James writes:
Hello Dr. Griffin,
I am writing to you on behalf of my hospital’s IPAC team in Toronto, Canada. I have faithfully converted our team into routine TWIV listeners so our IPAC program can be well informed. Our team has an inside joke I wanted to share with you:
This respiratory season has been unlike others and we have many instances that have multiple agents as the lab-confirmed cause of a respiratory outbreak (ie. COVID & RSV outbreaks on the same floor at the same time). As part of your clinical updates, and as part of our IPAC teams practice now, we routinely cite Occam’s razor and Hickam’s Dictum, especially during this respiratory season. I’d like to add my colleagues addition to your list of axioms. We were exasperated as one of our COVID outbreaks turned into a mixed COVID and Parainfluenza outbreak and Brigitte quipped:
“An outbreak can have as many virus’ as they damn well please” – Brigitte’s Dictum
I thought I’d share as this joke has legs, but nowhere to run except with TWIV listeners.
Thanks for everything.
James Callahan, RN, CIC
Supervisor, Community Health, Infection Prevention and Control
Michael Garron Hospital | Toronto East Health Network
Sweta writes:
Hello Dr Griffin,
Do you believe a fully vaccinated individual who is starting treatment(biologics)for Crohn’s disease should consider taking the bivalent booster before their first infusion therapy? Will such an individual be able to mount a response similar to that of an immunocompetent person if they get COVID while taking biologics and hadn’t been recently boosted?
Thank you!
Sweta [ sh w ai t aa ]
John writes:
I am disabled by long COVID and have tachycardia and have found some relief with ivabradine. If I get reinfected my plan is to take paxlovid to try to reduce the chances that my long COVID gets worse. However, ivabradine cannot be taken with paxlovid. The NIH guidance says don’t use paxlovid at all. The ID Society guidance doesn’t even mention ivabradine as a conflict. Since I don’t really leave the house, If I am reinfected it will almost certainly be by a family member (everyone in house is up to date with vaccines) so hopefully we’ll be able to identify them as sick early and I have a few days during incubation period where I can plan to stop ivabradine. How long do I need to stop taking ivabradine before I start paxlovid?
Angelika writes:
Hello,
Just a comment on death with/from covid.
In Sweden the definition of covid death has throughout the pandemic been:
death in an individual who either tested positive for covid or who was presumed to have covid within 30 days prior to death.
Greetings and thank you for your interesting weekly updates!
Angelika Skarin MD, PhD
Lund, Sweden
Kari writes:
Hello Dr. Griffin,
I hear you say it’s important to have a COVID plan with your physician ready to go . I want to contact my nurse practitioner now that I am no longer pregnant or under the care of my OB, but was hoping for a little more information to prepare myself for the conversation:
1. What is your experience with side effects of Paxlovid? I’m not concerned about annoying side effects like metallic taste, but wonder about side effects that might stop someone from taking the drug or any dangerous ones, like vomiting and severe allergic/anaphylactic reactions. How common are they? I have a sensitive stomach and a number of food and medication allergies severe enough to carry an Epipen, so new drugs always make me nervous. My allergic reactions tend to be pretty severe when they occur.
2. Is Remdesivir less likely to cause allergic reactions than Paxlovid?
3. What is your opinion on the new California guidance that everyone be given a chance to get Paxlovid — specifically, would you recommend Paxlovid to a vaccinated healthy 42-year-old person of normal weight (with very slight asthma)?
Thank you all for keeping your listeners updated and for providing such important information — and somehow keeping us entertained all at the same time!
Kari in Northern California