The Third Booster Shot Debate - Are U going to get the booster?

[EYESAILOR]

I do like lamb chops. Not so fond of preachy optometrists lol.

But peachy MDs?

 

[accnick]

I do like lamb chops. Not so fond of preachy optometrists lol.

You do know the difference between an optometrist and an ophthalmologist, don't you?

 

[EYESAILOR]

How's molnupiravir working out for you @EYESAILOR ?

The back story to this question for those who struggle to read Chief Stiped's writing is that during the pandemic and early rounds on vaccine approvals I wrote a post agreeing about how vaccination would play an important role, but that if antivirals under development were successful they would also play an important role.

IMHO antivirals are harder to discover and less predictable in outcome than vaccines. But the scale of the effort suggested something would emerge. The gen 1 antivirals were already in use. These were existing antivirals that had shown some efficacy against Covid. Remdesivir undoubtedly saved lives in the early days of the pandemic when hospitals and physicians were struggling to find protocols that saved lives. However it had several drawbacks including that it had to be administered intravenously .

Thus when the first antiviral that could be administered orally arrived (Molnupiravir) I described it as a very important development. Stiped described it as irresponsible and dangerous. Molnupiravir was quickly followed by Paxlovid which was approved by the FDA in the same irresponsible manner as Molnupiravir. I posted that Paxlovid has better efficacy statistics in trials than Molnupiravir, and less side effect risks but not zero side effect risk. I described Paxlovid as probably (given all the unknowns) an even more important development.

Back to the question. How has that worked worked out for me?

Covid finally caught up with me in the second half of 2021. I experienced symptoms in the late afternoon and tested positive that evening. I isolated at home and called my primary physician first thing the following morning who wrote me a stand by prescription for Paxlovid. I monitored my symptoms closely for that day and the next day. They stayed mild. The third day was crucial because you must take Paxlovid within the first five days of symptoms. My symptoms remained mild. I was working from home, consulting with patients and my staff via MSFT Teams and rescheduling surgery. On the fourth day, I made the call not to take Paxlovid . I strongly advise against anyone making this call on their own. You should consult your primary physician. Even I consulted with my primary physician, not because he knew more about Covid than I do, but because he could be more objective than me.
In my case, the symptoms plateaued by the 2nd day and remained mild. My vaccinations were up to date and I appeared to have a strong resistance. I was not in a higher risk category. We realized Paxlovid would probably get me back to work earlier by a couple of days but I was conscious of the rebound risk. Again, consult your primary care physician.

So Paxlovid has not "worked out" for me, because I did not use it but I was glad it was there in the armory of tools to defend myself in case my symptoms had been more pronounced.

How has it worked out overall?

• Paxlovid is prescribed for about 45% of Covid cases. Oral antivirals have become a very significant part of the protocol in the fight against Covid. Some even argue that it is underused (see Oped in today's NYT). I do not have the knowledge to comment on that. 45% seems to me to be a substantial number for any antiviral and for any drug that does have noticeable side effects and cannot be prescribed alongside certain medications so I dont necessarily agree with the NYT.
• For sure, Paxlovid has saved a lot of lives. All the data shows a significantly decreased mortality rate for those with significant symptoms who took Paxlovid in time.
• Paxlovid has played a role in helping patients who were unvaccinated. That is a two-edged sword because there are some infectious disease specialists who believe that the availability of Paxlovid has increased vaccine complacency and/or vaccine resistance .
• "Oh well, if I do get covid, I'll just take Paxlovid, so therefore I dont need to get vaccinated" . I dont agree with that sentiment because, for my demographic, I would much rather get vaccinated as a prophylactic than take Paxlovid as a cure. But that is my personal choice.

I have not been right in my forecasts about the development of further vaccines, but that is material for another post.

In the meatime, I notice that I have made the same spelling error again and written "stiped". In this case , of course, I did not mean "stupid" , just an inadvertent slip on the keyboard.

 

[hasher]

 

[EYESAILOR]

You do know the difference between an optometrist and an ophthalmologist, don't you?

