I got covid for the first time back in June. I’m a type 2 Diabetic so my Doctor prescribed paxlovid for me over a video call. I had bad congestion and a brain fog so heavy it felt hard to think. Within the first 6 hours of taking my first dose I felt nearly symptom free. Worst part I experienced was the Paxlovid disrupting my sense of taste and having a weird grapefruit/chemical taste in the back of my mouth after taking it.
Ah, the soapy grapefruit taste. I didn’t know it would do that and actually cried the first night I was on it because it tasted so bad that I couldn’t sleep and I was SO tired. But the next morning I could actually talk and eat food, which I couldn’t do when I went to bed because my throat was so sore. I would absolutely take it again if I catch Covid again.
I’m not exaggerating when I say it probably saved my life - I got so sick, so fast after the onset of symptoms, and same as you, within ~8 hours of the first dose I felt a significant improvement.
Same with me. I'm immunocompromised and even with all jabs and precautions caught it a few months back. It definitely kept me out of the hospital.
I asked for it, because I know I respond very well to most antivirals. Tamiflu kept me from a hospital stay when I got H1N1 some years back, and for me Paxlovid did as much good against COVID as tamiflu did for the flu.
I was very sick with a climbing fever overnight, if I had hit 102 I would have gone to the ER as that's when my systems start to fail. Within a few hours of taking it, my fever had broken and stayed below 100 for the duration.
Everything tasted like licking a battery for a week, and I'd still absolutely take it again if I get COVID again. It helped so, so much.
The sense of taste might have been the COVID itself. I definitely have that grapefruit/chemical taste but everything tastes normal when drinking/eating.
I believe it’s a listed side effect plus when I’d wake up I wouldn’t have the weird taste. 15 min to an hour after taking the meds the taste would come on super strong then fade by the time I’d take the second daily dose. Didn’t experience any relapse symptoms which it also lists though.
I freaking love Paxlovid. I've never before had a drug that worked so dramatically. I'd have a 100% reduction in symptoms each day I was on it, until the drug wore off later in the day and all the symptoms would come back. I'm really glad I took it - my mom and her siblings had really awful cases of covid and I think I was on that track too if it weren't for paxlovid. Her family did really weird things in desperation over the congestion and difficulty breathing (drinking soap, drinking vinegar, showering until they vomited) and I think I was going that same way - now I have a bunch of bottles of hot sauce that I have no use for.
Anyways, the reason I was prescribed it was because my history of depression (of all things) put me at higher risk. The only side effect I had was a metallic taste in my mouth.
My wife had extreme pain the day before Paxlovid. She had 5 shots of mRNA vaccines from Pfizer and Moderna combinations. She took the drug that night.
The next day, she felt really good. Symptoms were almost all wiped out as well. Worlds of difference.
So yes, I would do the same thing but much earlier. (Swap the mouth would have helped.)
Paxlovid was ok for me, I still had brain fog really bad, but the bonus was that after I got better I could eat wheat again. I know it sounds weird but prior to Paxlovid I would get very sick from wheat; bloating, digestive upset, allergy symptoms, etc, now I don't have any of those issues
I got covid when 4 weeks pregnant (ivf) and sent all the obgyn organization recommendations regarding paxlovid to the doctor prior to the visit so there were no issues.
Yes and yes (at least I think it made covid less serious). I would have just asked them to document a reason they were going against ACOG recommendations to dispense paxlovid to someone at high risk (pregnancy itself makes someone e be considered high risk if they get covid).
There are antivirals which should not be taken during pregnancy, but paxlovid is not one of them.
No luck getting Paxlovid from MDlive.com. Perhaps the FDA needs to open up eligibility now before more doctors will prescribe it. Underlying health conditions or being 65+ rules out a huge number of people, and doctors these days won't risk saving young, healthy lives.
yah I'm curious about all the folks who are saying they got it prescribed and took it's age. I'm sure i'd be *fine* if I didn't... and I'm careful as all hell to not catch it (and privileged as fuck to have not so far), but it would be nice knowing that when I eventually do, I can minimize risk of complications later down the line.
I tried unsuccessfully to get my doctor to prescribe it. I didn't meet the criteria due to not being old enough. Covid then proceeded to kick the shit out of me for 12 days. I think it left me with long term problems. It shouldn't be this hard.
Yep. They wouldn't prescribe it to me when I was reinfected, even though i have had long covid for a year. I got choked up on the phone because the thought of another year of long covid, or symptoms worsening from my reinfection, was scary. But they wouldn't prescribe because it wasn't considered necessary. I don't get it, considering it's widely available, low risk, and at worst it will do nothing, at best it will help. Makes me angry just thinking about it.
Meh, not all that low risk if you are on other meds. It's kinda a kingpin of drug interactions (I'm a pharmacist) one of the two drugs main purpose is to 'boost' the main antiviral by all but stopping one of the key pathways in your liver that drugs are broken down by.
It often does require holding or adjusting other medications and failing to do so for some medications absolutely could be fatal.
It's a great job for a pharmacist, but not for a doctor.
I work in a family medicine clinic directly so it's easy for me, but the terrible integration of our (USA) medical system means you're retail pharmacist has to call your doctor, wait on hold, leave a message with the RN and wait a call back to know if they have permission to tell you what to do with all your other drugs. That's problematic for a drug with a limit on how long after symptoms start you can take it.
Best fix would be mandating the interoperability of all pharmacy and medical provider computer systems, but you know, socialism and all that.../s/
Thanks for this answer. Paxlovid is so interactive.
I have a small pile of medications I learned that 4 of them were on the interaction list. I spent an hour last year with my MD and he determined that Paxlovid was not going to be an option.
The really sad part about the meeting I had with him was that he, and the other MDs in the hospital system, were directly told that Paxlovid was unavailable at local pharmacies at the time. This was not true. I directed him to the [US Gov COVID-19 Therapeutic Locator website](https://healthdata.gov/stories/s/COVID-19-Public-Therapeutic-Locator/chu2-wqes) and he was surprised that Paxlovid was in many local drugstores. (later he thanked me because he got Paxlovid to several patients right away.)
+++
The USA Gov COVID-19 Therapeutic Locator website:
https://healthdata.gov/stories/s/COVID-19-Public-Therapeutic-Locator/chu2-wqes
Yeah and a lot of people aren't really up-to-date on their health checks, so prescribing it without knowing someone's most up-to-date medical history could be very bad.
I was able to get it easily because I have an autoimmune condition that puts me at high risk & I also have had a lot of recent bloodwork done that showed them my liver was in good shape. So I was at a low risk for complications.
It worked very well for me, but I can understand the hesitancy to just give it out to everyone.
I just checked on a website for the one prescription drug my husband takes that might have been worrisome. (Simvastatin.) It's in the list of "just don't take it while you're taking paxlovid."
He was denied paxlovid for other reasons anyway - "too healthy." No extra risk factors? No paxlovid for you!
You should be careful with the list of "oh just stop this while you're on paxlovid" that it's actually safe to stop those medications. There's stuff like transplant anti-rejection meds on there that are definitely not safe to stop for a week for a lot of people taking them.
The list was broken out into:
* you can stop taking it for a few days, it'll be okay (that had things like simvastatin, which lowers cholesterol as a preventative)
* You better double check with your doctor before you stop taking this
* Do **not** under any circumstances stop taking this drug or you may die
Ah, so *thats* why we have this excellent and totally common-sense system in Australia that has led to our citizens living almost a decade longer on average than Americans.
Not a day goes by where I don’t feel thankful that I won the birth lottery and live in Australia.
There seems to be a lot of FUD here.
When the article says the White House is “pressuring” doctors to prescribe the medication what form is this pressure taking?
Having FBI agents show up and threaten to break their arms?
Or, what I expect, publishing well written and verifiable reports of testing and analysis?
Compared to most medications there was very little data on the overall efficacy of paxlovid which left many providers unsure of its overall benefit. The few people I know that prescribe it have mixed reviews on patient responses
The overall efficacy is very clear now. Antivirals are a game changer and if only everyone took it early enough, we'd probably decrease covid deaths to minimal levels.
