This is huge. ~90% decrease in hospitalization rate could mean that we no longer have to worry about COVID spikes filling up hospitals, one of the biggest issues during the pandemic. This could make COVID like the flu - something to avoid, but not something that's so dangerous that we shut down our lives to avoid it.
For the vast majority of the population, COVID is already like the flu, but as you pointed out, a large enough percentage of the population (particularly obese/elderly/immune compromised) of people who contract it are at risk of hospitalization that it creates a lot of anxiety about hospital capacity.
We're currently getting two pieces of good news on COVID:
This pill, and perhaps more importantly for the majority of people on the planet who won't have the ability to get this pill, the data on Omicron is currently showing a divergence (compared to previous waves) of cases and deaths. This divergence is rather apparent by looking at graphs of South Africa. Previous spikes in cases resulted in corresponding (lagging by a few days) spikes in deaths. Omicron isn't showing this.
Precisely why I started a strict 1800 calorie cutting diet and working out six times a week. Already down 11kg. Obesity makes you severely at risk yet it's not really highlighted by the news. They make it seem like everybody is at severe risk.
If anyone else wants to lose weight, it's simple but very difficult. It will test your discipline.
Find out your TDEE using this https://tdeecalculator.net/, subtract 500 and boom that's your ceiling. Don't eat anything beyond that. Use myfitnesspal to track calories and weigh your food using a scale. That simple. If you work out you will lose weight even quicker. You will succeed or fail in the kitchen. The gym is just gravy on top - fight your battle in the kitchen.
It's simple but _very_ difficult. Easily the hardest thing I've done in my life.
It is my understanding that most weight loss attempts are rather successful at the beginning (several weeks), they tend to slide towards a plateau in a few months and it is a real challenge not to gain the lost weight back in a year or two. Long term success rate seems to be around 20 per cent. [0]
At the risk of sounding stupid or glib, the best strategy is "not to play", e.g. never gain the extra weight in the first place. Which may not be feasible for people who grow up in fat families and already reach adulthood as obese.
The numbers are the numbers. # of hospitalizations/# of cases is not a high number. It doesn't have to be a high number to overwhelm hospitals, I get that. But it's still a small percentage.
When I caught it in February, before I was eligible for the vaccine, I was shocked by the reaction of most of my peers. They seemed surprised by my mild symptoms. The American public, as a whole, overestimates their own risk of hospitalization by orders of magnitude. You can be angry at me for recklessly stating this, and not piously pretending like the risk is evenly spread, but I'm not going to join in a mass delusion of pretending like 15 year old kids are statistically at risk from this virus. They aren't.
Unlikely until adequate testing supplies are available that may be resolved next year. By the time a case shows up at the hospital the infection is no longer being driven by viral replication. At that point inflammatory responses, like those dampened by the anti-IL-6 receptor antibody tocilizumab, dominate. https://www.nature.com/articles/d41573-021-00202-8
It seems strange that large scale manufacturing appears to have not even been started yet, the projections for 2022 are only for 200M treatment courses (the latest announcement, at the time of the above article the projection was 80M).
Biden is in the process of implementing some measures to make testing more available, but it is going to take some time and looks rather inadequate (500M free tests would last maybe a few weeks with everyone in the USA doing regular testing? Maybe they'd last a lot longer if everyone only did symptomatic testing, although regular testing is required in some places which will use up a lot of tests). But unless manufacturing is ramped up quickly the supply of this drug is going to be very low. The USA has prepurchased only 10M treatment courses. So we won't be able to just give it to anyone (at 168,409 cases per day 10M treatment courses would only last 59 days). But you can't tell yet who will get seriously ill and Paxlovid treatment has to start when symptoms start (and the number of people with symptoms may be much higher than the current case/day count). So someone is going to have to decide who lives and who dies. For older or immunocompromised people this is likely an easy choice and will be a boon. For younger, healthier people this may not be an option at all until supply becomes much larger.
Pfizer said they were going to help manufacturers make Paxlovid locally so that all countries would have access to it, license free. What is the status of those efforts? It seems to take 9 months to manufacture:
"Federal health officials are expected to ration early shipments to the hardest hit parts of the country. Pfizer said the small supply is due to the manufacturing time — currently about nine months. The company says it can halve production time next year."