@Wess saves money by taking the kids to a Podiatrist vs Pediatrist, but he himself prefers hanging out at doctors offices who specialize in small ruminants.

 

[Wess]

Nope, not at all.

 

[Wess]

But peachy MDs?

Yea there are a lot of those too. I recommend some fava beans and a nice Chianti!

 

[accnick]

@Wess saves money by taking the kids to a Podiatrist vs Pediatrist, but he himself prefers hanging out at doctors offices who specialize in small ruminants.

You're baahd....

 

[EYESAILOR]

You're baahd....

You are right. It was a stiped and uncalled for remark. My apologies for my stipedity,

Oops. Spellcheck. Obviously I meant stupidity. No offense intended.

 

[Chief Stipe]

The back story to this question for those who struggle to read Chief Stiped's writing is that during the pandemic and early rounds on vaccine approvals I wrote a post agreeing about how vaccination would play an important role, but that if antivirals under development were successful they would also play an important role.

IMHO antivirals are harder to discover and less predictable in outcome than vaccines. But the scale of the effort suggested something would emerge. The gen 1 antivirals were already in use. These were existing antivirals that had shown some efficacy against Covid. Remdesivir undoubtedly saved lives in the early days of the pandemic when hospitals and physicians were struggling to find protocols that saved lives. However it had several drawbacks including that it had to be administered intravenously .

Thus when the first antiviral that could be administered orally arrived (Molnupiravir) I described it as a very important development. Stiped described it as irresponsible and dangerous. Molnupiravir was quickly followed by Paxlovid which was approved by the FDA in the same irresponsible manner as Molnupiravir. I posted that Paxlovid has better efficacy statistics in trials than Molnupiravir, and less side effect risks but not zero side effect risk. I described Paxlovid as probably (given all the unknowns) an even more important development.

Back to the question. How has that worked worked out for me?

Covid finally caught up with me in the second half of 2021. I experienced symptoms in the late afternoon and tested positive that evening. I isolated at home and called my primary physician first thing the following morning who wrote me a stand by prescription for Paxlovid. I monitored my symptoms closely for that day and the next day. They stayed mild. The third day was crucial because you must take Paxlovid within the first five days of symptoms. My symptoms remained mild. I was working from home, consulting with patients and my staff via MSFT Teams and rescheduling surgery. On the fourth day, I made the call not to take Paxlovid . I strongly advise against anyone making this call on their own. You should consult your primary physician. Even I consulted with my primary physician, not because he knew more about Covid than I do, but because he could be more objective than me.
In my case, the symptoms plateaued by the 2nd day and remained mild. My vaccinations were up to date and I appeared to have a strong resistance. I was not in a higher risk category. We realized Paxlovid would probably get me back to work earlier by a couple of days but I was conscious of the rebound risk. Again, consult your primary care physician.

So Paxlovid has not "worked out" for me, because I did not use it but I was glad it was there in the armory of tools to defend myself in case my symptoms had been more pronounced.

How has it worked out overall?

• Paxlovid is prescribed for about 45% of Covid cases. Oral antivirals have become a very significant part of the protocol in the fight against Covid. Some even argue that it is underused (see Oped in today's NYT). I do not have the knowledge to comment on that. 45% seems to me to be a substantial number for any antiviral and for any drug that does have noticeable side effects and cannot be prescribed alongside certain medications so I dont necessarily agree with the NYT.
• For sure, Paxlovid has saved a lot of lives. All the data shows a significantly decreased mortality rate for those with significant symptoms who took Paxlovid in time.
• Paxlovid has played a role in helping patients who were unvaccinated. That is a two-edged sword because there are some infectious disease specialists who believe that the availability of Paxlovid has increased vaccine complacency and/or vaccine resistance .
• "Oh well, if I do get covid, I'll just take Paxlovid, so therefore I dont need to get vaccinated" . I dont agree with that sentiment because, for my demographic, I would much rather get vaccinated as a prophylactic than take Paxlovid as a cure. But that is my personal choice.

I have not been right in my forecasts about the development of further vaccines, but that is material for another post.