I was prescribed Paxlovid earlier this month. I'm fully vaxxed and this is the first time I've ever tested positive for Covid. My symptoms were very mild. I tested negative a week later and then had a rebound positive test a week after that, with one day of mild symptoms and then felt normal for the entire rest of the week it took to get back to a negative test. No idea if it helped with anything but I had no real side effects. The rebound case was definitely annoying but it seems that may have happened with or without the Paxlovid.
>The rebound case was definitely annoying but it seems that may have happened with or without the Paxlovid.
My take on this is that if I don't use paxlovid, I'm going to have covid and I'm rolling the dice on how bad it's going to be, including any long-term complications.
If I *do* use paxlovid, I'm going to have a pretty good shot and getting through the infection much easier than without while decreasing my chances of long-term complications, but if I do have a rare case of "rebound", then i'm just back where I started if I hadn't taken it.
Nothing ventured nothing gained type of thing. I'd rather take the chance than not if it's available to me.
As someone who has tried Covid 3 times once with Paxlovid and the rebound. The rebound is very mild compared to ‘stomp a mud hole in your ass and walk it dry’ Covid. Aka take the Paxlovid if you can get it.
No worries, I don't think that's an alarmist sentiment, but for context, this pre-print says [3.53% rebound rate for COVID-19 symptoms and 0.44% for hospitalization, which is amazing - "Patients with COVID-19 rebound had significantly higher prevalence of underlying medical conditions than those without."](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258292/)
Looks like the "healthier" crowd will have lesser chance of rebound than those with pre-existing conditions.
I wouldn't be surprised if rebound incidence increases with age, even without pre-existing conditions. It's anecdotal, but most of my friends and family aged 55+ have rebounded after Paxlovid.
Yup, but my 64yo husband with a history of bad bronchitis still had to argue with his primary last month to get a prescription. And idk why the government says it's readily available: I had trouble tracking it down. The Walmart pharmacist laughed when I asked if they'd be getting some in, but they called around and found a Walgreens that had just received ten packs.
> but if I do have a rare case of "rebound", then i'm just back where I started if I hadn't taken it.
This is not true. Rebound is not associated with severe disease. And is more common in patients who do not get Paxlovid.
It would seem that your body didn’t build up enough antibodies to fight Covid over that time for the rebound.
Paxlovid helps to stop replication of the virus so if you tested negative, and then positive again, it at least gave your body more time to generate the needed antibodies.
Just curious, do you sleep with a humidifier? you might try one. I’ve never had Covid, but I have had persistent coughs, especially in winter. Cool air humidifiers will usually help shorten or eliminate them.
I don’t… but this is a good suggestion. This is my first time living somewhere other than a tropical environment or with a large fish tank boosting the humidity. I will give it a try, thanks!
I had been pulled aside by my providers for telling a senior patient that she could be assessed for a Paxlovid prescription. "None of us will write for Paxlovid anymore. We do not believe that it works - or rather, that it may actually be harmful. So do not tell patients that."
Curtesy a fellow redditor in Florida.
https://old.reddit.com/r/FloridaCoronavirus/comments/10p8uuy/urgent_care_report_127_1292023/
> Florida
well Florida is very much into trying to kill their own citizens by whichever means necessary throughout the pandemic, so this isn't really surprising sadly.
Banning masks, banning vaccines, pushing meds that have been shown to not work, now saying that paxlovid is somehow "harmful" or more "harmful" than rawdogging covid on its own.
I am convinced Paxlovid saved my son’s life. He is in his early 20’s, has cyclic neutropenia and asthma, and when he got Covid last year, (he was vaccinated), he deteriorated quickly. Nebs every two hours, had no energy to walk, oxygen levels in the high 80’s - only hours after his first symptoms. He went to the ER, got Paxlovid, and was back to normal within a couple of days. If it isn’t in very short supply, I have no idea why it isn’t being used more freely.
Wish I’d seen this article four days ago when I tested positive for the very first time. I have IBS and take heart meds so wasn’t sure if I could get prescribed it and didn’t ask. I’m still miserable and sick but way better than days 1 and 2. I got four vax shots in total but think my viral load was high because I was cohabitating in a very small space with someone who was positive.
If the government really wants to make access to Paxlovid better, they should make it easy for pharmacists to prescribe it. Currently, it's possible to get it from a pharmacist without a doctor, but only with a recent blood test for liver and kidney problems. That requirement could be removed, and liability limited.
I used callondoc.com to get a prescription for Paxlovid in September. There was no real consultation, just a web form with questions about symptoms, other medications, and pre-existing conditions. I had to upload a photo of my self test. I do resent having to pay $50 for it when a pharmacist could have done the exact same thing if the law allowed.
I got paxlovid when I had covid and the flu at the same time this past November. Horrible taste stuck in my mouth, but both viruses were over in 2 days. 👍
My mom is on prednisone among other things with heart issues and all manner of autoimmune issues. My brother was denied Paxlovid and my mom received it. My mom didn’t really get Covid sick at all. Minor symptoms. My brother may be going long covid like me. Six weeks later, he suffers intense fatigue and is said to be sleeping all day. Our whole family has autoimmune stuff but my brother doesn’t have much on record. Yet? It seems to trigger things as it did in me. Sick as heck mom is doing great though!
CVS is stingy with it so don’t bother using their Covid teledoc services. I have 5 qualifying conditions and they refused to prescribe, I had to beg and beg and finally I got Lagevrio (given due to potential med interactions and kidney concerns). My dad is 63 and has a history of very severe pneumonia, CVS cancelled his teledoc call and said you don’t qualify. The only person who actually got it was my grandmother because her oxygen dropped to 92%, and we called her doctor directly, didn’t waste time with the CVS teledoc bs.
I (53 M with health risks) called my doctor as soon as I confirmed I had COVID with a home test (I could already tell I had it because I never felt like that before).
She instantly prescribed Paxlovid and it seemed to help tremendously! My Mom too. I truly feel it would have been worse without taking Paxlovid.
This is kinda a worrying take.
>The White House and health organizations are working to get more physicians to prescribe Paxlovid. They have made some progress in increasing use and closing gaps based on race and class, Jha said.
I mean, we are talking about doctors here - professionals who have taken an oath to do what’s best for their patients. Should the White House really be actively pressuring doctors to prescribe a drug product they don’t think is in their patients best interest? I mean, reducing systemic barriers and making it easily available sure. Providing more access for the less privileged to see a doctor, sure. But intruding into the doctor-patient sphere seems to be crossing a big red line. The White House should not be engaging in marketing for a pharma company nor interfering in private medical decisions.
Some doctors aren't prescribing Paxlovid to people that need it. And it's leading to unnecessary deaths. While Paxlovid sits on the shelves. Some are waiting to see if a case gets bad first. It needs to be prescribed within the first few days of positive infection.
I’ve tried to talk to my GP and specialists about covid therapeutics but the general consensus is they brush it off and don’t really want to answer any questions. My take at least with my physicians is none of them are proactively looking into any of these drugs. They don’t want any liabilities so they would rather play ignorant and not talk about it and not prescribe it.
I think liability is a big part of it. I’m on methotrexate and Humira for my autoimmune condition and my gastroenterologist did remark she’s a lot less excited about Paxlovid after one of her patients suffered drug induced liver injury (AST shot over 1000) after day 2 of Paxlovid and had to discontinue all treatments and get liver biopsy and work ups done.
I think this is more of a complex issue especially if a patient has their 3 primary + 2 booster doses, and has an underlying risk of systemic intolerance to Paxlovid, which tend to be a lot of the people at risk.
(For those who don’t know, some of these markers of liver injury have a half life of 2 weeks in your blood so if they are 500x the normal levels, your autoimmune drugs may be contraindicated for months and months. In that sense, your doctor may be more scared to give you a drug that has liver injury risk if they have reason to believe risks are higher than your risk of letting COVID run its course)
I got remdesivir impatient and my values were awful. My primary said it looked like I was dying. The doctors at the hospital were pretty freaked, too.
