I can say that Paxlovid was like an amzing drug for me, I felt better within 3 hours, and decided to make cookies. It was coming into Christmas and I had cookies to make, and it rteally helped me to go from 0 to 60 within hours. I had been forwarned about the taste so I had purchased Some Hall Immunity drops, that resolved that nasty side-effect. Great drug, never have I ever felt an impact like that from any drug, and I am 72!
I have seen others that did not take it and their illness lasted 8-9 days, before they tested negative. Me, I tested negative on day 5. And I felt pretty good most of the time. I worked extremely well for me!
I know it is *wrong* but why didn't your M-I-L take her spouse's Pax while she waited to get hers? I totally would have. If I get Covid again, I would grab a dose ASAP.
The first time I got sick in Summer 22,’ Paxlovid AND Ibuprofen didn’t do anything for me. I got really sick with several days of 103. I finally went to the ER. My nurse mentioned Motrin, and after a few days of that. I was much, much better. My second Covid experience, with paxlovid, was just a cold. I’m convinced that I may have been taking Paxlovid improperly the first time.
When I got Covid and started Paxlovid within 8 hours, I felt significantly better overnight, but I see now that it is possible I would have felt better even without the Paxlovid as my immune system, on its own, would have had more a chance to fight Covid by then! Though I did rebound 8 days after testing negative and was sicker than I had been initially for over a week which doesn't say much for my immune system! :)
For its manufacturer, this is the wonder of Paxlovid -- nobody know the effect it had on *them*. Two, uh, case studies: (1) 11/15/23, I tested +ve (I'm late middle aged); took Paxlovid within 18 hours; felt like crap for a few days, but tested +ve for 15 #$%&ing days, argh. God knows what role Pax played here. (2) ~11/20/23, other half tested +ve; Pax within 18 hours; tested -ve after 5 days... then +ve again 5 days later, this time for *9* days. Sure, maybe it could have been much worse, but our instincts say also a hell of a lot better -- and shorter. Doubt I'll use Pax if I get the plague again.
I wouldn't let past experience alter whether you do or do not in the future. That said, there are many "high risk people" who are not really high risk. I do think the net is a little broad at this point in the pandemic.
"don’t accept one-off anecdotes from physicians and scientists": More than thirty years ago, my late wife was being treated for breast cancer. At one point, her oncologist said there were two chemo options as the next phase of treatment. He said that each had approximately 50% effectiveness in clinical trials. He went over the side effects, which were similar, except A had a small (>5%) chance of death; B did not. He said he was recommending A, because an oncologist in the same practice had recently treated a patient with it, with good effect. I asked whether he thought that anecdotal evidence outweighed the evidence of the clinical trials. He got angry (whether at me or at himself?), and blustered a bit, but eventually reversed his choice when my wife, the patient, repeated the question. The chemo did help for a while, but of course we'll never know what the other choice might have done. I should add that otherwise he was a fine doctor - though the most empathetic doctors she had over the course of five years were two surgeons; quite the opposite of the stereotype. One became a good friend, who visited her at home when she was in hospice care.
Thank you for sharing this. Personal/lived experience can be meaningful in understanding the options. But I think it just bares context. When I do prescribe things that I rarely use, I might tell a patient my observations about the previous times I've recommended it, but I always caveat it with the fact that my experience may be random and that it might not work the same for the person in front of me as it did for others (either direction).
I don't know if this is a reverse anecdote. It is an anecdote and therefore full of uncertainty. I tested positive for Covid. Was able to get a Paxlovid RX from a psychiatrist. Not by PCP who BTW wanted me to come into their office three days later in order to get the meds! Yeah. no thanks. My neighbor who happened to probably pick up Covid on an international flight tested positive the day after I did. Just coincidence that we got it at the same time ... She goes to the same local PCP and could not get the drug. She ended up having a really bad cough that has lingered. I am going to say that maybe the Pax prevented me from getting the cough or other side effects other than tiredness. PS: Paxlovid was like being on some major not fun speed. It was rough but I am glad I took it.
