Inside Medicine. What Are You Seeing? [COVID-19 medical news]

I didn’t read the whole thing, but if they’re using PCR cycle threshold that only tells the viral load in the nasopharyngeal area at best, not systemically. There’s a BIG difference.

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That page is mostly paywalled.

Any explanation about the claim that “culture-war stupidity” or “political and media bias” caused a problem is in the part behind the paywall.

It’s behind Matt Taibbi’s Substack paywall. If you want anyone to be able to read it and comment in any substantive way, you’ll have to cut and paste. There are plenty of reasons besides political and media bias that could have led to a delay. They did cut the trial short for humanitarian reasons, after it became clear that it wouldn’t be ethical to continue offering a placebo.

EDIT: Robert Kadlec simply speculated that lives could have been saved if they would have released it before a RCT was conducted. They didn’t because they didn’t want to repeat the hydroxychloroquine and ivermectin disasters. It went through exactly as it should have, not letting the hype get ahead of the science.

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Anyone can read a free article on someone’s substack. I’m a subscriber to Taibbi, but I do it quite a bit with other columnists.

You can’t read it on the link you posted. If you Google the article, the full thing comes up. It is really a ways below Matt’s typically high standards. First he rails that Tamilfu was overhyped and then rails that Molnupirivir was underhyped. In the case of the later, it may have been delayed a little, but RCTs take time. It’s hard to have it both ways.

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I was able to read a longer excerpt when I googled the article. I couldn’t see the part about former HHS officials who wanted to accelerate funding for antivirals

I think the previous administration was right to bet on vaccines as our best chance of fighting and ending the pandemic. It was a risk to put so much money behind vaccines and relatively little behind treatment, but, it totally paid off. (Interestingly, the NIH did give Emory University researchers $35 million to fund the early stages of the development/testing of molnupiravir before Merck bought it. Still, a drop in the bucket compared to the $20 billion plus spent on vaccines.)

  1. Merck’s antiviral, molnupiravir: reduces the risk of hospitalization and death by about 50%. Costs the government $700 per patient.
  2. Monoclonal antibodies (mostly Regeneron): reduces the chance of hospitalization/death by at least 70%. Costs the government about $2,100 per patient.
  3. Vaccine: reduces the risk of hospitalization and death by about 90%. Costs the government about $35, not counting the investment in Operation Warp Speed.

Besides being far more effective, vaccines give the vaccinated the ability to self-generate an immune response in the future. Treatments 1 and 2 can not do that, so these people may need to be treated again and again.

Also, with the vaccine, you don’t have to worry about timing. Molnupiravir must be taken within the first six days of illness to be effective, and monoclonals must be given in the first ten days.

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Antivirals are notoriously challenging. The anit-herpetics are the only real functional drugs in that class. It took 23 years to get from the first HIV drug to the wildly successful triple therapy in use now. Tamilfu is a joke. There are no effective influenza medications, although that’s what molnupiravir was conceptualized as, and might work for influenza and other RNA viruses. There’s nothing yet for the common cold viruses.

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I agree. Also, the Covid vaccines likely have some crossover ability to prevent the four common cold coronaviruses, so that’s good.

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Does anyone know what the official position is for booster for a health care professional who was double vaxxed by January and got a (very mild ) breakthrough case in August? Get the booster now? Wait? Anybody “ inside” want to weigh in with thoughts.

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If you recently had a COVID-19 infection, it is recommended to get the booster six months after the primary vaccination and four weeks after the COVID-19 infection.

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The following official position applies only to Pfizer vaccine recipients in the US:

Recommendations may be coming soon with respect to Moderna and J&J vaccine recipients.

I knew about this. But I didn’t see that it speaks to a situation where one is vaccinated with Pfizer at least six months ago but had a Covid infection thereafter. @TexasTiger do you have a source for the 4 weeks in the context of a double vaccinated individual.

No literature reference, just recommendation from ID department.

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Thanks!

There is no data to support this. The literature on boosting anyone who isn’t pretty severely immunocompromised and thus likely mounted a suboptimal response in the first place, is soft at best. Anyone who has been double dosed AND infected has pretty bulletproof immunity for the foreseeable future.

I’m eligible now as a healthcare provider, but I’m waiting for the 6G chip! :rofl:

Seriously though, I’m getting a flu vaccine now and waiting on a COVID boost until later in the Fall. I don’t feel vulnerable now, based on how we conduct ourselves at work and in our personal life, and the boost data is soft, so I figured why not wait until we’re stuck inside more.

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I understand. Just passing along the recommendation from the ID department and the Vaccine Scientific Committee of a top 20 hospital.

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This is a complication I wouldn’t have predicted.

I wonder why this is hitting all the news outlets now? I didn’t read the article to see if anything was new, but this was first described in early 2020.

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The article linked a October 5th study by the British journal of Dermatology .