So Paxlovid may be the beginning of the end of COVID-19, but it seems it is not going to happen quickly. Certainly not in time for much use with Omicron.
Isn’t it still the case that a large percentage of hospitalizations are people who refused to get vaccinated? Is there any reason to believe these same folks would willingly take this?
One of my friends is an ICU nurse. My friend just laughs now when asked about whether vaccination works because nearly every single person in the ICU for the past few months has been unvaccinated.
One patient was basically 50/50 to die on the surgery table during a mechanical heart transplant due to covid destroying their natural heart, miraculously lived through it, and had the nerve to ask my friend whether they still needed to be vaccinated after they were being wheeled into the recovery area. It's almost comical the cognitive dissonance to challenge the team of doctors who literally just saved your life when they tell you to get the vaccine.
Being anti-vax is basically a religion at this point, so there's no use trying to convince people.
s/Being anti-vax is basically a religion/Being informed is basically a maze/
Not all people who are not vaccinated are anti-vaxxers, not all who are vaccinated think that the vaccination policies are sensible, and criticizing vaccination policy is not the same as being anti-vaxxer.
I never thought I'd be saying this, but Joe Rogan is right here. The claim that it's impossible to get covid twice contradicts obvious empirical evidence - and more importantly, reasoning from first principles gives you no particular reason why it would be true.
This dude is establishing an awfully high level of evidence - PCR tests, antigen tests, etc. between the two instances - which probably isn't even collected when people get covid. Why would you? If you're feeling awful, and you have a positive PCR test, why take an antigen test?
So there are quite possibly a number of cases where this dude's level of evidence doesn't exist, and he goes straight from absence of evidence to evidence of absence. But the extraordinary claim, that you can't get covid twice, is what needs high levels of evidence - which he handwaves away by saying maybe it was the flu. Prove that! Show the flu test results! The ordinary claim is that you can get it twice, and demanding extraordinary evidence for that is just foolish.
That's why she got a mechanical heart - she was rejected for a transplant because of her vax status. Which makes her hesitancy even more ridiculous since being unvax'd nearly killed her in two different ways.
While I agree being anti vax is something like a religion, the facts in your post are wrong, as has been pointed out by so many news outlets recently that even the CDC was bullshitting when they said 90% of ICU patients are unvaxxed.
The confusion (intentional or not) may stem from that 90% figure being of all ICU patients, covid or not, or just as a proportion of covid patients. People are still getting into car accidents, shot, and having heart attacks.
As a datapoint, my county publishes daily hospitalizations by vaccination status. Some vaccinated people are showing up, maybe 15-20%. So less than 90% unvaccinated there. But that is just hospitalization. For more serious outcomes I'd guess the unvaccinated percentage is higher even than 90%.
This is meaningless without knowing how the base rate (what portion of people in your country are vaccinated) compares to the US. If more people are vaccinated and vaccination is anything less than 100% effective against hospitalization, then by definition a smaller portion of those hospitalized will be unvaccinated.
> [Paxlovid] is sometimes falsely claimed to be a "repackaged" version of the antiparasitic drug ivermectin, which has been questionably promoted as a COVID-19 therapeutic
Don't underestimate the large number of people who are also completely scared of doctors and needles. Being able to get something they can pickup at a pharmacy and take in their own home is a win.
It seems likely that a forthcoming date with a ventilator might focus some peoples' minds... As far as I know, most anti-vaxers do accept treatment if they end up in hospital.
Problem is that by the time they get there, it's likely too late. I haven't seen the data, but I suspect many of these oral treatments need to be started early in the infection.
Not my experience. I've got several family members who are vigorously antivax. One was laid out by covid for a week plus lost a brother-in-law to it. Another persuaded her sister to avoid the vaccine and the sister is still on oxygen after spending weeks in the hospital with covid.
> Is there any reason to believe these same folks would willingly take this?
Yes, from the very beginning those who weren't comfortable with taking the vaccine have had hope for alternative medications from the pharmaceutical industry. See: hydrochloroquine, ivermectin, et. al.