In the meatime, I notice that I have made the same spelling error again and written "stiped". In this case , of course, I did not mean "stupid" , just an inadvertent slip on the keyboard.

Nice diatribe to dodge the question directed at you about Molnupiravir. Instead you talk about Nirmatrelvir/ritonavir trade name Paxlovid.

So it would be fair to say that Molnupiravir (Lagevrio) in the real world has not met your marketing expectations?

 

[EYESAILOR]

Nice diatribe to dodge the question directed at you about Molnupiravir. Instead you talk about Nirmatrelvir/ritonavir trade name Paxlovid.

So it would be fair to say that Molnupiravir (Lagevrio) in the real world has not met your marketing expectations?

1) Both are oral antivirals. They are directly comparable.
2) Paxlovid has significantly better efficacy numbers than Molnupiravir. 90% vs 30%.
3) All other things being equal that should massively favor Paxlovid. Why would a physician prescribe a drug with a 30% efficacy rate over a drug with a 90% efficacy rate? However Paxlovid has negative effects when interacting with several drugs that a patient may already be taking including blood thinners and cholesterol medicines. In those cases the physician advising a higher risk patient might prescribe Molnupiravir instead.
4) I am a physician not a marketing expert so I don't have marketing expectations. Yes, when Paxlovid was approved at the end of 2021 I wrote that I expected it to become the antiviral of choice over Molnupiravir
5) Initially I was wrong. (Score one to Stiped) In Q1 2022, Molunpiravir did $3.2 billion of sales while Paxlovid only did $1.1 bn. I have no good explanation for this. As I said I am not a marketing expert. However since then, Paxlovid grew rapidly and eclipsed Molunpiravir.
6) If I was not a candidate for Paxlovid, I might contemplate Remdesivir. But one should consult one's primary physician.

Eventually Paxlovid was prescribed more frequently than Molnupiravir, which is what I expected.
The total scale of oral antiviral prescriptions has been massive,so I suppose that is what I expected.

I was wrong in the first quarter of 2022 but I m not sure I had any specific expectations.

 

[Raz'r]

1) Both are oral antivirals. They are directly comparable.
2) Paxlovid has significantly better efficacy numbers than Molnupiravir. 90% vs 30%.
3) All other things being equal that should massively favor Paxlovid. Why would a physician prescribe a drug with a 30% efficacy rate over a drug with a 90% efficacy rate? However Paxlovid has negative effects when interacting with several drugs that a patient may already be taking including blood thinners and cholesterol medicines. In those cases the physician advising a higher risk patient might prescribe Molnupiravir instead.
4) I am a physician not a marketing expert so I don't have marketing expectations. Yes, when Paxlovid was approved at the end of 2021 I wrote that I expected it to become the antiviral of choice over Molnupiravir
5) Initially I was wrong. (Score one to Stiped) In Q1 2022, Molunpiravir did $3.2 billion of sales while Paxlovid only did $1.1 bn. I have no good explanation for this. As I said I am not a marketing expert. However since then, Paxlovid grew rapidly and eclipsed Molunpiravir.
6) If I was not a candidate for Paxlovid, I might contemplate Remdesivir. But one should consult one's primary physician.

Eventually Paxlovid was prescribed more frequently than Molnupiravir, which is what I expected.
The total scale of oral antiviral prescriptions has been massive,so I suppose that is what I expected.

I was wrong in the first quarter of 2022 but I m not sure I had any specific expectations.

Not sure there was enough Paxlovid to go around way back in Q1 2022. My wife took it sometime last summer. She did have a minor rebound, but 5 days of no detectable virus.

 

[EYESAILOR]

Not sure there was enough Paxlovid to go around way back in Q1 2022. My wife took it sometime last summer. She did have a minor rebound, but 5 days of no detectable virus.

Most likely. But nor was I making a marketing forecast.

Molnupiravir had first mover advantage but Pfizer came out with a much better molecule.

 

[Chief Stipe]

Molunpiravir did $3.2 billion of sales

$2.2b was USA taxpayer funded.

