And…reputable anecdotal case #2. Dr Peter Hotez from Texas Children’s Hospital that co-led the team that developed the Corbevax Covid vaccine that’s rolling out in India.
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Also curious if Pax was involved with this one.
From what I’ve heard, Pax is still keeping people out of the hospital, so it’s still fit-for-purpose, but the rebounds or reinfections seem to be more than anecdotal. (Trials were on Delta.)
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What does rebound mean in this context?
Symptoms have completely or mostly resolved, a couple of negative antigen tests, think it’s all pretty well run its course.
And then start testing positive on antigen tests again, with or without symptoms. ETA: Likely infectious.
Anecdotally, some people do report having worse symptoms on the relapse, but I haven’t heard of any yet that have ended up in the hospital, so Pax is still doing what it’s intended to do, keep those with risk factors out of the hospital.
I’m sure there are some ending up in the hospital (trials showed it to be 90% effective at reducing hospitalizations against the control group), but not enough to be making a splash on social media.
And there is the possibility it is a new infection, not a relapse, but that’s super quick to be reinfected.
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Yup, and they should meet on Thursday. From PBS:
There is one more hurdle: The Centers for Disease Control and Prevention must decide whether to formally recommend the booster for this age group. The CDC’s scientific advisers are scheduled to meet on Thursday.
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Bob Wachter has a fabulous thread on his own case study (his wife) and all his thoughts on Paxlovid. My personal perception is that he was starting to let his guard down a bit about Covid, and his wife being infected kind of brought it back up a bit.
https://twitter.com/bob_wachter/status/1526911763614011395?s=21&t=vlalbI8NPSHY4qGJPapX7w
Also, those in public health are really annoyed that doctors are not being proactive in offering Paxlovid to everyone eligible.
Yes, some of the people with risk factors still have a quite low risk of hospitalization. But cases are really surging in areas, which will cause hospital surges, which can be mitigated by giving Paxlovid to as many eligible people as possible. That’s how public health works.
Paxlovid has an excellent risk profile, so please, push for it if you or loved ones are eligible. (If you aren’t eligible, there is no data as of yet to support it being useful to take. Keeping an eye on that though.)
And yes, there are a long list of medication interactions to be aware of, but I’m seeing reputable comments on #medtwitter that there are only a few medications that are truly not compatible with Paxlovid, the others are more “be aware” notes, so make sure to ask follow up questions on how significant the interaction cautions are.
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Do you have a link to the list of medications would prevent you from taking it?
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Oh, looks like NIH has treatment guidelines out to specifically address this now!
“Because ritonavir-boosted nirmatrelvir (Paxlovid) is the only highly effective oral antiviral for the treatment of COVID-19, drug interactions that can be safely managed should not preclude the use of this medication.
Clinicians should be aware that many commonly used medications can be safely coadministered with ritonavir-boosted nirmatrelvir despite its drug-drug interaction potential.”
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Thanks, good to know. I am on one of the “withhold” medications. All my other meds are
on the 1st list.
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YLE has a pretty spot-on evaluation of where we are right now:
One bit I thought worth highlighting:
“ One group suggested that an “acceptable” endemic level of SARS-CoV-2 would be to keep peak COVID-19 deaths in a surge below the peak of a bad flu season.”
She links to this JAMA article from January, but it’s behind a registration wall. The same authors put out a detailed roadmap in March that I’ve been meaning to read. (I’ve only made it through the executive summary so far.). Lots of additional familiar big names attached to it as well: Trevor Bedford, Akiko Iwasaki, Michael Mina, Jennifer Nuzzo, Paul Offitt, David Putrino…
Notably, this is what they are targeting:
And this is where we are at:
With hospitalizations ticking up for a couple of weeks now, we are now due for deaths to start ticking up as well.
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Oh my word, DH and I were just talking about this today
Oh, good. I designate you the monkeypox focal point. I…just…can’t…
FWIW, apparently the lovely smallpox vax scar on my arm is something like 6% likelihood of giving me any level of protection at this point.
https://www.cdc.gov/poxvirus/monkeypox/clinicians/smallpox-vaccine.html
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Do we still give smallpox vaccinations? Yes? I don’t remember. I have my vaccination scar but I really don’t remember that one with the kids
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Thanks for the links. I bet the usaf gave DH one and my oldest son In the army.
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No, we’re not doing this. 
I thought this was really hard to spread between humans. 
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Yep. ‘Spose to be. 
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Nope. I think they quit around 1970ish? Anyway, I was born in 72 and didn’t get the vaccine. DH was born in 1966 and did get it. The vaccine, not actuall smallpox.
Also, some people we know were just in Montreal
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Routine vaccination stopped in 1972.
I was born in 1970. I have the scar so obviously got vaccinated.
But…I distinctly remember getting vaccinated in kindergarten (lined us all up and did everyone), which would have been 1975-76. But I could be cross remembering the scar with a different vaccination event?
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“ A different version of the smallpox vaccine was at one time given routinely to all children in the United States at about 1 year of age. By the 1960s, the risk of smallpox in the United States was dramatically reduced. Therefore, because the risks of the vaccine outweighed its benefits, routine administration of the smallpox vaccine to infants in the United States was discontinued in 1972.”
Yeah, so I was probably vaccinated for smallpox prior to 1972 and the vaccination I’m remembering was for something else.
Also, better than the other data I saw:
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