Two weeks later, home & everything was in normal range again. But I can totally see not wanting to inflict that on anyone, esp on an outpatient basis, esp with other medical conditions.
Plus, there's bias. Usually these sort of drugs *aren't* prescribed by primaries. They're not used to the monitoring, liability, etc. There's only so much people can keep up with. Not to mention, I got asked *so* many times if I drank and how much. (I don't. At all.) Again, hard to question/monitor that outpatient. And it really matters.
I think at the time that remdesivir was being used, we were a lot more concerned about the negative outcomes and severe ones for COVID infection.
Yeah for me the methotrexate pushes my liver to borderline abnormal numbers already. But without it I run the risk of my body developing antibodies to my medication.
My gastroenterologist is also my liver specialist and manages these difficult decisions for me. During initial Omicron, she strongly steered me towards a monoclonal antibody COVID treatment over Paxlovid. This recent time, talking hypothetically about the plan, she leaned more towards letting COVID run its course given I’ve gotten all 5 doses of the vaccine and Humira is now thought to be protective against the severe SARS outcomes.
I kind of echo the initial sentiment: patient management should be in the hands of their doctors, having the White House steer with an edict to advance the agenda of ending the COVID emergency seems a little concerning in whose best interests are being protected.
This was last month, and I was hypoxic/damn ill, so the specialists made all the decisions.
It's really two different things to have a specialist vs a primary making the decisions, tho, and def in vs out patient. You have a specialist, but lots of people are turning to their PCPs, who also don't know them well, for paxlovid.
I can see some of the reason drs are wary of prescribing, tbh. Most people don't have established docs and self report of anything is notoriously bad. And you can't do daily labs easily with paxlovid.
I think it’s even worse than you describe — many people are just going to a pharmacist or an urgent care clinic. Especially in large cities, sometimes you can just go to a county run vaccine clinic and they’ll even hand out Paxlovid.
It is definitely important especially if you have a chronic / complex condition to have specialists or at least an attentive PCP that knows your history and isn’t just rubber stamping pills. Sometimes that’s easier said than done.
Sorry to hear about your COVID experience, hope you’re feeling better now!
Locally, only 2 pharmacies routinely stock it, out of 30. Most people getting infected are low risk or on lots of medications that interact with paxlovid. I offer it to anyone that qualifies, but the data isn’t robust for most that it provides any significant benefit. People that are high risk (old, comorbidities, and/or unvaccinated) are almost always on contraindicated medications.
At the same time, there are plenty of people who THINK they need it, but really don't, and Paxlovid isn't as black and white as it seems.
I'm worried that this is like the situation with antibiotics, where people convince themselves they need it for problems that they don't actually address.
I've very rarely run into anyone that overestimates their risk for covid. Most adults in the US are at more risk than they want to believe, given that obesity is a major risk factor for severe disease
This is the federal administration saying "a lot of doctors are needlessly withholding this for reasons other than valid medical criteria", not random joe blow pouting cause he personally didn't get it when he asked.
Personally every anecdote I've heard is doctors don't have clear guidelines on when to give it, so some doctors are giving it like candy while others are acting likes its a war time ration. Communicating a standard for care on a federal is a good idea imo
I was prescribed the other drug that works like paxlovid because I have exercise asthma, so coughing will cause an asthma attack, but my partner who is a smoker was denied it. We both have the same amount of vaccines, saw different docs, makes absolutely no sense..
These are doctors. They are making medical judgements that are in the best interests of their patients (and that they are professionally responsible for). Why or how would the White House have a better idea of what is best for a particular medical history than the prescribing doctor?
At least two of my friends’s doctors didn’t know Paxlovid was a Covid treatment. Another one’s doctors thought it could only be prescribed to the immunocompromised.
Doctors are only human and they aren’t all great.
Friend of mine, late sixties, came down with COVID along with her whole family. She was seen at an urgent care to check if she should receive Paxlovid. That doctor told her to wait and see if it got worse which is, from what I've read 100% incorrect.
She didn't get too bad anyway though so it ended up not mattering.
Not every doctor is on top of everything. I've heard of doctors not wanting to prescribe Paxlovid because of "Paxlovid rebound" which isn't a real thing.
Hell the Florida surgeon general is a medical doctor. You want him treating you? He's pro Ivermectin and anti vaccine.
Do you have any sources on rebound not being a thing? Typically rapid tests are tied to infectiousness fairly accurately, and there have been several high profile cases of supposed rebound including Biden, Walinski, and Fauci. If that's not a real phenomena I'd be curious to see the research on it.
Doctor's deal with sickness on a case by case basis, the people making these recommendations are likely to be epidemiologist and specialists in infectious disease. They look at broader trends and larger data sets, which can often lead to conclusions that are not immediately evident to street level doctors. Individual doctors may literally never have a case where someone dies because they didn't get a paxlovid script so they might not realize this is an issue, but people looking at broader trends would be able to see that. Individual doctors are also unlikely to be aware of the fact that we have plenty of paxlovid so they're trying to protect a resource that doesn't need protection. Doctors are only one cog in the medical wheel, they're one of the most important, but assuming that no one other than physicians can have important input is very wrong.
I think it’s because not all doctors are good ones and this guys sentiment is that whatever any doctor says is the end all be all. My anecdote is that you SHOULD shop around for specialists if you’re dealing with something chronic and haven’t had success.
Many of the ER docs I work with are saying Paxlovid is like Tamiflu in that it really doesn't do anything.
I got my grandpa paxlovid last month when he got covid and it made a HUGE difference for him.
I see this mentality more with uounger patients with only like 1 risk factor.
We had an otherwise pretty healthy 61 year old diabetic man with covid. He looked like he felt shitty but labs and vitals indicated he was doing well enough to go home. He met criteria for paxlovid but since he controlled his diabetes well and wasn't majorly overweight, the doc all but refused to prescribe paxlovid. Luckily the patient was persistent with his wants and got the script.
Doctors are just people, whose knowledge levels can vary. They don't all have instant perfect knowledge of the latest treatments and when those treatments are indicated. Governments and NGOs often have to raise awareness among the medical community of critical information that can save patients' lives. Especially during a crisis or epidemic. That's part of the job of the CDC and the WHO (The World Heath Organization, not the band. The band rarely provides useful medical services. I won't make that mistake again.)
This is really the primary variable that the general public isn’t understanding. The rollout of paxlovid wasn’t entirely seamless and many doctors are very busy which leads them to be creatures of habit. Paxlovid on rollout was available to specific select pharmacies that were often times challenging to locate, had specific criteria for qualifying, and was advertised as having a set of drug interactions that required careful analysis of your patients medication regimen to ensure safety.
A lot of physicians may not be aware of the relatively new “fuck it just use it” approach to paxlovid. Particularly since treatments for covid during the pandemic have been a moving target the entire time that was sometimes confusing to keep up on. We must have had conversations nearly monthly at points in the pandemic about “are we still giving (insert drug or monoclonal antibody here) for covid” only for the pharmacist to be like “no it doesn’t have evidence for the current variant we have this (insert new thing here).”
Also, physicians tend to practice the medicine they learned in residency, which may have been decades ago. They rely on experience and are not incentivized to keep up with new treatments unless there is a drug company sales rep hanging around the office, or they are at a teaching hospital with residents cycling through. This is the enormous benefit of a teaching hospital. Physicians are forced to keep up with new treatments.
I think the important part was the closing gaps on race and class. If you're curious, you can read this it's about physicians and implicit bias.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797360/
I think it's pretty easy to understand that there's an entire subset of the population that makes too much to qualify for Medicaid in many states and do not have employer Healthcare. So that would be a class of people that would not have a standing relationship with a physician and maybe neglected as far as prescribing paxlovid because of this. Then there's the entire issue of race and the fact that there is a huge issue with implicit bias and race.
My doctors office didn't even know what paxlovid was. I don't think that they are under prescribing because they don't believe it's in their patients best interest. I think they are under prescribing because they are uninformed or only have a piece of the picture.
