...Sotrovimab, is in exceptionally short supply – last wk, UCSF had none in stock. So that’s out. My fave, the Pfizer pill Paxlovid, which
the chance of hospitalization by ~90%, is also hard to find. @UCSF, we’ll only use it in severely immuno-…(16/25)
https://www.pfizer.com/news/press-release/press-release-detail/pfizer-announces-additional-phase-23-study-results …
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…-suppressed folks. 3rd choice: Remdesivir, an IV drug that we’ve long used in hospital, but recently shown to
hospital & death rates by 87% in hi-risk outpatients. https://www.nejm.org/doi/full/10.1056/NEJMoa2116846 … Because it’s IV, its use is also limited to patients at much
risk than my son…(17/25)41 replies 239 retweets 3,433 likesShow this thread -
… Finally, Merck’s Molnupiravir. Like Paxlovid, it's a 5-day pill.https://www.merck.com/news/merck-and-ridgeback-biotherapeutics-provide-update-on-results-from-move-out-study-of-molnupiravir-an-investigational-oral-antiviral-medicine-in-at-risk-adults-with-mild-to-moderate-covid-19/ … It’s less effective (~30% benefit) than Paxlovid, but more available. Should my son go on it? A 30% risk-reduction sounds OK. But when your risk is only 0.3% for hospitalization,...(18/25)
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...a 30% benefit would translate into 0.3%⇾0.2%, or 1/300 going to 1/500. You’d need to treat about 1100 people like my son with 5 days of pills to prevent one hospitalization (“number needed to treat,” NNT). And chance of death is probably ~1/5000, with a NNT of 20,000. (19/25)
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I called his doc, who noted that the pills have benefit when used before day 5. “I’d err on not treating,” he said wisely, but might reconsider if things worsened in the next couple of days. It’s now day 4. Pulse ox is fine, heart rate has slowed, he's a bit less flu-ish(20/25)
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..., but his throat still hurts like hell. When 5d are up, we’ll do another rapid (if I can find one) – if neg he’ll leave isolation (& wear an KN95). If pos, he’ll stay isolated until it’s neg, or day 10. He’ll still mask for 5d more. And that – we hope – will be that. (21/25)
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Am I worried about Long Covid? A little. The literature is a mess: some studies show 50% of people have persistent (>1 month) symptoms. Other studies say it's more like 5%. It seems like vax lowers the risk. So it’s a concern, but there’s not much we can do but wait & see.(22/25)
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Any lessons? First, thank God for vaccines! Yes, he had Covid, but his vax slashed the odds of a severe case, hospitalization & death. 2nd, concerns re: false neg rapid tests in Omi are real, as are shortages of tests & meds. Omi's lesson: lower your guard & it'll pounce.(23/25)
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Should he have watched movies with his friend? I think so – it seemed like a fairly safe encounter. But while Omi is surging, even low risk stuff – things that were safe last mth – may now be risky. Given how quickly this storm may pass, it seems wise to hunker down a bit.(24/25)
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My son should do OK, but the illness & the anxiety it causes are miserable. Resigning ourselves to getting Omicron doesn’t seem right, especially since the surge may be short-lived. I still think it’s an experience best avoided – for you and your loved ones – if you can. (25/end)
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I hope he gets better soon! Please let us know if we can get some rapid tests to you. Lots of people have a few stashed, and we’ve been exchanging them based on who needs them at the moment and ordering more as we find them. Seems to be a sensible way to deal with the shortage.
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