It all needs to be put in the context of the vaccine being the fastest approved vaccine ever; vaccines having issues in the past; CNN, Joe Biden, etc. spreading FUD about the "warp speed" nature of the vaccine as late as October of last year (prior to the election); and, most of all, the propensity for humans to prefer to take inaction that won't necessarily cause them harm.
e.g., if you don't get a vaccine, you may get COVID, you might not, it may be minor, it may be severe. But it's one of those "whatever will be, will be" sort of things. Whereas if one is wary of the vaccine, and they willingly get it, they perceive they may be playing a direct, active role in bringing harm to themselves.
But once you know you have COVID, you have it, therefore there's no other option than to take action.
If you listen to the anti-vax crowd, a lot of the push-back is because the vaccines are new, only had emergency-use authorization, no long-term studies, etc.
This pill will fit into most of those objections as well. HCQ, ivermectin, and the like have all been around for a long time and even though their was no clinical efficacy on COVID, the anti-vax crowd was onboard with them because they have been around for so long.
> CNN, Joe Biden, etc. spreading FUD about the "warp speed" nature
I love the posts on twitter of people who basically said in early 2020 they would never ever take a vaccine approved by Trump. And by late 2021 they are saying the unvaccinated are the scum of the earth basically.
That's not what the position was. They didn't want to take a vaccine solely approved by Trump because he has been proven to lie about the pandemic for political gain, and politicized once independent institutions like the CDC. They wanted other apolitical, credentialed, highly trusted authorities to say the vaccine was safe before taking it. I don't see why that's an unreasonable position. The position was never "we are not taking the vaccine ever". It was "we're not taking a vaccine only Trump says is safe".
This is really playing the semantics game and I think it's disingenuous. The fact is, those other highly trusted authorities, both governmental and independent, were going to say the vaccine was safe anyway. It's all part of the "Trump will do whatever he wants, he's a dictator" narrative that largely was never true. You'll recall that he had every opportunity, supposedly, to approve the vaccines before the election. But he didn't.
In reality, the people who said "we're not taking a vaccine only Trump says is safe" were playing a political game, spreading FUD about a very good thing (the vaccine) because this was the only issue on which Trump could ever lose the election. So every single media organization, and Joe Biden himself, made sure to spread FUD about the vaccine (making sure to add "Trump" to their reasoning, so as not to appear anti-science), right up until the election was over, and then suddenly everyone who still had some doubts was an awful anti-vaxxer who desperately wanted to eat horse paste.
So you can't have your cake and eat it too and be all "haha, we were just kidding, why don't you think the vax is safe that's so weird".
To think it was all done so we could pay an extra $1.50 per gallon of gas, though.
I think you could have made your point without attacking my character. I think it would have made your post stronger too.
> The fact is, those other highly trusted authorities, both governmental and independent, were going to say the vaccine was safe anyway.
They were going to say the vaccine was safe if it was in fact safe. People feared Trump was going to say it was safe no matter the results, and then he would leverage the executive branch (CDC, FDA, NIH) to make that a reality. This fear of course was not unfounded, as Trump had been doing this very thing since day 1 of his presidency, when he ordered the National Park Service to doctor a photo of his inauguration to match his rhetoric that it was the biggest inauguration of all time.
It is true that Trump used these organizations for political ends, installed political appointees in those places that muzzled actual researchers and made recommendations contrary to public health interests (for example, the CDC position on meat packing plants, which changed suddenly due to political appointees getting involved in something that used to be apolitical). He ordered his administration to slow down testing to make case numbers look better. He touted Hydroxychloroquine as a "miracle cure", whereas today it's hardly even mentioned because it doesn't actually cure Covid. He put his own unqualified family members in charge of securing PPE, which of course was a disaster. He elevated an unqualified radiologist that he saw on Fox News to COVID advisor who was rebuked by his own colleagues for "[promoting] a view of COVID-19 that contradicts medical science." Taken as a whole, after all of that (and more), it's no wonder people were wary of him and his government claiming anything. Joe Biden or the Democrats didn't have to say anything to make people feel that way.