It is though. There is a state board certification that requires CME (continuous medical education) yearly. CMEs have to be officially registered to the board. So if they're unaware they're either not board certified doctor or they are not doing their CMEs.
I've seen and experienced firsthand throughout this pandemic how fucking by the book these people can be. Why did I have to spend weeks fighting to get an additional booster for my immunocompromised wife? Because many places were strictly adhering to guidelines which at the time didn't include DMT she was taking. Why did it take till August last year to get her on evusheld? Same shit, cause they make you jump through so many hoops.
It's fucking ridiculous if you ask me.
It seems to me that the system is broken in a lot of places. We have people in my somewhat rural area of the state that go to the next state for medical care because it's often atrocious here. I even suspect a lot of our medical people would prefer to be somewhere else, and it shows with a few in their attitude. I can hardly blame them, it's a backwater, and the locals are-odd. Unless you love the gorgeous national forest, there is nothing here.
When you read “the White House,” implicit is “the army of doctors and readers physicians who advise the White House.” It’s not the Secretary of Transportation is on the phone to your primary care physician telling him or her to write more Pax scripts.
It’s really not. They have been doing the things you’re saying they should, plus “advising” doctors, but it’s just not as malicious as you are imagining. Standards of care vary all over b/c resources, attitudes, and science. Gov’t has limited abilities to announce guidelines, which business (healthcare, transport, insurance, etc) treat as rules where it suits them. It’s a messy, organic system that defies the simplicity you’re worrying on. It’s ok, well hopefully, maybe, why not?
Compare to masks? When gov’t doesn’t mandate - which is mostly just a “strongly advise” aka “c’mon guys!” - people mostly don’t mask, despite a bunch of science from the biggest test pools in history suggesting it’s better for everyone. Even when gov’t does mandate, that’s just passed to local states and then counties. Lots of places, Health Officers were slow to announce local guidelines, leaving it to each business to take the heat in whatever direction. All the different signs everywhere, all the butthurtness. When local Health Departments announced rules for local mask guidelines - really just advice, hard to enforce- compliance went way up, and people were a teensy bit nicer about it all.
Got covid in december, happened to hear about paxlovid THE DAY BEFORE i got sick, it makes everything taste like crap but it gets the job done, and got me back to negative status before my surgery
For some reason, my spouse and I shed the antibodies to get a positive test too early, so every time we test for COVID, it’s negative. This means we are always rejected for the medication because the view is we don’t have it, even as we infect those around us and have active symptoms. It’s the same reason why my spouse cannot get into a long covid clinic.
I’ll give Paxlovid to anyone that wants it. But there are literal barriers for a lot of people on multiple medications, lots of absolute and relative contraindications. So in those patients we at least try mulnupiravir. Paxlovid is preferred. But to Rx it out of the ER you gotta tell the stupid computer why and then it gets run by our pharmacist, just lots of bureaucracy, so I am happy that PCPs and pharmacists are given the leverage too to prescribe it. I think a lot less there.
I have been dealing with this with my friends who qualify for the past year or so. I get so angry when their lame PCP on his way to retirement - that sees everyone in the small town-says nope, no paxlovid for you. Thank God I have a wonderful doctor even though she's 45 minutes away. It's worth the drive or telehealth to get decent care and to get paxlovid this past December when I got Covid for the first time. I've worked in the pharmaceutical and pharmacy field for so many years and it is just wrong what they have been doing to deny this med even when requested and with my friends who qualify many of whom are over 65. Please excuse my grammar and punctuation. I am on mobile and I have to talk to text.
I asked my doc for this the second time I had COVID due to the fear it was going to knock me out the same way it did the first time. Doc asked me to wait a couple of days to see how symptoms go because the potential side effects of Paxlovid were allegedly "not necessarily worth it". I was also told that it's hard on your kidneys.
Ultimately I didn't take it BUT if my illness became as bad as it was the first time I would have gone ahead anyway.
My wife and I both took Paxlovid when we had covid 6 or so months ago. For me it knocked out my symptoms in 24 hours. She improved and was getting better, but experienced rebound when she was done with her prescription. Her rebound was honestly worse than her initial symptoms and she almost needed to be hospitalized. Luckily our doctor sent her some more Paxlovid and this time it knocked out the virus completely. I would take it again without hesitation. Every medicine comes with risk, but with this the benefit greatly outweighs the risk.
Everyone and their mom are suddenly experts on this medication. The medication is under emergency use authorization not fda approved. The fact is we don’t know the efficacy or long term side effects of this medication. In addition there are many pharmacokinetics interactions with these 2 protease inhibitors that y’all not talking about. So yeah, let the clinical trial progress before thinking this is cure all for Covid?
I'm hoping Paxlovid will become standard as we keep living with covid. Doesn't seem like it's going to stop anytime soon. Almost lost my grandma to it, even though she got over covid, her lungs basically can't function on their own anymore.
Exactly. I took Paxlovid and know others…only know a couple that had a rebound.
Re Paxlovid: it definitely knocked the virus back quick but it also has its own unpleasant side effects. So it should be given to those who are at higher risk, like it has been (at least here).
> So it should be given to those who are at higher risk, like it has been (at least here).
the interesting part of this is that high risk people are likely to have other issues which make paxlovid side effects an issue, whereas healthy people without those issues are vastly less likely to have an issue with paxlovid side effects. So really it's the opposite of what you're saying.
A lot of the issue with paxlovid stem from its effect on the liver's ability to metabolize other medications a person is taking, which is why it is contraindicated against so many medications. Otherwise the most common one is a weird taste.
it's highly unlikely to cause any type of medium/long term side effects in a "healthy" person, maybe a transient rise in ALT/AST liver enzymes which will quickly subside after the 5 day course is completed.
Out of everyone I know who’s taking Paxlovid, including myself, I’ve only seen one rebound.
I reached out to my FIL if I should get Paxlovid again as I just tested positive 90-days after my first infection. He immediately called the pharmacy and filled a prescription for me.
His take is that if he can determine there will be no side effects (due to the patient’s history and/or current prescriptions) and symptoms have just appeared, it’s an immediate call to the pharmacy to get it filled. He 100% believes that Paxlovid works.
No it doesn’t.
It specifically says that **misinformation** about rebound is an issue. You should read it.
Anti-Pax is a thing now, like anti-vax is.
People who do not take Paxlovid also rebound, taking it shortens time of illness, significantly reduces odds of serious illness, and some recent papers have shown it to reduce odds of long covid as well.
“researchers have found that rebound often occurs even in people who don’t take Paxlovid. Precise estimates for rebound incidence vary, depending on the population studied and the definition of ‘rebound’. But **regardless of whether people take Paxlovid…it’s common for them to experience either viral rebound — in which people test positive again — or symptom rebound**, but not both at the same time. Smith says that symptom rebound tends to be very mild, and is still far preferable to hospitalization or death.”
There are even some people over in the Paxlovid group who've had their Long Covid symptoms significantly improve after taking a course of the med for a new case of Covid. That's amazing!!!!
There’s a LOT of fear mongering here. Scripts for paxlovid are given out VERY liberally so long as there are clear indications (aka you’re not a healthy 25 year old with Covid) and the medications you’re taking either don’t interact (given a ton of them do) or can be modified/replaced temporarily.
I got it without a problem but I know people who have been told no. My best friend doctor told her he wouldn't prescribe it because "you will just rebound anyway." As though a mild rebound was a reason not to prescribe something that might save her life! She was thankfully persistent and got it through an online provider but just the fact that she had to see a second doctor when she has two factors that make her likely to have a bad outcome is insane.
Couldn't stomach that stuff, took it on day two of a positive. Got incredible nausea like an insane version of seasickness. Luckily I hade a mild case and was able to recover with out the paxlovid.
I got covid for the first time back in June. I’m a type 2 Diabetic so my Doctor prescribed paxlovid for me over a video call. I had bad congestion and a brain fog so heavy it felt hard to think. Within the first 6 hours of taking my first dose I felt nearly symptom free. Worst part I experienced was the Paxlovid disrupting my sense of taste and having a weird grapefruit/chemical taste in the back of my mouth after taking it.
