Wendy writes:
Hello to Dr. Griffin and all the TWIVers! I am truly grateful for this podcast. As a lawyer I know how to find good sources and double-check information, yet I’m not sure how well I’d understand the nuances of COVID-19 and other diseases without your guidance.
I’m writing as a New Yorker planning a trip this summer to the Canadian provinces of Nova Scotia and New Brunswick. I’m 67, fully vaccinated and boosted with the latest formula, and generally in good health. Because I listen to Dr. Griffin, I’d like to be able to get Paxlovid if I need it during the trip.
Naively, I thought—Canada: Sane people! Good health care system! No problem! Well, as it turns out, not so much.
According to the article from January 2024 that I’ve linked to below, Paxlovid is sitting in stockpiles in Canada while physicians fail to prescribe it for all the same flawed “reasons” that Dr. Griffin debunks week after week, including doubts about its effectiveness in vaccinated individuals.
The guidelines for prescribing it are also flawed. The drug is approved in Canada for adults at high risk of severe illness. But each province decides what this means, often based on a hodgepodge of criteria that can include age, vaccination status, how long since the person’s last vaccine dose, and various medical conditions. In some provinces, like Ontario and Manitoba, just being older is enough. But in other provinces, including those I’ll be visiting, the “hodgepodge” method applies and it’s not at all clear to me that I’d be eligible. So if I were to contract COVID-19 I might have to go to Maine, where it appears I’d be able to get a prescription.
Also, I learned that Paxlovid has been free in Nova Scotia since 2022, but soon only adults with immune deficiencies will have this benefit. No one else. The out-of-pocket price, by the way, is $1288 CAN or about $1000 USD at current exchange rates. (See second link below.)
Sigh. Curious to hear Dr. Griffin’s thoughts about this messy situation to the north.
Many thanks,
Wendy
Ellen writes:
Dear Daniel,
On the recent TWIV on the lab leak hypothesis, Vincent remarked in passing that 10-20% of transmissions occurred by a super-spreader . I’ve been consoling myself with the assumption that the vast majority of transmissions occurred with an encounter with a super-spreader which, given the low level of Covid at the moment, has to be rather rare. How far off the mark am I?
Thanks for all you do for everyone,
Ellen
Jeff writes:
Hello TWIV team
Thank you again for all you do
I am writing about the recent Nature Communications paper on Paxlovid in adolescents that you briefly discussed in the last clinical update. I was interested in what seemed to be a clinically significant benefit in using Paxlovid on otherwise healthy teenagers. As a pediatrician, we are well accustomed to using licensed products beyond their strict FDA approvals because pediatric trials are often limited or lacking entirely, but we do want to see some evidence of benefits that outweigh the potential harms. Up until now, when asked by my patients about using Paxlovid, the general response has been that we don’t have good evidence that it improves outcomes in healthy children. My question is: Does that statement still hold true, or are we starting to see good evidence that Paxlovid is beneficial in teenagers?
Thanks
Jeff
Gail writes:
I asked my doctor if I should get another vaccine 4 months after the last one and he shocked me by saying that the developing data shows that the more covid boosters one has, the greater the risk of immunosuppression and cancer. He said when you add that data into their lack of effectiveness against Covid, he’s discouraging patients from getting any additional shots, including those who would be at high risk from the disease. I was completely taken by surprise. Have you seen any data confirming a greater risk of immunosuppression and/or cancer as a result of getting Covid vaccines?
Thanks,
Gail