> "When you do testing to that extent, you're going to find more people, you're going to find more cases," Trump said. "So I said to my people, 'Slow the testing down, please.' They test and they test."
I mean, maybe Joe Biden and the Democrats were, but that's not what I've seen from "most people". I don't think most people play political games. Most people hate politics, but most people know when they're being lied to and gaslit constantly. In my reality, what I saw from people in my community was distrust in government for valid reasons. The way the Trump administration handled the pandemic left no confidence by Fall 2020 that they had our best interests in mind. That's not Joe Biden's fault or "the media's" fault.
> So you can't have your cake and eat it too and be all "haha, we were just kidding, why don't you think the vax is safe that's so weird".
There are still valid reasons to distrust the vaccine. I didn't take it until June and July because I wanted to see how things landed. I believe it's okay if people are still waiting because they just need more time to see how things play out. But that's not the reasoning I see from most antivaxxers I know. Their logic doesn't seem to be influenced by the reasoning that can be traced back to Democrats, or really any reasoning at all. Which Democrats were talking about microchips as a reason for distrust of vaccines? What media outlet was pushing that idea? Maybe you can argue Democrats created a general distrust and people filled in the blanks with whatever, but that seems tenuous to me.
> Is there any reason to believe these same folks would willingly take this?
There are also a lot of folks who can't get vaccinated, who would take this.
I suspect a lot of the folks who refuse to get vaccinated would take this if they were hospitalized with Covid. But since you don't usually get hospitalized until a week after you get symptoms, many won't have the option anyway.
The people who refuse vaccines don't do it for a really strong principled reason, AFAICT. I think they compartmentalize vaccines and the industry that makes them completely distinct from the rest of the pharma industry. Even more than that they view the Covid vaccine differently than flu or any other vaccine - largely for political reasons.
I think people who refuse or are reluctant to be vaccinated do it for a variety of reasons. Some (I think a minority) are some degree of conspiracy nuts who think it's all a plot to reduce population and enable government mind control via altered DNA, etc.
Some don't trust that the speed of the process as well as the immense political pressure to "do something" really sussed out the true effectiveness, safety, and immunity conferred by the vaccines, noting that coronaviruses have never had successful vaccines before now, as they mutate too rapidly.
I'm in the second camp. I viewed the situation as entirely different from traditional, well studied vaccines for endemic diseases such as measles, mumps, etc. I eventually did get vaccinated as I was under threat to lose my job if I didn't. I didn't want it otherwise, and time has shown that they aren't nearly as effective as initially promised. Most of the initial promises that the vaccines were the key to ending the pandemic have turned out to be wrong, the only thing we can really now say is that they offer some (short-term?) protection to the recipient, and at least in the case of the Janssen/J&J vaccine they are not as safe as promised either.
I will add that I don't like doctors, and I'm not a pill-popper. I don't take medicines that I don't need. I would be loathe to take any long-term prescription meds for any reason. Short term courses of antibiotics I will use. Other OTC very sparingly. I don't think I've taken more than a few Advils in the past 5 years, and that was when I had a tooth extracted.
> Some don't trust that the speed of the process as well as the immense political pressure to "do something" really sussed out the true… [etc]
This is your “second camp” but I don’t see how this isn’t another form of conspiracy nut. You’ve just got a suspicion that things aren’t right and are fact-fitting to that. If you’re measuring risks, there’s no comparison between Unvaccinated vs. Vaccinated.
I honestly think you severely underestimate the amount of people not taking it due to being conspiracy nuts.
I never thought I'd know ANYONE like this, but now almost every antivaxxer I know has some crackpot insanity reason for not getting vaccinated. None of them are worried about safety, FDA approval, etc. Hell my FIL thinks COVID-19 was meant to bring the endtimes so Jesus will come back and the rapture will happen. So do ALL of his constituents of his Church more or less.
So let's not mitigate the crackpots to a "minority" because it's simply not true.