 

[Chief Stipe]

Molnupiravir had first mover advantage

The science showed from the start that it had a low efficacy, was mutagenic AND because of that was likely to cause faster variant evolution. The results since its EUA have provided more evidence to the point where some countries have dropped its use.

Yet you promoted it and the people behind its development. That's what I refer to as your marketing expectations.

Worse you derided and ridiculed those that accurately referenced the science at the time.

I hope the investigations into what in my opinion amounts to fraud is wide reaching. It wouldn't surprise me if many so called physicians benefited financially from Ridgebacks efforts.

 

[EYESAILOR]

The science showed from the start that it had a low efficacy, was mutagenic AND because of that was likely to cause faster variant evolution. The results since its EUA have provided more evidence to the point where some countries have dropped its use.

Yet you promoted it and the people behind its development. That's what I refer to as your marketing expectations.

Sigh......

Nov 15th 2021:

I think Paxlovid from Pfizer is looking more promising than Molnupiravir from Merck and Ridgeback.

As in vaccines there is a lot of work going on in this area, and over time the best therapies will emerge.

Like Molnupiravir, the Paxlovid placebo trial was terminated by the independent data assessment committee after consulting with the FDA . The effectiveness of the drug is extraordinary high at 89%. Safety looks good too, but will continue to be studied. It is also aimed at high risk patients.

 

[Chief Stipe]

Sigh......

Nov 15th 2021:

You can sigh all you wish @EYESAILOR however you cannot deny that you spruiked Molnupiravir as a possible game changer when the evidence and the science raised significant doubts.

I find it appalling that a physician (supposedly) would promote the widespread administration of any drug that by your own admission hadn't undergone full and proper trials. That must raise questions about your motivations and the sources of your own funding. Same source as Topol's perchance?

 

[Steam Flyer]

You can sigh all you wish @EYESAILOR however you cannot deny that you spruiked Molnupiravir as a possible game changer when the evidence and the science raised significant doubts.

I find it appalling that a physician (supposedly) would promote the widespread administration of any drug that by your own admission hadn't undergone full and proper trials. That must raise questions about your motivations and the sources of your own funding. Same source as Topol's perchance?

Why are you continuing to lie? Habit? Only way to get ahead? Don't know the difference?

1- you can barely spell "science."

2- if you're angry about fraud in spending then it's only because none of the green is going your way.

 

[EYESAILOR]

You can sigh all you wish @EYESAILOR however you cannot deny that you spruiked Molnupiravir as a possible game changer when the evidence and the science raised significant doubts.

I find it appalling that a physician (supposedly) would promote the widespread administration of any drug that by your own admission hadn't undergone full and proper trials. That must raise questions about your motivations and the sources of your own funding. Same source as Topol's perchance?

Chiefly Stupid

Nobody knows or cares where your bitter, twisted hatred and distrust comes from. You and your sock puppets lost all credibility a long time ago.

You throw out accusations about public figures purporting to call them "published facts" then decline to support your accusations. You misrepresent other members of these forums with complete disregard for what they actually wrote. You ask rhetorical questions, and when someone bothers to give you a sensible and well researched answer, you snarl and spit incoherently in response. You promote miracle cures and snake oil in the face of research that contradicts their efficacy. You deride real science and people who devote their lives to research as corrupt. You accuse anyone who disagrees with you on sailing anarchy as shills on the payroll of big pharma (as if pharmaceutical companies give a fuck about the opinions expressed on SA). You stand on your soap box howling at the moon about covid, conspiracy and Ukrainian nazis, and nobody is listening.

Chief, as you sit there in your darkened room, reading this hurtful post, hunched over your laptop. I have one piece of advice. Open the shades. Go outside . Go for a walk in the sunshine . Take a car ride down to the ocean. Throw a rock.
When you come back, dont open your laptop. Give it a few days. You will find that you dont care.

 

[veni vidi vici]

Instead of ignoring awkward questions, how about explaining how the human immune system works.

%1,000’s better than the Pfizer inoculation