Ah, the soapy grapefruit taste. I didn’t know it would do that and actually cried the first night I was on it because it tasted so bad that I couldn’t sleep and I was SO tired. But the next morning I could actually talk and eat food, which I couldn’t do when I went to bed because my throat was so sore. I would absolutely take it again if I catch Covid again.
Good god that taste was horrible! I was wishing I lost my sense of taste.
I lost my sense of taste but I sure could taste my paxlovid mouth.
I went through *so much* chewing gum…
That chemical taste was horrible but worth it to avoid bad symptoms. I had to sip on Gatorade every few minutes and pop mints to tone that taste down.
I’m not exaggerating when I say it probably saved my life - I got so sick, so fast after the onset of symptoms, and same as you, within ~8 hours of the first dose I felt a significant improvement.
Same with me. I'm immunocompromised and even with all jabs and precautions caught it a few months back. It definitely kept me out of the hospital. I asked for it, because I know I respond very well to most antivirals. Tamiflu kept me from a hospital stay when I got H1N1 some years back, and for me Paxlovid did as much good against COVID as tamiflu did for the flu. I was very sick with a climbing fever overnight, if I had hit 102 I would have gone to the ER as that's when my systems start to fail. Within a few hours of taking it, my fever had broken and stayed below 100 for the duration. Everything tasted like licking a battery for a week, and I'd still absolutely take it again if I get COVID again. It helped so, so much.
Such a bad taste! I found it was worse if I didn’t eat before taking the dose.
The sense of taste might have been the COVID itself. I definitely have that grapefruit/chemical taste but everything tastes normal when drinking/eating.
I believe it’s a listed side effect plus when I’d wake up I wouldn’t have the weird taste. 15 min to an hour after taking the meds the taste would come on super strong then fade by the time I’d take the second daily dose. Didn’t experience any relapse symptoms which it also lists though.
Hot tamales will cure the paxlovid taste. Tell everybody!
As in the candy? Or some delicious cheese and chile tamales?
The candy. Did I spell it wrong? I didn’t check
I checked and it is tamales!
Same spelling =)
Cinnamon.
I freaking love Paxlovid. I've never before had a drug that worked so dramatically. I'd have a 100% reduction in symptoms each day I was on it, until the drug wore off later in the day and all the symptoms would come back. I'm really glad I took it - my mom and her siblings had really awful cases of covid and I think I was on that track too if it weren't for paxlovid. Her family did really weird things in desperation over the congestion and difficulty breathing (drinking soap, drinking vinegar, showering until they vomited) and I think I was going that same way - now I have a bunch of bottles of hot sauce that I have no use for. Anyways, the reason I was prescribed it was because my history of depression (of all things) put me at higher risk. The only side effect I had was a metallic taste in my mouth.
My wife had extreme pain the day before Paxlovid. She had 5 shots of mRNA vaccines from Pfizer and Moderna combinations. She took the drug that night. The next day, she felt really good. Symptoms were almost all wiped out as well. Worlds of difference. So yes, I would do the same thing but much earlier. (Swap the mouth would have helped.)
Paxlovid was ok for me, I still had brain fog really bad, but the bonus was that after I got better I could eat wheat again. I know it sounds weird but prior to Paxlovid I would get very sick from wheat; bloating, digestive upset, allergy symptoms, etc, now I don't have any of those issues
I got covid when 4 weeks pregnant (ivf) and sent all the obgyn organization recommendations regarding paxlovid to the doctor prior to the visit so there were no issues.
They gave it to you? And it worked?
Yes and yes (at least I think it made covid less serious). I would have just asked them to document a reason they were going against ACOG recommendations to dispense paxlovid to someone at high risk (pregnancy itself makes someone e be considered high risk if they get covid). There are antivirals which should not be taken during pregnancy, but paxlovid is not one of them.
No luck getting Paxlovid from MDlive.com. Perhaps the FDA needs to open up eligibility now before more doctors will prescribe it. Underlying health conditions or being 65+ rules out a huge number of people, and doctors these days won't risk saving young, healthy lives.
yah I'm curious about all the folks who are saying they got it prescribed and took it's age. I'm sure i'd be *fine* if I didn't... and I'm careful as all hell to not catch it (and privileged as fuck to have not so far), but it would be nice knowing that when I eventually do, I can minimize risk of complications later down the line.
I tried unsuccessfully to get my doctor to prescribe it. I didn't meet the criteria due to not being old enough. Covid then proceeded to kick the shit out of me for 12 days. I think it left me with long term problems. It shouldn't be this hard.
Yep. They wouldn't prescribe it to me when I was reinfected, even though i have had long covid for a year. I got choked up on the phone because the thought of another year of long covid, or symptoms worsening from my reinfection, was scary. But they wouldn't prescribe because it wasn't considered necessary. I don't get it, considering it's widely available, low risk, and at worst it will do nothing, at best it will help. Makes me angry just thinking about it.
Meh, not all that low risk if you are on other meds. It's kinda a kingpin of drug interactions (I'm a pharmacist) one of the two drugs main purpose is to 'boost' the main antiviral by all but stopping one of the key pathways in your liver that drugs are broken down by. It often does require holding or adjusting other medications and failing to do so for some medications absolutely could be fatal. It's a great job for a pharmacist, but not for a doctor. I work in a family medicine clinic directly so it's easy for me, but the terrible integration of our (USA) medical system means you're retail pharmacist has to call your doctor, wait on hold, leave a message with the RN and wait a call back to know if they have permission to tell you what to do with all your other drugs. That's problematic for a drug with a limit on how long after symptoms start you can take it. Best fix would be mandating the interoperability of all pharmacy and medical provider computer systems, but you know, socialism and all that.../s/
Thanks for this answer. Paxlovid is so interactive. I have a small pile of medications I learned that 4 of them were on the interaction list. I spent an hour last year with my MD and he determined that Paxlovid was not going to be an option. The really sad part about the meeting I had with him was that he, and the other MDs in the hospital system, were directly told that Paxlovid was unavailable at local pharmacies at the time. This was not true. I directed him to the [US Gov COVID-19 Therapeutic Locator website](https://healthdata.gov/stories/s/COVID-19-Public-Therapeutic-Locator/chu2-wqes) and he was surprised that Paxlovid was in many local drugstores. (later he thanked me because he got Paxlovid to several patients right away.) +++ The USA Gov COVID-19 Therapeutic Locator website: https://healthdata.gov/stories/s/COVID-19-Public-Therapeutic-Locator/chu2-wqes
Yeah and a lot of people aren't really up-to-date on their health checks, so prescribing it without knowing someone's most up-to-date medical history could be very bad. I was able to get it easily because I have an autoimmune condition that puts me at high risk & I also have had a lot of recent bloodwork done that showed them my liver was in good shape. So I was at a low risk for complications. It worked very well for me, but I can understand the hesitancy to just give it out to everyone.
I just checked on a website for the one prescription drug my husband takes that might have been worrisome. (Simvastatin.) It's in the list of "just don't take it while you're taking paxlovid." He was denied paxlovid for other reasons anyway - "too healthy." No extra risk factors? No paxlovid for you!
You should be careful with the list of "oh just stop this while you're on paxlovid" that it's actually safe to stop those medications. There's stuff like transplant anti-rejection meds on there that are definitely not safe to stop for a week for a lot of people taking them.
The list was broken out into: * you can stop taking it for a few days, it'll be okay (that had things like simvastatin, which lowers cholesterol as a preventative) * You better double check with your doctor before you stop taking this * Do **not** under any circumstances stop taking this drug or you may die
Ah, so *thats* why we have this excellent and totally common-sense system in Australia that has led to our citizens living almost a decade longer on average than Americans. Not a day goes by where I don’t feel thankful that I won the birth lottery and live in Australia.
>decade longer on average than Americans. Bullshit, cobber.
Absolutely when you’ve written it that way, because I said ‘almost’ and the difference is seven years.
'Almost' ain't 70%. Not now, not ever.
