Antiviral Injustice
My unpublished Letter to the Editor to a newspaper that wrote a story about the pandemic and interviewed healthcare provider business executives instead of doctors and scientists.
It’s really a shame that many people who could take Paxlovid are not being given it.
Bai Y, Du Z, Wang L, Lau E, Fung I, Holme P, et al. Public Health Impact of Paxlovid as Treatment for COVID-19, United States. Emerg Infect Dis. 2024;30(2):262-269. https://doi.org/10.3201/eid3002.230835 Under a low-transmission scenario in which the Rt of the virus is 1.2, we estimated that treating 20% of symptomatic cases with Paxlovid would avert 10.54 million (95% CI 3.03–21.12 million) cases, 280,000 (95% CI 30,000–590,000) hospitalizations, and 33,850 (95% CI 1,690–71,150) deaths in the United States over a 300-day period
Often because of ridiculous disinformation.
Yes, Paxlovid is recommended for covid and the science says it works pretty well. So let’s not get distracted by confused people, including doctors, repeating misinformation. CHLOE HUMBERT JAN 16, 2024 Some doctors go against clinical indications when it comes to covid. I’ve been hearing a lot about people who are reporting that doctors are telling their elderly family members not to get Paxlovid.
The question is why aren’t more people, especially doctors and professionals, pushing more articles, op-eds, and even letters to the editor with good medical science, and why aren’t more newspapers publishing them? I know the answer isn’t that my well-referenced Letter to the Editor was rejected because I’m not a doctor, because they published fluoride fearmongering misinformation from a rando in the Letters to the Editor just recently. The letter was bad enough that a local dentist, president of the Pennsylvania Dental Association, submitted a debunk letter.
The Times-Tribune also publish lots of dubious political content even for the opinion page, including covid denialism. And on January 6th, 2024, the anniversary of the insurrection, they published a letter of Sedevacantism that called progressives “enemies of Jesus” - including clergy, and The Pope. So it’s not that they’re too picky about the content.
Perhaps these are “accidental” choices. Such as the choice they made to write a front page article on covid in January quoting unscientific and unclear speculations about how covid may or may not be handled “like the flu” from a business school graduate CEO of a clinic and the opinions of the MBA who is the head of marketing at a hospital instead of actual doctors and scientists.
Times-Tribune - COVID-19 cases on the rise in many areas in NEPA BY JIM LOCKWOOD STAFF WRITER Jan 19, 2024 “We have moved to mandatory masking only at our Neonatal Intensive Care Unit (NICU) located at Moses Taylor Hospital (in Scranton) out of an abundance of caution,” Poslock said in a statement.
Moses Taylor Hospital scandalized in The Washington Post in 2020 for having nurses expose vulnerable babies in the NICU after shifts in a covid ward.
“Out of an abundance of caution.” That’s what we heard a million + Americans dead of covid ago. The healthcare corporations have certainly delivered an abundance, but not of caution.
My rejected LTE to the Times-Tribune in Scranton Pennsylvania in February 2024:
I was glad to see the paper’s January page one article on the continuing pandemic threat. Wastewater data in Lackawanna County1 shows that covid outbreaks persist into February, and The New York Times tracker shows hospitalizations2 are at least as high if not higher than a year ago. I was however disappointed that instead of interviewing doctors and public health experts, the people interviewed were the business school graduate CEO of a clinic3 and the head of marketing with an MBA at the hospital4 that was scandalized in The Washington Post in 2020. (That hospital had nurses, including a pregnant nurse, potentially exposing babies in the NICU after shifts in a covid ward.)5 And sadly, effective covid antiviral treatment wasn't mentioned until the end of another article, back in section B and omitted in the web edition. The NIH Covid19 treatment page6 recommends Paxlovid for CDC’s “People with Certain Medical Conditions” - which includes being 50+, a current or former smoker, or unvaccinated.7 Dr. Eric Topol,8 Dr. Jeremy Faust,9 and Dr. Ashish Jha,10 former White House COVID-19 Coordinator, have all emphasized that the FDA has a checklist tool for prescribers11 to navigate special cases and overcome many prescription conflicts, yet some doctors still needlessly exclude patients from effective treatment. A retired doctor wrote in MedPage Today about being denied Paxlovid for a trip abroad, despite that physicians are free to prescribe off-label for just-in-case. Dr. Simborg was told it was because of supply fears,12 which are not reported in the U.S. If shortages are a concern, leadership should prepare because a study found that less than 15% of high-risk patients with covid even get Paxlovid, and 48,000 deaths could’ve been avoided during the study period if usage was higher.13
Note: I have no conflicts to disclose and I am not being compensated to promote medical products.
