Honestly, how do you know you wouldn’t have felt better anyway without the Paxlovid? I’ve seen more than a few vaccinated patients in my clinic at this point who thought they had minor seasonal allergies or a slight cold and turned out to have Covid. They recovered completely within a day or two without any treatment whatsoever. I seem…
Honestly, how do you know you wouldn’t have felt better anyway without the Paxlovid? I’ve seen more than a few vaccinated patients in my clinic at this point who thought they had minor seasonal allergies or a slight cold and turned out to have Covid. They recovered completely within a day or two without any treatment whatsoever. I seem to recall one chortling husband with “allergies” who caught the virus from his vaccinated wife, who’d been entirely asymptomatic and only found out she was positive a week or two prior because she had to get a screening Covid test before her routine colonoscopy.
I get it. But I also see many patients who don’t take anything at all and also feel better within literally hours.
Bottom line, there should be a study done.
Tamiflu HAS been studied that way and the conclusion was that it shortens the course of influenza by about one day. That’s not nothing but it’s not a huge decrease either.
All of this ignores the fact that doctors are being pushed to prescribe Paxlovid not so much for symptom relief as for prevention of hospitalization / death. I have to say I tend to agree with Buzz that for most vaccinated individuals it probably doesn’t really do that. I also agree that stopping an anticoagulant in order to prescribe an antiviral of questionable benefit in a patient at risk for thrombosis, infected with a virus with known procoagulant tendencies, seems hazardous.
I do think the best we'll ever get is the incomplete EPIC-SR study, and the lack of symptom improvement in the Paxlovid group in a largely vaccinated population over placebo tells me all I need to know: on a population level, Paxlovid won't help much with symptom resolution. That said, I don't want to deny anyone's anecdotes! I'm sure some immune people really benefit from a sudden down-ramp of viral replication; but suspect most don't, and others have any short-term benefit counteracted by rebound, hence the lack of overall benefit in the trial in this regard. The problem is we don't know who the responders will be! And I agree, Mike - lots of people turn around "on a dime" without any meds; it's just some people's Covid disease course, and can make a placebo look really good.
“Tamiflu HAS been studied that way and the conclusion was that it shortens the course of influenza by about one day. That’s not nothing but it’s not a huge decrease either.”
Elderberry syrup. Vitamin D3. Vitamin C. All highly effective for the flu. And Covid. And I would try on RSV as well. And IVM.
Of course it is impossible to say with certainty on the basis of one patient that Paxlovid made any difference. That said, I have had my share of viral illnesses over 71 years, and I can say with certainty that I have never had any viral illness improve as mine did after 12 hours on Paxlovid. Could be coincidence, but based on the mechanism of function, it would be surprising if symptoms did *not* improve rapidly. I am pretty sure rapid improvement was also frequently observed in controlled trials. I do have a second data point: my younger brother (67) reported exactly the same rapid improvement with Paxlovid. His wife (64, double vaccinated and double boosted, but did not 'qualify' for Paxlovid) suffered 7 days of miserable symptoms, followed by gradual improvement over 7 days. I'd take the Paxlovid over that every time. BTW, my fever had reached 102.7F within 24 hours of first noted symptoms, with a terrible headache, dry cough, and all-over body aches..... and all symptoms were getting worse before the Paxlovid.
Honestly, how do you know you wouldn’t have felt better anyway without the Paxlovid? I’ve seen more than a few vaccinated patients in my clinic at this point who thought they had minor seasonal allergies or a slight cold and turned out to have Covid. They recovered completely within a day or two without any treatment whatsoever. I seem to recall one chortling husband with “allergies” who caught the virus from his vaccinated wife, who’d been entirely asymptomatic and only found out she was positive a week or two prior because she had to get a screening Covid test before her routine colonoscopy.
I felt better within hours - before that it was three days of misery. My friend got it earlier and it stopped the disease right away
I get it. But I also see many patients who don’t take anything at all and also feel better within literally hours.
Bottom line, there should be a study done.
Tamiflu HAS been studied that way and the conclusion was that it shortens the course of influenza by about one day. That’s not nothing but it’s not a huge decrease either.
All of this ignores the fact that doctors are being pushed to prescribe Paxlovid not so much for symptom relief as for prevention of hospitalization / death. I have to say I tend to agree with Buzz that for most vaccinated individuals it probably doesn’t really do that. I also agree that stopping an anticoagulant in order to prescribe an antiviral of questionable benefit in a patient at risk for thrombosis, infected with a virus with known procoagulant tendencies, seems hazardous.
I do think the best we'll ever get is the incomplete EPIC-SR study, and the lack of symptom improvement in the Paxlovid group in a largely vaccinated population over placebo tells me all I need to know: on a population level, Paxlovid won't help much with symptom resolution. That said, I don't want to deny anyone's anecdotes! I'm sure some immune people really benefit from a sudden down-ramp of viral replication; but suspect most don't, and others have any short-term benefit counteracted by rebound, hence the lack of overall benefit in the trial in this regard. The problem is we don't know who the responders will be! And I agree, Mike - lots of people turn around "on a dime" without any meds; it's just some people's Covid disease course, and can make a placebo look really good.
“Tamiflu HAS been studied that way and the conclusion was that it shortens the course of influenza by about one day. That’s not nothing but it’s not a huge decrease either.”
Elderberry syrup. Vitamin D3. Vitamin C. All highly effective for the flu. And Covid. And I would try on RSV as well. And IVM.
Of course it is impossible to say with certainty on the basis of one patient that Paxlovid made any difference. That said, I have had my share of viral illnesses over 71 years, and I can say with certainty that I have never had any viral illness improve as mine did after 12 hours on Paxlovid. Could be coincidence, but based on the mechanism of function, it would be surprising if symptoms did *not* improve rapidly. I am pretty sure rapid improvement was also frequently observed in controlled trials. I do have a second data point: my younger brother (67) reported exactly the same rapid improvement with Paxlovid. His wife (64, double vaccinated and double boosted, but did not 'qualify' for Paxlovid) suffered 7 days of miserable symptoms, followed by gradual improvement over 7 days. I'd take the Paxlovid over that every time. BTW, my fever had reached 102.7F within 24 hours of first noted symptoms, with a terrible headache, dry cough, and all-over body aches..... and all symptoms were getting worse before the Paxlovid.