleviate nausea and vomiting; that's part of my treatment for exactly that reason and it's making a huge difference to me: I can enjoy food during chemo!
I didn't take the poll, because it left out the option I would choose - opting for a premium subscription to avoid ads AND get full content. But if I have to choose, I'd accept ads rather than less content. I remember when you posted every day - surely unsustainable over the long run, but great for us readers!
:) Daily was fun to do--Facebook was paying me to do nothing at that point because they had sunsetted Bulletin but had to fulfill the writer contracts. So I could "afford" to do that for a time. On the other hand, these days, Five on Friday could be broken up into smaller posts during the week. But I decided it was better for me to do it this way (i.e. one "newsletter" post on Fridays, rather than short daily things). Not sure which is best!
Yes indeed, one reason to upgrade for some might be to avoid ads.
Dr Faust, have you seen this preprint about a nasal spray researchers from Harvard and BWH developed? It says it lasts 8 hours and prevents most viruses, including COVID. It's being marketed as Profi Nasal Spray. One of the main ingredients is pectin derived from apples. It seems like a great product to use for going to dentist or as another layer of protection along with masking, but is it too good to be true or something hopeful: A Drug-Free Pathogen Capture and Neutralizing Nasal Spray (PCANS) to Prevent Emerging Respiratory Infections. https://www.biorxiv.org/content/10.1101/2023.10.02.560602v1
Here’s a nice review of nose sprays— personally I got the Betadine product from Canada— the Profi never got a peer reviewed publication that I could find.
The Oxford English Dictionary says that preventative is the “corrupt form” of preventive. Would have liked to have seen Kate Middleton use the more proper term, even if she didn’t say “adjuvant.”
I'm more worried that people might think that they need chemo for prevention, rather than treatment. Example: some biopsy looks indeterminate. The wise thing to do is to watch and wait. But someone might think "preventative chemo" is needed. Nope.
Good point. There are probably many examples like that.
Dr. Faust, I really look forward to Inside Medicine and appreciate your perspective and the topics discussed. And just wanted to say, "thank you!"
With respect to sunsetting Covid-19 guidelines, where will we look for treatment guidance? Will another group take it over? It's not like Covid is going to go away anytime soon, how do those of us interested keep up with current or changing recommendations? While I get we aren't in the crisis times of 2020, will accepting, "we're in a much different place now" and "we have the tools," set us up for unmitigated gamble?
Will you help me better understand, "most people have some degree of immunity to Covid-19." Honestly, it's confusing to me when the consensus of research I've seen agrees that after vaccination or infection, the immunity wanes and the risk of reinfection returns. Wastewater is currently showing infections are decreasing, but most places are still "medium," not "low." And Easter and Spring Break are here. What are cases going to look like in a few weeks? Covid appears to be evolving to no distinct seasonality, and people are still definitely developing re-infections. Are NIH and CDC moving toward a "herd immunity" approach? That seems impossible to achieve given a constantly adapting, mutating virus like Covid-19. Taking away guidelines, dropping isolation and no masking in healthcare... It's making it harder not easier to protect myself and leaves me feeling more vulnerable and less safe.
What I mean by "most people have some degree of immunity" what I mean is that the risk of a severe outcome is nowhere near as high as it was in 2020 when nobody had any immunity. The risk of infection is close to zero after a time, but we forget that the vaccines were meant to prevent severe covid19 pneumonia. They do that exceedingly well. Today, the hopsitalizations we see are mainly the tip-over I always talk about.
Obviously I have no idea what case counts will be at any time. But two things are true at the same time: 1. Getting infected now is less dangerous for most people than it ever has been. 2. each infection carries some risk.
We can't do herd immunity. This virus really won't permit that. But we can keep the herd "protected," for example, by having high risk folks stay up to date on immunizations so that when they do get an infection, it is less bad.
I estimate that Infection Fatality Rate dropped from about 1% in 2020 to 0.04% summer 2023 and now about 0.025% but that's for the whole population and is obviously higher for high risk individuals.
Messaging and outreach should focus really really hard on getting those at high risk to get booster shots at least twice a year.
It should also be dramatically easier for high risk individuals to get serology tests and additional shots if serology shows a weak response to a shot.
Okay, that helps me better understand.
“Adjuvant chemotherapy” is exactly what my doctors are calling what I am getting right now: in late October I had a routine colonoscopy at which they found something that had to be removed, which it was in December. Now I'm getting chemotherapy in case some cells remain; they got everything they know about in the procedure but they say outcomes are much better if surgery is followed up promptly by chemo.
I hope all is well. Indeed they do this when they benefit is greater than the risks. I'm not an oncologist, but this is a familiar pattern.
So far it's going OK, side effects pretty manageable. Of course I won't really know until future years: did it come back and could it be treated if it did...
Oh, I see that medpage article mentions ondansetron to alleviate nausea and vomiting; that's part of my treatment for exactly that reason and it's making a huge difference to me: I can enjoy food during chemo!
yeah this drug really helps people
I didn't take the poll, because it left out the option I would choose - opting for a premium subscription to avoid ads AND get full content. But if I have to choose, I'd accept ads rather than less content. I remember when you posted every day - surely unsustainable over the long run, but great for us readers!
:) Daily was fun to do--Facebook was paying me to do nothing at that point because they had sunsetted Bulletin but had to fulfill the writer contracts. So I could "afford" to do that for a time. On the other hand, these days, Five on Friday could be broken up into smaller posts during the week. But I decided it was better for me to do it this way (i.e. one "newsletter" post on Fridays, rather than short daily things). Not sure which is best!
Yes indeed, one reason to upgrade for some might be to avoid ads.
I like the Five on Friday format, rather than shorter daily news from you. See? I guess I just suggested a Poll you could do, 😉
Thanks too for asking for comments, sharing is good,
Dr Faust, have you seen this preprint about a nasal spray researchers from Harvard and BWH developed? It says it lasts 8 hours and prevents most viruses, including COVID. It's being marketed as Profi Nasal Spray. One of the main ingredients is pectin derived from apples. It seems like a great product to use for going to dentist or as another layer of protection along with masking, but is it too good to be true or something hopeful: A Drug-Free Pathogen Capture and Neutralizing Nasal Spray (PCANS) to Prevent Emerging Respiratory Infections. https://www.biorxiv.org/content/10.1101/2023.10.02.560602v1
Here’s a nice review of nose sprays— personally I got the Betadine product from Canada— the Profi never got a peer reviewed publication that I could find.
https://mccormickmd.substack.com/p/nasal-sprays-for-covid-prevention
Thank you, Jan, I'm going to read the review right now.
Thanks for the information about Profi : this is where I bought the Betadine spray https://www.northernvitality.us/products/betadine-cold-defence-nasal-spray-20ml
I like the Five on Friday!
I do not like five on Friday.
So you’d prefer these be broken up into shorter daily posts? Just trying to figure out what people want