CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS –11/20/2021

HELLO, 

Covid is taking a break in our area. Have a nice weekend but remain cautious.

NOTE FROM A VERY EXPERIENCED PRIVATE INTERNIST REGARDING NEW ANTIVIRAL (COVID) ORAL DRUGS USE:

‘’Tests for Covid are likely most sensitive on day 4 of symptoms for a pill that needs to be given by day 3.

‘’Not enough people have immediate access to rapid PCR tests for Covid to see if they are infected, so these pills cannot change a Covid epidemic. Quick antigen tests are great when positive but often falsely negative, especially in that first three-day window.

“THEREFORE: if the pill is going to change the game it will need to be “allowed” to be given the same way that flu medicine (Tamiflu) is given, which is if Dr. Harris or Dr. X  think you have the infection right now, test or no test,  they will prescribe the antiviral medication… (Office flu tests perform with very similar low sensitivity/high specificity that Covid antigen, does so use a few early in the season then just make clinical diagnosis because Tamiflu also must be given early to help.)

“TAKE HOME: The antiviral oral drugs must be affordable and, more importantly, if doctors must be freed up to prescribe the drugs early, based on clinical grounds,  without a test to prove it is definitely Covid.  If doctors are not allowed by the government to treat early without waiting for positive tests, there will not be enough of the medicine prescribed to change the epidemic — even though it helps those patients fortunate enough to have been treated with it early, positive test or not.

‘’(The Tamiflu analogy is fine but this pill works different and better than Tamiflu and the bad part of the analogy is it lulls us into thinking the two diseases are comparable and they are not–one of ’em can kill you, the other, grievously hurts your feelings but usually not forever.”

With COVID cases spiking, no end in sight ( My doctor friend also sent this article)

”…We want control,” Fauci said. “And I think the confusion is, at what level of control are you going to accept it in its endemicity?”

A virus becomes endemic when it is no longer spreading at pandemic levels but is also impervious to actual eradication. Downgrading the coronavirus to an endemic pathogen would in effect concede that we will live with it for the foreseeable future, but without the disruptions caused by pandemic spread….The goal isn’t quite as modest as it seems, since only one virus — smallpox — has ever been eradicated. If the coronavirus became endemic, it would be relegated to a seasonal problem, similar to the influenza that invariably shows up with the cold weather…”

Could oral antiviral pills be a game-changer for COVID-19? An infectious disease physician explains why these options are badly needed

 ( J. Harris: News Summary today from Yahoo that discusses the need for almost immediate use of the oral drugs to get any benefit from them:)

Molnupiravir reduced the risk of death or hospitalization by about 50% in non-hospitalized adult patients with mild to moderate COVID-19 when treated within five days of symptom onset. Paxlovid reduced this risk by about 89% for patients treated within three days of symptoms and 85% for patients treated within five days. Importantly, no patients who took either drug died in the studies. Because the drugs were not studied head to head, it’s difficult to say whether one will be better than the other in the real world. In early November, Britain became the first country to approve molnupiravir for use…Molnupiravir did not help hospitalized patients [who are generally already sick for several days] recover faster from COVID-19. It is likely that Paxlovid would also not be useful at the point of hospitalization. Most patients who are in the hospital with COVID-19 are sick because of unregulated inflammation and not because the virus is still replicating in their bodies….Researchers are also working on repurposing existing drugs to treat COVID. Inhaled steroids like budesonide and an antidepressant called fluvoxamine are particularly promising…

While it’s exciting to see new treatments for COVID-19, prevention is still the best strategy. The COVID-19 vaccines continue to be the most effective tool for helping to end the pandemic.

FROM HOPKINS:

1. F.D.A. Authorizes Coronavirus Booster Shots for All Adults (New York Times) The Food and Drug Administration on Friday authorized booster shots of both the Pfizer-BioNTech and Moderna vaccines for everyone 18 and older, opening up eligibility to tens of millions more fully vaccinated adults. The move simplifies eligibility, fulfills a pledge by President Biden to offer the shots to every American adult and formally allows a practice already in place in at least 10 states. Fearful that waning protection and the onset of winter will set off a wave of breakthrough infections, a growing number of governors had already offered boosters to everyone 18 and older ahead of the holidays.

Evaluation of the BNT162b2 Covid-19 Vaccine in Children 5 to 11 Years of Age

”...This study describes immunization against SARS-CoV-2 infection with an mRNA vaccine in children younger than 12 years of age and documents the safety, immunogenicity, and efficacy of a Covid-19 vaccine in this population; trials of other vaccines are under way.Direct benefits of preventing SARS-CoV-2 infection in children include protection against severe disease, hospitalizations, and severe or long-term complications, such as MIS-C. Indirect benefits include the likelihood of reduced transmission in the home and in school settings, including transmission affecting vulnerable persons, and safer in-person learning.26-29 Without effective Covid-19 vaccines for this age group, children could potentially become ongoing reservoirs of infection and sources of newly emerging variants.26,30 Covid-19–associated school closures and quarantines also have social and economic costs for families and caregivers.16-19 Widespread vaccination across age groups is therefore essential in ongoing efforts to curtail the pandemic….A Covid-19 vaccination regimen consisting of two 10-μg doses of BNT162b2 administered 21 days apart was found to be safe, immunogenic, and efficacious in children 5 to 11 years of age…. The robust virus-neutralizing response observed in 5-to-11-year-olds was similar to that seen in 16-to-25-year-olds from the pivotal trial, which demonstrated 95% vaccine efficacy among persons at least 16 years of age from 7 days to approximately 2 months after the second dose.3 Immunobridging…”

AND LAST BUT NOT LEASED:

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