One problem here is there are two camps in the vaccine resistant group:
1. Those who did not want to take the vaccine but did
2. Those who will not take the vaccine under nearly any condition
With many people's jobs being threatened and ability to eat in restaurants, etc being limited, most unvaxxed are in the second camp. At this stage I'd say they must have very strong feelings on it and are more likely to think the vaccine is much more dangerous than the data suggests or has some other nefarious purpose.
I'm vaccinated and I did it voluntarily as it seemed like it met the risk/reward trade-off for me. I've always been against mandates. I probably won't take the current booster unless forced (more of the same for a very different and likely mild variant meet my cost/benefit threshold), but I will take it if my job hinges on it. Rational people weigh cost/benefit. Losing your job definitely tilts the ledger, but I imagine many people who felt coerced into their decision are pretty sore over it and we will suffer some serious political repercussions for this, in my view, unnecessary mandate.
> The people who refuse vaccines don't do it for a really strong principled reason, AFAICT.
I am very often around circles of people who haven't been vaccinated: family members, friends, friends of family members, friends of friends, etc. There's a good mix between political reasons, and principled reasons. Most fall into the latter group, including myself: I refused to get the vaccine until it was in general availability for at least 6 months. This was the time period I felt comfortable with where I figured if any issues were to arise, we'd have found out about it by then.
Others have longer personal time frames. Others don't want to get it at all. But usually, it is for a strong principled reason. The fact of the matter is, past vaccines have caused issues; vaccines are not without their risks. Do the benefits outweigh the risks? Absolutely! But it's a personal choice. At this point, with all the data we've seen with how harmless and beneficial they are, I believe it to be an unwise one to not get vaxxed, but it's a personal choice nonetheless.
> Even more than that they view the Covid vaccine differently than flu or any other vaccine - largely for political reasons.
But, in fact, the COVID vaccine is very different than any other vaccine. Not only is it brand new technology that to this point was a failure in other trials with other diseases, it was also fast-tracked and released far sooner than any other in history. And it is for a virus that largely most severely affects the elderly, obese, and those with preexisting conditions.
People also forget that the very news organizations and politicians pretentiously shaming people for not getting vaccinated today, are the very same news organizations and politicians that spread fear and doubt about the vaccine just prior to the election. [0] Our current president did the same thing.
Perhaps if they didn't politicize it in the first place, or even plant seeds of fear...they would have more of a leg to stand on when it comes to being so divisive about the matter.
Some do, some don't. I know two anti-vaxxers and one of them takes medication for mental illness and the other doesn't trust any doctors for any reason but does all kinds of homeopathy and other psuedoscientific shit.
Yes, because a lot of people falsely believe the risk of the vaccine is greater than the risk of COVID—19. But once you contract COVID you move in to a new higher-risk pool. There have been news stories of unvaccinated people asking for the vaccine once they’re hospitalized, which by then is sadly too late.
It's also too late for antiviral drugs, though, FWIW. This drug needs to be taken within three days of symptom onset. By the time most people are hospitalized, the viral phase of illness is pretty much over.
I was referring to various antivirals, not just protease inhibitors. Plenty of patients are given monoclonal antibody infusions during hospitalization (see for example the former US president).
Monoclonal antibodies have to be administered in a clinical setting because they're administered by IV, but they also work best when administered early (diminishing returns after five days[0]), whereas most hospitalizations don't occur until the inflammatory phase of disease, in the second week. Remdesivir is/was the only antiviral being regularly given to patients with severe disease, probably out of a desire to ration it and only use it for people with the worst cases, but that's probably why it didn't really work very well, and is now mostly being abandoned[1].
The drugs that are most effective for hospitalized patients aren't antivirals, they're immune modulators: steroids like dexamethasone, and IL6 inhibitors like tocilizumab (which technically is a humanized monoclonal antibody, but not against COVID, and doesn't have any sort of antiviral mechanism of action).
Sorry, what other category? The logical inverse of "unvaccinated folks who caught covid now asking for vaccines" is... "vaccinated folks who didn't get covid who now want to be... unvaccinated?". I guess I don't understand your assertion.
It's extremely promising, but unfortunately it's going to take a while before there's enough to go around, so there may not be that much effect immediately.
