Zvi, what are the chances that Paxlovid ends up having way more side-effects than the trials showed? I heard David Friedberg on the all-in podcast mention that he was pretty nervous about it because the drug messed with some pretty fundamental biological machinery, and that under non-covid circumstances it would be tested for a lot longer. I don’t doubt that for people that end up at the ICU the benefits will overwhelm whatever side-effects end up happening, but how would the risk evaluation go for people with mild or mild-to-severe illness?
These are good questions. The following is not medical advice. It’s just framing the situation you’re describing in a little more detail.
The Paxlovid trial had about 1,000 participants. Soon, we’ll be giving it to tens or hundreds of thousands of people who are seriously ill. This will give us more data about safety.
For an individual patient over the next couple months, one challenge is that Paxlovid must be taken so early that you can’t be sure about the trajectory of your illness. More severe symptoms tend to kick in after Paxlovid’s window of efficacy expires. You have to infer your likelihood of severe illness from your risk category and the severity of your symptoms vs. the number of days you’ve been sick.
If you are in a low-risk category, it’s unlikely you’ll have the opportunity to take Paxlovid before we have a lot more data. If you do, you’ll be weighing the risk of rare unknown side effects against the low chance of developing a more serious illness. At that point, I can only say to consult with your doctor.
Law of Large Numbers should attach, shouldn’t it? In Bayesian terms we should have enough information unless we expect fraud/suppression to be taking place. And their incentives are not to make that happen, it would not go well for Pfizer.
I heard David Friedberg on the all-in podcast mention that he was pretty nervous about it because the drug messed with some pretty fundamental biological machinery…
Just heard that episode today and was thinking the samething. The scuttlebutt I’ve heard elsewhere is that paxlovid has several mechanisms to prevent viral replication. One of those mechanisms is similar to an HIV medication that has some known contraindications. OTOH HIV meds you take for life, Paxlovid you take for a few weeks. So my guess is that in the given the timespan you’re taking it, the risk is much lower.
Zvi, what are the chances that Paxlovid ends up having way more side-effects than the trials showed? I heard David Friedberg on the all-in podcast mention that he was pretty nervous about it because the drug messed with some pretty fundamental biological machinery, and that under non-covid circumstances it would be tested for a lot longer. I don’t doubt that for people that end up at the ICU the benefits will overwhelm whatever side-effects end up happening, but how would the risk evaluation go for people with mild or mild-to-severe illness?
These are good questions. The following is not medical advice. It’s just framing the situation you’re describing in a little more detail.
The Paxlovid trial had about 1,000 participants. Soon, we’ll be giving it to tens or hundreds of thousands of people who are seriously ill. This will give us more data about safety.
For an individual patient over the next couple months, one challenge is that Paxlovid must be taken so early that you can’t be sure about the trajectory of your illness. More severe symptoms tend to kick in after Paxlovid’s window of efficacy expires. You have to infer your likelihood of severe illness from your risk category and the severity of your symptoms vs. the number of days you’ve been sick.
If you are in a low-risk category, it’s unlikely you’ll have the opportunity to take Paxlovid before we have a lot more data. If you do, you’ll be weighing the risk of rare unknown side effects against the low chance of developing a more serious illness. At that point, I can only say to consult with your doctor.
Law of Large Numbers should attach, shouldn’t it? In Bayesian terms we should have enough information unless we expect fraud/suppression to be taking place. And their incentives are not to make that happen, it would not go well for Pfizer.
Just heard that episode today and was thinking the samething. The scuttlebutt I’ve heard elsewhere is that paxlovid has several mechanisms to prevent viral replication. One of those mechanisms is similar to an HIV medication that has some known contraindications. OTOH HIV meds you take for life, Paxlovid you take for a few weeks. So my guess is that in the given the timespan you’re taking it, the risk is much lower.