FDA authorizes first antiviral pill for Covid, Paxlovid
npr.org
npr.org
However, as long as covid doesn't mutate in a way that makes this pill ineffective (I don't know whether that's possible or not?) it could eventually effectively end the pandemic once they have enough doses.
For the vast majority of the population, COVID is already like the flu, but as you pointed out, a large enough percentage of the population (particularly obese/elderly/immune compromised) of people who contract it are at risk of hospitalization that it creates a lot of anxiety about hospital capacity.
We're currently getting two pieces of good news on COVID:
This pill, and perhaps more importantly for the majority of people on the planet who won't have the ability to get this pill, the data on Omicron is currently showing a divergence (compared to previous waves) of cases and deaths. This divergence is rather apparent by looking at graphs of South Africa. Previous spikes in cases resulted in corresponding (lagging by a few days) spikes in deaths. Omicron isn't showing this.
Click between cases and deaths on this chart to see for yourself: https://ig.ft.com/coronavirus-chart/?areas=usa&areas=zaf&are...
* Many public health authorities consider being overweight (and just obese) to be a risk factor.
When I caught it in February, before I was eligible for the vaccine, I was shocked by the reaction of most of my peers. They seemed surprised by my mild symptoms. The American public, as a whole, overestimates their own risk of hospitalization by orders of magnitude. You can be angry at me for recklessly stating this, and not piously pretending like the risk is evenly spread, but I'm not going to join in a mass delusion of pretending like 15 year old kids are statistically at risk from this virus. They aren't.
The distributions of cases and deaths by age group on this CDC dashboard are striking: https://covid.cdc.gov/covid-data-tracker/#demographics
If anyone else wants to lose weight, it's simple but very difficult. It will test your discipline.
Find out your TDEE using this https://tdeecalculator.net/, subtract 500 and boom that's your ceiling. Don't eat anything beyond that. Use myfitnesspal to track calories and weigh your food using a scale. That simple. If you work out you will lose weight even quicker. You will succeed or fail in the kitchen. The gym is just gravy on top - fight your battle in the kitchen.
It's simple but _very_ difficult. Easily the hardest thing I've done in my life.
At the risk of sounding stupid or glib, the best strategy is "not to play", e.g. never gain the extra weight in the first place. Which may not be feasible for people who grow up in fat families and already reach adulthood as obese.
But the still-nonobese people should be vigilant.
Some don't trust that the speed of the process as well as the immense political pressure to "do something" really sussed out the true effectiveness, safety, and immunity conferred by the vaccines, noting that coronaviruses have never had successful vaccines before now, as they mutate too rapidly.
I'm in the second camp. I viewed the situation as entirely different from traditional, well studied vaccines for endemic diseases such as measles, mumps, etc. I eventually did get vaccinated as I was under threat to lose my job if I didn't. I didn't want it otherwise, and time has shown that they aren't nearly as effective as initially promised. Most of the initial promises that the vaccines were the key to ending the pandemic have turned out to be wrong, the only thing we can really now say is that they offer some (short-term?) protection to the recipient, and at least in the case of the Janssen/J&J vaccine they are not as safe as promised either.
I will add that I don't like doctors, and I'm not a pill-popper. I don't take medicines that I don't need. I would be loathe to take any long-term prescription meds for any reason. Short term courses of antibiotics I will use. Other OTC very sparingly. I don't think I've taken more than a few Advils in the past 5 years, and that was when I had a tooth extracted.
I never thought I'd know ANYONE like this, but now almost every antivaxxer I know has some crackpot insanity reason for not getting vaccinated. None of them are worried about safety, FDA approval, etc. Hell my FIL thinks COVID-19 was meant to bring the endtimes so Jesus will come back and the rapture will happen. So do ALL of his constituents of his Church more or less.
So let's not mitigate the crackpots to a "minority" because it's simply not true.
1. Those who did not want to take the vaccine but did
2. Those who will not take the vaccine under nearly any condition
With many people's jobs being threatened and ability to eat in restaurants, etc being limited, most unvaxxed are in the second camp. At this stage I'd say they must have very strong feelings on it and are more likely to think the vaccine is much more dangerous than the data suggests or has some other nefarious purpose.