So much uncertainty, indeed! Maybe Pax helped you...or maybe your neighbor had an undiagnosed predisposition to a rougher lung response no matter what. It's all very chaotic, isn't it!
I wonder if this principle recently applied to me - I have been under extreme stress due to my parent’s stroke and was suffering anxiety and digestive issues. I started on a SSRI and after a few days going to a higher dose started to have really bad digestive issues. Since I had not been on them long my doc stopped the med, I came in to discuss and switched to a new med and after just one night felt so much better. Was it really a virus that happened at the same time as the first med increased? Would I have felt better anyway having stopped the med? Probably will never know but happy that things are much more stable now.
Oh wow so hard to know! I do think that side effects are another interesting wrinkle. If you start a drug and get a really obvious side effect, and then stop the drug and it goes away...that's still an anecdote, but a compelling one, compared to "X happened, and then Y happened." And as you point out, sometimes things happen at the same time. That's why these things can be so hard to interpret.
Causal or temporal: it’s hard to separate. Paxlovid is getting utilized less and less — now that it’s subject to insurance coverage and I’m seeing ER providers who never seem to even consider it, in eligible cases. The goal of Paxlovid is to reduce severe illness and hospitalizations, not immediate symptom reduction--in my experience the the acute illness waxes and wanes. A more impactful story would have been if she didn't get it and how long/severe her symptoms were vs her treated spouse. Your title is "Paxlovid works"--but the post seems to imply that it doesn't.
The interesting thing is that "Paxlovid works" (still, we think) in doing what it is supposed to do--which is exactly as you said: preventing bad outcomes, not really dealing with symptoms. But people have really clung to the idea that it helps with symptoms, despite minimal evidence on that.
My belief on Pax is that it is both under and overprescribed. (Under-prescribed to super high risk and over prescribed to the worried well).
I can say that Paxlovid was like an amzing drug for me, I felt better within 3 hours, and decided to make cookies. It was coming into Christmas and I had cookies to make, and it rteally helped me to go from 0 to 60 within hours. I had been forwarned about the taste so I had purchased Some Hall Immunity drops, that resolved that nasty side-effect. Great drug, never have I ever felt an impact like that from any drug, and I am 72!
i had amazing desires to clean after taking it@
Well maybe it did, and maybe it would have happened anyway! That's what I'm after here. It's just hard to know.
I have seen others that did not take it and their illness lasted 8-9 days, before they tested negative. Me, I tested negative on day 5. And I felt pretty good most of the time. I worked extremely well for me!
I know it is *wrong* but why didn't your M-I-L take her spouse's Pax while she waited to get hers? I totally would have. If I get Covid again, I would grab a dose ASAP.
That's clever :) I didn't think of it at the time.
Well, it *is* against the rules but I "ahem" it works in a pinch.
The first time I got sick in Summer 22,’ Paxlovid AND Ibuprofen didn’t do anything for me. I got really sick with several days of 103. I finally went to the ER. My nurse mentioned Motrin, and after a few days of that. I was much, much better. My second Covid experience, with paxlovid, was just a cold. I’m convinced that I may have been taking Paxlovid improperly the first time.
Motrin is ibuprofen.
When I got Covid and started Paxlovid within 8 hours, I felt significantly better overnight, but I see now that it is possible I would have felt better even without the Paxlovid as my immune system, on its own, would have had more a chance to fight Covid by then! Though I did rebound 8 days after testing negative and was sicker than I had been initially for over a week which doesn't say much for my immune system! :)
For its manufacturer, this is the wonder of Paxlovid -- nobody know the effect it had on *them*. Two, uh, case studies: (1) 11/15/23, I tested +ve (I'm late middle aged); took Paxlovid within 18 hours; felt like crap for a few days, but tested +ve for 15 #$%&ing days, argh. God knows what role Pax played here. (2) ~11/20/23, other half tested +ve; Pax within 18 hours; tested -ve after 5 days... then +ve again 5 days later, this time for *9* days. Sure, maybe it could have been much worse, but our instincts say also a hell of a lot better -- and shorter. Doubt I'll use Pax if I get the plague again.