References:
Biobot Analytics - COVID-19 Wastewater Monitoring in the U.S. - Lackawanna County, PA https://biobot.io/data/#county-42069
The New York Times - Track Covid-19 in Lackawanna County, Pa. https://www.nytimes.com/interactive/2023/us/lackawanna-pennsylvania-covid-cases.html
Linkedin - Joseph Hollander - CEO at Scranton Primary Health Care Center, Inc https://www.linkedin.com/in/joseph-hollander-93b8b5130/
Linkedin - Annmarie Poslock, MBA - VP Marketing & Communications Commonwealth Health https://www.linkedin.com/in/annmarieposlock/
The Washington Post - Anguished nurses say Pennsylvania hospital risked infecting cancer patients, babies and staff with covid-19. Heroic effort to treat patients despite rationing of protective gowns, masks and tests. - By Desmond Butler April 11, 2020 at 10:34 a.m. EDT The pregnant nurse said she was sent back and forth between the “covid floor” and the neonatal intensive care unit, known as the NICU, where she normally treated vulnerable newborns and recovering mothers. It wasn’t just her baby she was worried about, she said, but the immunocompromised newborns and mothers who she was treating without informing them that she was also working on the covid floor. Even as she cared for patients symptomatic of covid-19, administrators provided her with crucial protective gear only after tests came back positive, usually several days after she first attended to the infected patients. https://www.washingtonpost.com/health/2020/04/11/amid-chaos-anguished-nurses-say-pennsylvania-hospital-risked-infecting-cancer-patients-babies-staff/
NIH - COVID-19 Treatment Guidelines - Clinical Management of Adults Summary https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/clinical-management-of-adults-summary/
CDC - Covid-19 - People with Certain Medical Conditions - Updated May 11, 2023 https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
Ground Truths - Paxlovid and Long Covid - A new study sheds light on a bonus benefit after the acute phase - ERIC TOPOL - NOV 06, 2022 https://erictopol.substack.com/p/paxlovid-and-long-covid
Inside Medicine Paxlovid or your statin? Patients on some medications are sometimes told they can't take Paxlovid. Is that the right move? JEREMY FAUST, MD JAN 05, 2024 https://insidemedicine.substack.com/p/paxlovid-or-your-statin
Medscape - White House COVID Chief on Why Paxlovid Is Underused Eric J. Topol, MD; Ashish K. Jha, MD, MPH January 31, 2023 https://www.medscape.com/viewarticle/987439
FDA.gov - PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers https://www.fda.gov/media/158165/download
MedPage Today - COVID's Latest Adaptation: It Has Lulled us to Sleep — My doctor's refusal to prescribe "just-in-case" Paxlovid speaks volumes by Donald W. Simborg, MD February 15, 2024 I was aware that nirmatrelvir/ritonavir is not approved for "just in case" travel usage, even in high-risk travelers such as myself. But, as a former physician, I also know that physicians are free to prescribe medications "off-label," and I have friends who have been prescribed nirmatrelvir/ritonavir for "just in case" travel occasions. My primary care physician gave me the antibiotic but denied the nirmatrelvir/ritonavir. He said he had discussed it with his colleagues, and they all agree that if everyone prescribed nirmatrelvir/ritonavir "just in case" for travel purposes, we would develop a shortage of nirmatrelvir/ritonavir. I was astonished by that response. How many people still travel overseas at my age? And how many of them are requesting "just in case" nirmatrelvir/ritonavir? It seems highly unlikely that giving us those prescriptions would cause a supply chain problem at Pfizer. In fact, a study found that less than 15% of high-risk patients who actually contract COVID take the medication! The researchers determined that over 48,000 deaths could have been prevented if just half of the eligible patients in the U.S. had gotten nirmatrelvir/ritonavir during the time period of the research. https://www.medpagetoday.com/opinion/second-opinions/108763
The New York Times - Paxlovid Cuts Covid Death Risk. But Those Who Need It Are Not Taking It. With Covid deaths rising to about 1,500 per week, researchers question why Paxlovid use has remained low among high-risk patients. By Christina Jewett Jan. 4, 2024, 12:15 p.m. ET https://www.nytimes.com/2024/01/04/health/paxlovid-covid-treatment.html