I'm vaccinated and I did it voluntarily as it seemed like it met the risk/reward trade-off for me. I've always been against mandates. I probably won't take the current booster unless forced (more of the same for a very different and likely mild variant meet my cost/benefit threshold), but I will take it if my job hinges on it. Rational people weigh cost/benefit. Losing your job definitely tilts the ledger, but I imagine many people who felt coerced into their decision are pretty sore over it and we will suffer some serious political repercussions for this, in my view, unnecessary mandate.
This is your “second camp” but I don’t see how this isn’t another form of conspiracy nut. You’ve just got a suspicion that things aren’t right and are fact-fitting to that. If you’re measuring risks, there’s no comparison between Unvaccinated vs. Vaccinated.
I am very often around circles of people who haven't been vaccinated: family members, friends, friends of family members, friends of friends, etc. There's a good mix between political reasons, and principled reasons. Most fall into the latter group, including myself: I refused to get the vaccine until it was in general availability for at least 6 months. This was the time period I felt comfortable with where I figured if any issues were to arise, we'd have found out about it by then.
Others have longer personal time frames. Others don't want to get it at all. But usually, it is for a strong principled reason. The fact of the matter is, past vaccines have caused issues; vaccines are not without their risks. Do the benefits outweigh the risks? Absolutely! But it's a personal choice. At this point, with all the data we've seen with how harmless and beneficial they are, I believe it to be an unwise one to not get vaxxed, but it's a personal choice nonetheless.
> Even more than that they view the Covid vaccine differently than flu or any other vaccine - largely for political reasons.
But, in fact, the COVID vaccine is very different than any other vaccine. Not only is it brand new technology that to this point was a failure in other trials with other diseases, it was also fast-tracked and released far sooner than any other in history. And it is for a virus that largely most severely affects the elderly, obese, and those with preexisting conditions.
People also forget that the very news organizations and politicians pretentiously shaming people for not getting vaccinated today, are the very same news organizations and politicians that spread fear and doubt about the vaccine just prior to the election. [0] Our current president did the same thing.
Perhaps if they didn't politicize it in the first place, or even plant seeds of fear...they would have more of a leg to stand on when it comes to being so divisive about the matter.
[0]: https://www.cnn.com/2020/09/01/health/eua-coronavirus-vaccin...
We call that propaganda and advertisements...
We don’t see the millions in the other category.
- unvaccinated who get covid and are fine (the vast majority)
- someone vaccinated who still got severely sick and may die
Pretty much any other slant of “news”.
The drugs that are most effective for hospitalized patients aren't antivirals, they're immune modulators: steroids like dexamethasone, and IL6 inhibitors like tocilizumab (which technically is a humanized monoclonal antibody, but not against COVID, and doesn't have any sort of antiviral mechanism of action).
[0] https://www.infectiousdiseaseadvisor.com/home/meetings/id-we... [1] https://www.healio.com/news/infectious-disease/20201120/who-...
Yes, from the very beginning those who weren't comfortable with taking the vaccine have had hope for alternative medications from the pharmaceutical industry. See: hydrochloroquine, ivermectin, et. al.
It all needs to be put in the context of the vaccine being the fastest approved vaccine ever; vaccines having issues in the past; CNN, Joe Biden, etc. spreading FUD about the "warp speed" nature of the vaccine as late as October of last year (prior to the election); and, most of all, the propensity for humans to prefer to take inaction that won't necessarily cause them harm.
e.g., if you don't get a vaccine, you may get COVID, you might not, it may be minor, it may be severe. But it's one of those "whatever will be, will be" sort of things. Whereas if one is wary of the vaccine, and they willingly get it, they perceive they may be playing a direct, active role in bringing harm to themselves.
But once you know you have COVID, you have it, therefore there's no other option than to take action.
This pill will fit into most of those objections as well. HCQ, ivermectin, and the like have all been around for a long time and even though their was no clinical efficacy on COVID, the anti-vax crowd was onboard with them because they have been around for so long.
I love the posts on twitter of people who basically said in early 2020 they would never ever take a vaccine approved by Trump. And by late 2021 they are saying the unvaccinated are the scum of the earth basically.
Consistent ;)
In reality, the people who said "we're not taking a vaccine only Trump says is safe" were playing a political game, spreading FUD about a very good thing (the vaccine) because this was the only issue on which Trump could ever lose the election. So every single media organization, and Joe Biden himself, made sure to spread FUD about the vaccine (making sure to add "Trump" to their reasoning, so as not to appear anti-science), right up until the election was over, and then suddenly everyone who still had some doubts was an awful anti-vaxxer who desperately wanted to eat horse paste.