I wouldn't let past experience alter whether you do or do not in the future. That said, there are many "high risk people" who are not really high risk. I do think the net is a little broad at this point in the pandemic.
"don’t accept one-off anecdotes from physicians and scientists": More than thirty years ago, my late wife was being treated for breast cancer. At one point, her oncologist said there were two chemo options as the next phase of treatment. He said that each had approximately 50% effectiveness in clinical trials. He went over the side effects, which were similar, except A had a small (>5%) chance of death; B did not. He said he was recommending A, because an oncologist in the same practice had recently treated a patient with it, with good effect. I asked whether he thought that anecdotal evidence outweighed the evidence of the clinical trials. He got angry (whether at me or at himself?), and blustered a bit, but eventually reversed his choice when my wife, the patient, repeated the question. The chemo did help for a while, but of course we'll never know what the other choice might have done. I should add that otherwise he was a fine doctor - though the most empathetic doctors she had over the course of five years were two surgeons; quite the opposite of the stereotype. One became a good friend, who visited her at home when she was in hospice care.
Thank you for sharing this. Personal/lived experience can be meaningful in understanding the options. But I think it just bares context. When I do prescribe things that I rarely use, I might tell a patient my observations about the previous times I've recommended it, but I always caveat it with the fact that my experience may be random and that it might not work the same for the person in front of me as it did for others (either direction).
I don't know if this is a reverse anecdote. It is an anecdote and therefore full of uncertainty. I tested positive for Covid. Was able to get a Paxlovid RX from a psychiatrist. Not by PCP who BTW wanted me to come into their office three days later in order to get the meds! Yeah. no thanks. My neighbor who happened to probably pick up Covid on an international flight tested positive the day after I did. Just coincidence that we got it at the same time ... She goes to the same local PCP and could not get the drug. She ended up having a really bad cough that has lingered. I am going to say that maybe the Pax prevented me from getting the cough or other side effects other than tiredness. PS: Paxlovid was like being on some major not fun speed. It was rough but I am glad I took it.
So much uncertainty, indeed! Maybe Pax helped you...or maybe your neighbor had an undiagnosed predisposition to a rougher lung response no matter what. It's all very chaotic, isn't it!
I wonder if this principle recently applied to me - I have been under extreme stress due to my parent’s stroke and was suffering anxiety and digestive issues. I started on a SSRI and after a few days going to a higher dose started to have really bad digestive issues. Since I had not been on them long my doc stopped the med, I came in to discuss and switched to a new med and after just one night felt so much better. Was it really a virus that happened at the same time as the first med increased? Would I have felt better anyway having stopped the med? Probably will never know but happy that things are much more stable now.
Oh wow so hard to know! I do think that side effects are another interesting wrinkle. If you start a drug and get a really obvious side effect, and then stop the drug and it goes away...that's still an anecdote, but a compelling one, compared to "X happened, and then Y happened." And as you point out, sometimes things happen at the same time. That's why these things can be so hard to interpret.
FWIW: "post hoc" translates as “*after* this". I'm sure you already know this, but I thought it might be helpful to mention it.
yeah I was playing with different translations and ended up with a version that amounted to a typo. Fixed!
Causal or temporal: it’s hard to separate. Paxlovid is getting utilized less and less — now that it’s subject to insurance coverage and I’m seeing ER providers who never seem to even consider it, in eligible cases. The goal of Paxlovid is to reduce severe illness and hospitalizations, not immediate symptom reduction--in my experience the the acute illness waxes and wanes. A more impactful story would have been if she didn't get it and how long/severe her symptoms were vs her treated spouse. Your title is "Paxlovid works"--but the post seems to imply that it doesn't.
The interesting thing is that "Paxlovid works" (still, we think) in doing what it is supposed to do--which is exactly as you said: preventing bad outcomes, not really dealing with symptoms. But people have really clung to the idea that it helps with symptoms, despite minimal evidence on that.
My belief on Pax is that it is both under and overprescribed. (Under-prescribed to super high risk and over prescribed to the worried well).