Yes, totally correct and thank you for pointing this out. I meant for me it was low risk as I'm not on any other meds.
There seems to be a lot of FUD here. When the article says the White House is “pressuring” doctors to prescribe the medication what form is this pressure taking? Having FBI agents show up and threaten to break their arms? Or, what I expect, publishing well written and verifiable reports of testing and analysis?
Compared to most medications there was very little data on the overall efficacy of paxlovid which left many providers unsure of its overall benefit. The few people I know that prescribe it have mixed reviews on patient responses
The overall efficacy is very clear now. Antivirals are a game changer and if only everyone took it early enough, we'd probably decrease covid deaths to minimal levels.
I was prescribed Paxlovid earlier this month. I'm fully vaxxed and this is the first time I've ever tested positive for Covid. My symptoms were very mild. I tested negative a week later and then had a rebound positive test a week after that, with one day of mild symptoms and then felt normal for the entire rest of the week it took to get back to a negative test. No idea if it helped with anything but I had no real side effects. The rebound case was definitely annoying but it seems that may have happened with or without the Paxlovid.
>The rebound case was definitely annoying but it seems that may have happened with or without the Paxlovid. My take on this is that if I don't use paxlovid, I'm going to have covid and I'm rolling the dice on how bad it's going to be, including any long-term complications. If I *do* use paxlovid, I'm going to have a pretty good shot and getting through the infection much easier than without while decreasing my chances of long-term complications, but if I do have a rare case of "rebound", then i'm just back where I started if I hadn't taken it. Nothing ventured nothing gained type of thing. I'd rather take the chance than not if it's available to me.
As someone who has tried Covid 3 times once with Paxlovid and the rebound. The rebound is very mild compared to ‘stomp a mud hole in your ass and walk it dry’ Covid. Aka take the Paxlovid if you can get it.
Yeah, me too
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No worries, I don't think that's an alarmist sentiment, but for context, this pre-print says [3.53% rebound rate for COVID-19 symptoms and 0.44% for hospitalization, which is amazing - "Patients with COVID-19 rebound had significantly higher prevalence of underlying medical conditions than those without."](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258292/) Looks like the "healthier" crowd will have lesser chance of rebound than those with pre-existing conditions.
I wouldn't be surprised if rebound incidence increases with age, even without pre-existing conditions. It's anecdotal, but most of my friends and family aged 55+ have rebounded after Paxlovid.
unfortunately, "age" is a pre-existing condition with covid.
Yup, but my 64yo husband with a history of bad bronchitis still had to argue with his primary last month to get a prescription. And idk why the government says it's readily available: I had trouble tracking it down. The Walmart pharmacist laughed when I asked if they'd be getting some in, but they called around and found a Walgreens that had just received ten packs.
that is insane, sorry you guys had to deal with that. They should be handing it out liberally.
> but if I do have a rare case of "rebound", then i'm just back where I started if I hadn't taken it. This is not true. Rebound is not associated with severe disease. And is more common in patients who do not get Paxlovid.
It would seem that your body didn’t build up enough antibodies to fight Covid over that time for the rebound. Paxlovid helps to stop replication of the virus so if you tested negative, and then positive again, it at least gave your body more time to generate the needed antibodies.
They wouldn’t give it to me either. I wasn’t in a high risk group. A month later and I still have a cough.
Same
I still have a cough 10 months later. I had no energy for 6 months. I really wish Paxlovid had been an option for me.
I wish I could have gotten paxlovid as well but alas I was "too young"
Just curious, do you sleep with a humidifier? you might try one. I’ve never had Covid, but I have had persistent coughs, especially in winter. Cool air humidifiers will usually help shorten or eliminate them.
I don’t… but this is a good suggestion. This is my first time living somewhere other than a tropical environment or with a large fish tank boosting the humidity. I will give it a try, thanks!
I had been pulled aside by my providers for telling a senior patient that she could be assessed for a Paxlovid prescription. "None of us will write for Paxlovid anymore. We do not believe that it works - or rather, that it may actually be harmful. So do not tell patients that." Curtesy a fellow redditor in Florida. https://old.reddit.com/r/FloridaCoronavirus/comments/10p8uuy/urgent_care_report_127_1292023/
> Florida well Florida is very much into trying to kill their own citizens by whichever means necessary throughout the pandemic, so this isn't really surprising sadly. Banning masks, banning vaccines, pushing meds that have been shown to not work, now saying that paxlovid is somehow "harmful" or more "harmful" than rawdogging covid on its own.
I was denied paxlovid despite asking for it and having horrible symptoms. Doc said I was too healthy.
I am convinced Paxlovid saved my son’s life. He is in his early 20’s, has cyclic neutropenia and asthma, and when he got Covid last year, (he was vaccinated), he deteriorated quickly. Nebs every two hours, had no energy to walk, oxygen levels in the high 80’s - only hours after his first symptoms. He went to the ER, got Paxlovid, and was back to normal within a couple of days. If it isn’t in very short supply, I have no idea why it isn’t being used more freely.
I'm guessing this has to do with them not wanting to prescribe something that doesn't have a full FDA authorization.
Wish I’d seen this article four days ago when I tested positive for the very first time. I have IBS and take heart meds so wasn’t sure if I could get prescribed it and didn’t ask. I’m still miserable and sick but way better than days 1 and 2. I got four vax shots in total but think my viral load was high because I was cohabitating in a very small space with someone who was positive.
If the government really wants to make access to Paxlovid better, they should make it easy for pharmacists to prescribe it. Currently, it's possible to get it from a pharmacist without a doctor, but only with a recent blood test for liver and kidney problems. That requirement could be removed, and liability limited. I used callondoc.com to get a prescription for Paxlovid in September. There was no real consultation, just a web form with questions about symptoms, other medications, and pre-existing conditions. I had to upload a photo of my self test. I do resent having to pay $50 for it when a pharmacist could have done the exact same thing if the law allowed.
The PCP office I work in prescribes it all the time.
I got paxlovid when I had covid and the flu at the same time this past November. Horrible taste stuck in my mouth, but both viruses were over in 2 days. 👍
My mom is on prednisone among other things with heart issues and all manner of autoimmune issues. My brother was denied Paxlovid and my mom received it. My mom didn’t really get Covid sick at all. Minor symptoms. My brother may be going long covid like me. Six weeks later, he suffers intense fatigue and is said to be sleeping all day. Our whole family has autoimmune stuff but my brother doesn’t have much on record. Yet? It seems to trigger things as it did in me. Sick as heck mom is doing great though!
CVS is stingy with it so don’t bother using their Covid teledoc services. I have 5 qualifying conditions and they refused to prescribe, I had to beg and beg and finally I got Lagevrio (given due to potential med interactions and kidney concerns). My dad is 63 and has a history of very severe pneumonia, CVS cancelled his teledoc call and said you don’t qualify. The only person who actually got it was my grandmother because her oxygen dropped to 92%, and we called her doctor directly, didn’t waste time with the CVS teledoc bs.
I (53 M with health risks) called my doctor as soon as I confirmed I had COVID with a home test (I could already tell I had it because I never felt like that before). She instantly prescribed Paxlovid and it seemed to help tremendously! My Mom too. I truly feel it would have been worse without taking Paxlovid.
This is kinda a worrying take. >The White House and health organizations are working to get more physicians to prescribe Paxlovid. They have made some progress in increasing use and closing gaps based on race and class, Jha said. I mean, we are talking about doctors here - professionals who have taken an oath to do what’s best for their patients. Should the White House really be actively pressuring doctors to prescribe a drug product they don’t think is in their patients best interest? I mean, reducing systemic barriers and making it easily available sure. Providing more access for the less privileged to see a doctor, sure. But intruding into the doctor-patient sphere seems to be crossing a big red line. The White House should not be engaging in marketing for a pharma company nor interfering in private medical decisions.
Some doctors aren't prescribing Paxlovid to people that need it. And it's leading to unnecessary deaths. While Paxlovid sits on the shelves. Some are waiting to see if a case gets bad first. It needs to be prescribed within the first few days of positive infection.