So you can't have your cake and eat it too and be all "haha, we were just kidding, why don't you think the vax is safe that's so weird".
To think it was all done so we could pay an extra $1.50 per gallon of gas, though.
> The fact is, those other highly trusted authorities, both governmental and independent, were going to say the vaccine was safe anyway.
They were going to say the vaccine was safe if it was in fact safe. People feared Trump was going to say it was safe no matter the results, and then he would leverage the executive branch (CDC, FDA, NIH) to make that a reality. This fear of course was not unfounded, as Trump had been doing this very thing since day 1 of his presidency, when he ordered the National Park Service to doctor a photo of his inauguration to match his rhetoric that it was the biggest inauguration of all time.
It is true that Trump used these organizations for political ends, installed political appointees in those places that muzzled actual researchers and made recommendations contrary to public health interests (for example, the CDC position on meat packing plants, which changed suddenly due to political appointees getting involved in something that used to be apolitical). He ordered his administration to slow down testing to make case numbers look better. He touted Hydroxychloroquine as a "miracle cure", whereas today it's hardly even mentioned because it doesn't actually cure Covid. He put his own unqualified family members in charge of securing PPE, which of course was a disaster. He elevated an unqualified radiologist that he saw on Fox News to COVID advisor who was rebuked by his own colleagues for "[promoting] a view of COVID-19 that contradicts medical science." Taken as a whole, after all of that (and more), it's no wonder people were wary of him and his government claiming anything. Joe Biden or the Democrats didn't have to say anything to make people feel that way.
> "When you do testing to that extent, you're going to find more people, you're going to find more cases," Trump said. "So I said to my people, 'Slow the testing down, please.' They test and they test."
I mean, maybe Joe Biden and the Democrats were, but that's not what I've seen from "most people". I don't think most people play political games. Most people hate politics, but most people know when they're being lied to and gaslit constantly. In my reality, what I saw from people in my community was distrust in government for valid reasons. The way the Trump administration handled the pandemic left no confidence by Fall 2020 that they had our best interests in mind. That's not Joe Biden's fault or "the media's" fault.
> So you can't have your cake and eat it too and be all "haha, we were just kidding, why don't you think the vax is safe that's so weird".
There are still valid reasons to distrust the vaccine. I didn't take it until June and July because I wanted to see how things landed. I believe it's okay if people are still waiting because they just need more time to see how things play out. But that's not the reasoning I see from most antivaxxers I know. Their logic doesn't seem to be influenced by the reasoning that can be traced back to Democrats, or really any reasoning at all. Which Democrats were talking about microchips as a reason for distrust of vaccines? What media outlet was pushing that idea? Maybe you can argue Democrats created a general distrust and people filled in the blanks with whatever, but that seems tenuous to me.
There are also a lot of folks who can't get vaccinated, who would take this.
I suspect a lot of the folks who refuse to get vaccinated would take this if they were hospitalized with Covid. But since you don't usually get hospitalized until a week after you get symptoms, many won't have the option anyway.
One patient was basically 50/50 to die on the surgery table during a mechanical heart transplant due to covid destroying their natural heart, miraculously lived through it, and had the nerve to ask my friend whether they still needed to be vaccinated after they were being wheeled into the recovery area. It's almost comical the cognitive dissonance to challenge the team of doctors who literally just saved your life when they tell you to get the vaccine.
Being anti-vax is basically a religion at this point, so there's no use trying to convince people.
I am not even sure CDC was directly making such claims and some of the 90% figures were directly from regional hospital systems, not the CDC.
Source please?
https://fullfact.org/health/dr-hilary-lorraine-kelly-90-perc...
Considering the unlikeliness of being able to get COVID twice, that is, in fact a god question with a very non-trivial answer.
McCullough on getting COVID twice (2m54s): https://youtu.be/5kGK_dZsQ4U
s/Being anti-vax is basically a religion/Being informed is basically a maze/
Not all people who are not vaccinated are anti-vaxxers, not all who are vaccinated think that the vaccination policies are sensible, and criticizing vaccination policy is not the same as being anti-vaxxer.
Agreed. I am vaccinated, but I think that most of the Federal and Oregon state policy is political baloney.
This dude is establishing an awfully high level of evidence - PCR tests, antigen tests, etc. between the two instances - which probably isn't even collected when people get covid. Why would you? If you're feeling awful, and you have a positive PCR test, why take an antigen test?