However, as long as covid doesn't mutate in a way that makes this pill ineffective (I don't know whether that's possible or not?) it could eventually effectively end the pandemic once they have enough doses.
Are all of us who teach at universities supposed to take pre-exposure prophylaxis before setting feet into a lecture theater? How about some lifestyle changes? Why is proper ventilation never discussed?
>The drug, which belongs to a family called protease inhibitors, doesn't target the virus' spike protein, as the vaccines do.
Apparently, only one of the three available monoclonal antibodies seem to be effective against Omicron at the moment, so this can't come soon enough. How is Pfizer so successful in this space at the moment?
At this point all Covid restrictions need to be gone. It’s time to go back to normal. Triple vaxxed people are not dying and are barely being hospitalized.
Kids can be vaccinated and now there’s antiviral pills. All empirical data shows that if you’re boosted you’re fine.
It’s over.
It’s time to stop listening to Doomer politicians and bureaucrats until vaccinated people start dying at rates similar to March 2020.
Over?! Anecdotally my local hospital is full and a neighboring state had to call up the National Guard. Maybe not the same crisis level of 2020, but it's far from "over".
Hospitals fill up every winter from respiratory viruses. The healthcare system is designed to fill up. There's no point having expensive rooms, machines, and staff sitting idle. Planners forecast seasonal requirements and build healthcare around the maximum.
We're probably going to see increased demands on hospitals simply due to the larger numbers of old people.
For example, 2009 Swine Flu (remember that?) is about as deadly as 2020 COVID. But now in eg. the USA, there are 2.9m 80-84 year old men (elderly men are in the prime risk category for COVID deaths), compared to 2.3m in 2009:
These demographic trends were exacerbated by weak flu seasons in 2018 and 2019.
Crises always bring light to pre-existing failures in systems. COVID is simply exposing Western societies as aged, overweight, and Vitamin-D deficient.
While I'm inclined to agree that the outlook now is better than the onset of the pandemic, this antiviral was just approved and only with an emergency use authorization. I think until there's more than enough of this to go around and we see actual hospitalization rates go down to "normal" even in the face of infection spikes, we're still not completely ready to say this is "over".
Covid deaths in 2021 will outnumber 2020 and currently both hospitalization and death rates are not extremely far off from the first wave. Of course vaccinated people are better protected, but the "it's over" thing is kind of meaningless. And right now this is before the holidays and new years. Omicron is probably not even remotely close to having peaked yet.
> People refuse vaccines because they are experimental - will they believe an even newer drug?
They don't refuse vaccines because they are 'experimental'[1] (They are happy to demand vitamin C, or ivermectin, etc, etc, etc.), they refuse them because it's the position their political tribe has adopted.
[1] They've gone through all the same human trials as any other vaccine - it's just that they went through those trials at the same time, as opposed to one-after-the-other.
Vitamin C and Ivermectin aren't experimental. I'm not against the vaccine, but to say that an emergency approved drug is as circumspect as older drugs (e.g. Ivermectin was approved as early as the 1980s) is misleading.
That being said, I still think it's the right move to take the vaccine because the statistics show that it is effective.
In my anecdotal experience, vaccine hesitancy, or whatever you call it, cannot be attributed to a party allegiance in the US. There are as many if not more liberal vaccine refusers as there are conservative ones
> There are as many if not more liberal vaccine refusers as there are conservative ones
No, there aren't, unless you torture the definitions to the point of uselessness, or unless your personal experience means that you personally know 50 liberals and 5 conservatives (and 6 unvaccinated people, split evenly between the two). [1]
Or, if you have to use your eyes to believe it, look at any vaccination rate map [2], and contrast it to how those states vote.
> cannot be attributed to a party allegiance in the US. There are as many if not more liberal vaccine refusers as there are conservative ones
Why must there be a single attributable factor? It seems likely that there are multiple. Party allegiance certainly appears to be one of these from numerous polls and analyses [1]. Poverty and insurance status is likely another [2].
Reducing vaccine rejection down to "political tribalism" is probably wrong and definitely not helpful. There are people across the entire political spectrum who refuse vaccines, and this is pretty much a global phenomenon.