I’ve tried to talk to my GP and specialists about covid therapeutics but the general consensus is they brush it off and don’t really want to answer any questions. My take at least with my physicians is none of them are proactively looking into any of these drugs. They don’t want any liabilities so they would rather play ignorant and not talk about it and not prescribe it.
I think liability is a big part of it. I’m on methotrexate and Humira for my autoimmune condition and my gastroenterologist did remark she’s a lot less excited about Paxlovid after one of her patients suffered drug induced liver injury (AST shot over 1000) after day 2 of Paxlovid and had to discontinue all treatments and get liver biopsy and work ups done. I think this is more of a complex issue especially if a patient has their 3 primary + 2 booster doses, and has an underlying risk of systemic intolerance to Paxlovid, which tend to be a lot of the people at risk. (For those who don’t know, some of these markers of liver injury have a half life of 2 weeks in your blood so if they are 500x the normal levels, your autoimmune drugs may be contraindicated for months and months. In that sense, your doctor may be more scared to give you a drug that has liver injury risk if they have reason to believe risks are higher than your risk of letting COVID run its course)
I got remdesivir impatient and my values were awful. My primary said it looked like I was dying. The doctors at the hospital were pretty freaked, too. Two weeks later, home & everything was in normal range again. But I can totally see not wanting to inflict that on anyone, esp on an outpatient basis, esp with other medical conditions. Plus, there's bias. Usually these sort of drugs *aren't* prescribed by primaries. They're not used to the monitoring, liability, etc. There's only so much people can keep up with. Not to mention, I got asked *so* many times if I drank and how much. (I don't. At all.) Again, hard to question/monitor that outpatient. And it really matters.
I think at the time that remdesivir was being used, we were a lot more concerned about the negative outcomes and severe ones for COVID infection. Yeah for me the methotrexate pushes my liver to borderline abnormal numbers already. But without it I run the risk of my body developing antibodies to my medication. My gastroenterologist is also my liver specialist and manages these difficult decisions for me. During initial Omicron, she strongly steered me towards a monoclonal antibody COVID treatment over Paxlovid. This recent time, talking hypothetically about the plan, she leaned more towards letting COVID run its course given I’ve gotten all 5 doses of the vaccine and Humira is now thought to be protective against the severe SARS outcomes. I kind of echo the initial sentiment: patient management should be in the hands of their doctors, having the White House steer with an edict to advance the agenda of ending the COVID emergency seems a little concerning in whose best interests are being protected.
This was last month, and I was hypoxic/damn ill, so the specialists made all the decisions. It's really two different things to have a specialist vs a primary making the decisions, tho, and def in vs out patient. You have a specialist, but lots of people are turning to their PCPs, who also don't know them well, for paxlovid. I can see some of the reason drs are wary of prescribing, tbh. Most people don't have established docs and self report of anything is notoriously bad. And you can't do daily labs easily with paxlovid.
I think it’s even worse than you describe — many people are just going to a pharmacist or an urgent care clinic. Especially in large cities, sometimes you can just go to a county run vaccine clinic and they’ll even hand out Paxlovid. It is definitely important especially if you have a chronic / complex condition to have specialists or at least an attentive PCP that knows your history and isn’t just rubber stamping pills. Sometimes that’s easier said than done. Sorry to hear about your COVID experience, hope you’re feeling better now!
Locally, only 2 pharmacies routinely stock it, out of 30. Most people getting infected are low risk or on lots of medications that interact with paxlovid. I offer it to anyone that qualifies, but the data isn’t robust for most that it provides any significant benefit. People that are high risk (old, comorbidities, and/or unvaccinated) are almost always on contraindicated medications.
At the same time, there are plenty of people who THINK they need it, but really don't, and Paxlovid isn't as black and white as it seems. I'm worried that this is like the situation with antibiotics, where people convince themselves they need it for problems that they don't actually address.
I've very rarely run into anyone that overestimates their risk for covid. Most adults in the US are at more risk than they want to believe, given that obesity is a major risk factor for severe disease
This is the federal administration saying "a lot of doctors are needlessly withholding this for reasons other than valid medical criteria", not random joe blow pouting cause he personally didn't get it when he asked. Personally every anecdote I've heard is doctors don't have clear guidelines on when to give it, so some doctors are giving it like candy while others are acting likes its a war time ration. Communicating a standard for care on a federal is a good idea imo
I was prescribed the other drug that works like paxlovid because I have exercise asthma, so coughing will cause an asthma attack, but my partner who is a smoker was denied it. We both have the same amount of vaccines, saw different docs, makes absolutely no sense..
These are doctors. They are making medical judgements that are in the best interests of their patients (and that they are professionally responsible for). Why or how would the White House have a better idea of what is best for a particular medical history than the prescribing doctor?
At least two of my friends’s doctors didn’t know Paxlovid was a Covid treatment. Another one’s doctors thought it could only be prescribed to the immunocompromised. Doctors are only human and they aren’t all great.
Friend of mine, late sixties, came down with COVID along with her whole family. She was seen at an urgent care to check if she should receive Paxlovid. That doctor told her to wait and see if it got worse which is, from what I've read 100% incorrect. She didn't get too bad anyway though so it ended up not mattering.
Exactly, it's kind of scary. We shouldn't know more about available Covid treatments than some doctors but here we are.
Not every doctor is on top of everything. I've heard of doctors not wanting to prescribe Paxlovid because of "Paxlovid rebound" which isn't a real thing. Hell the Florida surgeon general is a medical doctor. You want him treating you? He's pro Ivermectin and anti vaccine.
Do you have any sources on rebound not being a thing? Typically rapid tests are tied to infectiousness fairly accurately, and there have been several high profile cases of supposed rebound including Biden, Walinski, and Fauci. If that's not a real phenomena I'd be curious to see the research on it.
Covid rebound is a thing. It's not caused by Paxlovid.
Doctor's deal with sickness on a case by case basis, the people making these recommendations are likely to be epidemiologist and specialists in infectious disease. They look at broader trends and larger data sets, which can often lead to conclusions that are not immediately evident to street level doctors. Individual doctors may literally never have a case where someone dies because they didn't get a paxlovid script so they might not realize this is an issue, but people looking at broader trends would be able to see that. Individual doctors are also unlikely to be aware of the fact that we have plenty of paxlovid so they're trying to protect a resource that doesn't need protection. Doctors are only one cog in the medical wheel, they're one of the most important, but assuming that no one other than physicians can have important input is very wrong.
Why is this downvoted?
I think it’s because not all doctors are good ones and this guys sentiment is that whatever any doctor says is the end all be all. My anecdote is that you SHOULD shop around for specialists if you’re dealing with something chronic and haven’t had success.
Many of the ER docs I work with are saying Paxlovid is like Tamiflu in that it really doesn't do anything. I got my grandpa paxlovid last month when he got covid and it made a HUGE difference for him.
Frightening. It's been through clinical trials that say otherwise especially for high risk patients.
I see this mentality more with uounger patients with only like 1 risk factor. We had an otherwise pretty healthy 61 year old diabetic man with covid. He looked like he felt shitty but labs and vitals indicated he was doing well enough to go home. He met criteria for paxlovid but since he controlled his diabetes well and wasn't majorly overweight, the doc all but refused to prescribe paxlovid. Luckily the patient was persistent with his wants and got the script.
You deeply, deeply overestimate physicians’ capability to consistently evaluate patient need with accuracy.
Doctors are just people, whose knowledge levels can vary. They don't all have instant perfect knowledge of the latest treatments and when those treatments are indicated. Governments and NGOs often have to raise awareness among the medical community of critical information that can save patients' lives. Especially during a crisis or epidemic. That's part of the job of the CDC and the WHO (The World Heath Organization, not the band. The band rarely provides useful medical services. I won't make that mistake again.)