So there are quite possibly a number of cases where this dude's level of evidence doesn't exist, and he goes straight from absence of evidence to evidence of absence. But the extraordinary claim, that you can't get covid twice, is what needs high levels of evidence - which he handwaves away by saying maybe it was the flu. Prove that! Show the flu test results! The ordinary claim is that you can get it twice, and demanding extraordinary evidence for that is just foolish.
My understanding is people change their whole tune pretty quick when they're in abject misery from catching Covid.
Neither one has changed their tune at all.
Suspect this will help, ironically
https://www.theguardian.com/commentisfree/2021/dec/21/paxlov...
It seems strange that large scale manufacturing appears to have not even been started yet, the projections for 2022 are only for 200M treatment courses (the latest announcement, at the time of the above article the projection was 80M). Biden is in the process of implementing some measures to make testing more available, but it is going to take some time and looks rather inadequate (500M free tests would last maybe a few weeks with everyone in the USA doing regular testing? Maybe they'd last a lot longer if everyone only did symptomatic testing, although regular testing is required in some places which will use up a lot of tests). But unless manufacturing is ramped up quickly the supply of this drug is going to be very low. The USA has prepurchased only 10M treatment courses. So we won't be able to just give it to anyone (at 168,409 cases per day 10M treatment courses would only last 59 days). But you can't tell yet who will get seriously ill and Paxlovid treatment has to start when symptoms start (and the number of people with symptoms may be much higher than the current case/day count). So someone is going to have to decide who lives and who dies. For older or immunocompromised people this is likely an easy choice and will be a boon. For younger, healthier people this may not be an option at all until supply becomes much larger.
Pfizer said they were going to help manufacturers make Paxlovid locally so that all countries would have access to it, license free. What is the status of those efforts? It seems to take 9 months to manufacture:
https://www.india.com/news/world/pfizer-pill-paxlovid-become...
"Federal health officials are expected to ration early shipments to the hardest hit parts of the country. Pfizer said the small supply is due to the manufacturing time — currently about nine months. The company says it can halve production time next year."
So Paxlovid may be the beginning of the end of COVID-19, but it seems it is not going to happen quickly. Certainly not in time for much use with Omicron.
https://www.acsh.org/news/2021/12/02/how-does-pfizers-paxlov...
hmm I wonder what changed since they discontinued the other Ritonavir treatment: https://www.who.int/news/item/04-07-2020-who-discontinues-hy...
Apparently, only one of the three available monoclonal antibodies seem to be effective against Omicron at the moment, so this can't come soon enough. How is Pfizer so successful in this space at the moment?
Kids can be vaccinated and now there’s antiviral pills. All empirical data shows that if you’re boosted you’re fine.
It’s over.
It’s time to stop listening to Doomer politicians and bureaucrats until vaccinated people start dying at rates similar to March 2020.
people overall are still dying at comparable rates to the first two waves right now (https://www.nytimes.com/interactive/2021/us/covid-cases.html)
Covid deaths in 2021 will outnumber 2020 and currently both hospitalization and death rates are not extremely far off from the first wave. Of course vaccinated people are better protected, but the "it's over" thing is kind of meaningless. And right now this is before the holidays and new years. Omicron is probably not even remotely close to having peaked yet.
The supermajority of the country is fully vaccinated. It’s time to move on.
Is this so difficult to understand?
Low priority for Covid treatment if you’re not vaccinated. Problem solved.
If you want anti vaxxers to hold the entire medical infrastructure of the country hostage indefinitely be my guest.
We're probably going to see increased demands on hospitals simply due to the larger numbers of old people.
For example, 2009 Swine Flu (remember that?) is about as deadly as 2020 COVID. But now in eg. the USA, there are 2.9m 80-84 year old men (elderly men are in the prime risk category for COVID deaths), compared to 2.3m in 2009:
https://www.populationpyramid.net/united-states-of-america/2...
These demographic trends were exacerbated by weak flu seasons in 2018 and 2019.
Crises always bring light to pre-existing failures in systems. COVID is simply exposing Western societies as aged, overweight, and Vitamin-D deficient.
No, they don't "fill up".
> The healthcare system is designed to fill up.
No, the generalized ideal occupancy rate is about 85%. The smaller the hospital, the lower the ideal occupancy rate.
My local hospital is at 115%. All elective surgeries have been cancelled. This is not normal by any stretch of the imagination.