Thank you for the great work that you do. As a lay person, I came to your podcast in March of 2020 and have been a faithful listener since. I am so grateful for all I have learned from your podcast; thank you.
As I lie here in bed, struggling with my first Covid infection, I was wondering if you could ask Doctor Griffin, or any other TWiVer, about Paxlovid age-related guidance. I’m a fifty-one year old male. I have had five shots at this point: the first three Pfizer, a fourth Moderna, a fifth bivalent Pfizer (though, somewhat ironically, that fifth only an hour before picking my daughter up from a week-long school camp; she tested positive the next day, me two days after that).
How strictly should clinicians be prescribing Paxlovid based on age? In TWiV #942, Doctor Offit mentioned a recent study that showed Paxlovid wasn’t effective in the forty to sixty-four vaccinated age cohort. Does Doctor Griffin use that same age-based guidance when he prescribes Paxlovid?
I was surprised to see how tricky it was for me to get a Paxlovid prescription. I felt like saying to one physician that refused to give it to me based solely on my age “But I listen to TWiV and I would like to have it!” I did eventually get a prescription, but it felt like some unnecessary stress in the early hours of a Covid infection.
Thank you again for your amazing work and for your contribution to science and to global health. I am always proud to wear my TWiV t-shirt and drink from my TWiV coffee mug.
Can Dr. Griffin explain his repeated references to Hickem and Occam?
How long do people remain contagious with COVID? I thought contagion was extremely unlikely after day 5 as long as symptoms were improving, but this study suggests otherwise.
In this small study, 75% of people with COVID had a positive RAT on day 6 and half of those had culturable virus, suggesting contagiousness. No one with a negative RAT had culturable virus.
One person in my home has COVID and is still RAT positive and symptomatic on Day 16 (and counting). Since I am very high risk, this person has remained in isolation, awaiting either a negative test or resolution of symptoms. Is this prudent or is it overkill? I really do not want to catch COVID if I can possibly avoid it.
I KNOW YOU AREN’T TOO CONCERNED ABOUT PAXLOVID REBOUND BUT YOUR COLLEAGUE, DR. DAVID HO, SEEMS CONCERNED. PLEASE DISCUSS HOW TO MANAGE (DIAGNOSE AND TREAT) PATIENTS WHO HAVE COVID/PAXLOVID REBOUND. DO THEY NEED EXTENDED ISOLATION?
THANKS – DR. TERRY MCDANNOLD (RETIRED INTERNIST)
Paul got Covid, age = 71, did not take Paxlovid.
This is not to pick on Paul Offit, but wondering if there’s a more nuanced understanding about taking the med. depending on how one feels, or careful self-knowledge of disease progression. My “philosophy” is that’s it’s always better not to take meds unless absolutely necessary.
In a study reviewed in TWiV 941 (last clinical update), the rate of long covid from Omicron in the boosted was stated to be 4% at 12-16 weeks, and 95% of patients get better (even if it’s a process).
Therefore, Is it reasonable to say then the rate of “permanent long covid” is really only 0.2%, or am I missing something?