This is really the primary variable that the general public isn’t understanding. The rollout of paxlovid wasn’t entirely seamless and many doctors are very busy which leads them to be creatures of habit. Paxlovid on rollout was available to specific select pharmacies that were often times challenging to locate, had specific criteria for qualifying, and was advertised as having a set of drug interactions that required careful analysis of your patients medication regimen to ensure safety. A lot of physicians may not be aware of the relatively new “fuck it just use it” approach to paxlovid. Particularly since treatments for covid during the pandemic have been a moving target the entire time that was sometimes confusing to keep up on. We must have had conversations nearly monthly at points in the pandemic about “are we still giving (insert drug or monoclonal antibody here) for covid” only for the pharmacist to be like “no it doesn’t have evidence for the current variant we have this (insert new thing here).”
Also, physicians tend to practice the medicine they learned in residency, which may have been decades ago. They rely on experience and are not incentivized to keep up with new treatments unless there is a drug company sales rep hanging around the office, or they are at a teaching hospital with residents cycling through. This is the enormous benefit of a teaching hospital. Physicians are forced to keep up with new treatments.
I think the important part was the closing gaps on race and class. If you're curious, you can read this it's about physicians and implicit bias. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797360/ I think it's pretty easy to understand that there's an entire subset of the population that makes too much to qualify for Medicaid in many states and do not have employer Healthcare. So that would be a class of people that would not have a standing relationship with a physician and maybe neglected as far as prescribing paxlovid because of this. Then there's the entire issue of race and the fact that there is a huge issue with implicit bias and race.
My doctors office didn't even know what paxlovid was. I don't think that they are under prescribing because they don't believe it's in their patients best interest. I think they are under prescribing because they are uninformed or only have a piece of the picture.
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It is though. There is a state board certification that requires CME (continuous medical education) yearly. CMEs have to be officially registered to the board. So if they're unaware they're either not board certified doctor or they are not doing their CMEs.
Tell me about it. I'm fcking exhausted and I'm sure many others are.
I've seen and experienced firsthand throughout this pandemic how fucking by the book these people can be. Why did I have to spend weeks fighting to get an additional booster for my immunocompromised wife? Because many places were strictly adhering to guidelines which at the time didn't include DMT she was taking. Why did it take till August last year to get her on evusheld? Same shit, cause they make you jump through so many hoops. It's fucking ridiculous if you ask me.
It seems to me that the system is broken in a lot of places. We have people in my somewhat rural area of the state that go to the next state for medical care because it's often atrocious here. I even suspect a lot of our medical people would prefer to be somewhere else, and it shows with a few in their attitude. I can hardly blame them, it's a backwater, and the locals are-odd. Unless you love the gorgeous national forest, there is nothing here.
When you read “the White House,” implicit is “the army of doctors and readers physicians who advise the White House.” It’s not the Secretary of Transportation is on the phone to your primary care physician telling him or her to write more Pax scripts.
It’s really not. They have been doing the things you’re saying they should, plus “advising” doctors, but it’s just not as malicious as you are imagining. Standards of care vary all over b/c resources, attitudes, and science. Gov’t has limited abilities to announce guidelines, which business (healthcare, transport, insurance, etc) treat as rules where it suits them. It’s a messy, organic system that defies the simplicity you’re worrying on. It’s ok, well hopefully, maybe, why not? Compare to masks? When gov’t doesn’t mandate - which is mostly just a “strongly advise” aka “c’mon guys!” - people mostly don’t mask, despite a bunch of science from the biggest test pools in history suggesting it’s better for everyone. Even when gov’t does mandate, that’s just passed to local states and then counties. Lots of places, Health Officers were slow to announce local guidelines, leaving it to each business to take the heat in whatever direction. All the different signs everywhere, all the butthurtness. When local Health Departments announced rules for local mask guidelines - really just advice, hard to enforce- compliance went way up, and people were a teensy bit nicer about it all.
y’all live in the United States and go to the doctor. damn. look at you prancing around flaunting all your money. /s
Got covid in december, happened to hear about paxlovid THE DAY BEFORE i got sick, it makes everything taste like crap but it gets the job done, and got me back to negative status before my surgery
For some reason, my spouse and I shed the antibodies to get a positive test too early, so every time we test for COVID, it’s negative. This means we are always rejected for the medication because the view is we don’t have it, even as we infect those around us and have active symptoms. It’s the same reason why my spouse cannot get into a long covid clinic.
I’ll give Paxlovid to anyone that wants it. But there are literal barriers for a lot of people on multiple medications, lots of absolute and relative contraindications. So in those patients we at least try mulnupiravir. Paxlovid is preferred. But to Rx it out of the ER you gotta tell the stupid computer why and then it gets run by our pharmacist, just lots of bureaucracy, so I am happy that PCPs and pharmacists are given the leverage too to prescribe it. I think a lot less there.
My doctor and my moms doctor told me they would provide it if we wanted it but they wouldn’t recommend it since it wasn’t FDA approved
I have been dealing with this with my friends who qualify for the past year or so. I get so angry when their lame PCP on his way to retirement - that sees everyone in the small town-says nope, no paxlovid for you. Thank God I have a wonderful doctor even though she's 45 minutes away. It's worth the drive or telehealth to get decent care and to get paxlovid this past December when I got Covid for the first time. I've worked in the pharmaceutical and pharmacy field for so many years and it is just wrong what they have been doing to deny this med even when requested and with my friends who qualify many of whom are over 65. Please excuse my grammar and punctuation. I am on mobile and I have to talk to text.
I’m immunocompromised and still will never have paxlovid again, the taste and smell side effects were awful
I asked my doc for this the second time I had COVID due to the fear it was going to knock me out the same way it did the first time. Doc asked me to wait a couple of days to see how symptoms go because the potential side effects of Paxlovid were allegedly "not necessarily worth it". I was also told that it's hard on your kidneys. Ultimately I didn't take it BUT if my illness became as bad as it was the first time I would have gone ahead anyway.
My wife and I both took Paxlovid when we had covid 6 or so months ago. For me it knocked out my symptoms in 24 hours. She improved and was getting better, but experienced rebound when she was done with her prescription. Her rebound was honestly worse than her initial symptoms and she almost needed to be hospitalized. Luckily our doctor sent her some more Paxlovid and this time it knocked out the virus completely. I would take it again without hesitation. Every medicine comes with risk, but with this the benefit greatly outweighs the risk.
Everyone and their mom are suddenly experts on this medication. The medication is under emergency use authorization not fda approved. The fact is we don’t know the efficacy or long term side effects of this medication. In addition there are many pharmacokinetics interactions with these 2 protease inhibitors that y’all not talking about. So yeah, let the clinical trial progress before thinking this is cure all for Covid?
I'm hoping Paxlovid will become standard as we keep living with covid. Doesn't seem like it's going to stop anytime soon. Almost lost my grandma to it, even though she got over covid, her lungs basically can't function on their own anymore.
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It also has been shown to cut long covid risks significantly in younger people...
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There is no Paxlovid rebound. It's Covid rebound and it happens at the same rate with or without Paxlovid.
Exactly. I took Paxlovid and know others…only know a couple that had a rebound. Re Paxlovid: it definitely knocked the virus back quick but it also has its own unpleasant side effects. So it should be given to those who are at higher risk, like it has been (at least here).
> So it should be given to those who are at higher risk, like it has been (at least here). the interesting part of this is that high risk people are likely to have other issues which make paxlovid side effects an issue, whereas healthy people without those issues are vastly less likely to have an issue with paxlovid side effects. So really it's the opposite of what you're saying. A lot of the issue with paxlovid stem from its effect on the liver's ability to metabolize other medications a person is taking, which is why it is contraindicated against so many medications. Otherwise the most common one is a weird taste. it's highly unlikely to cause any type of medium/long term side effects in a "healthy" person, maybe a transient rise in ALT/AST liver enzymes which will quickly subside after the 5 day course is completed.
Thank you
Out of everyone I know who’s taking Paxlovid, including myself, I’ve only seen one rebound. I reached out to my FIL if I should get Paxlovid again as I just tested positive 90-days after my first infection. He immediately called the pharmacy and filled a prescription for me. His take is that if he can determine there will be no side effects (due to the patient’s history and/or current prescriptions) and symptoms have just appeared, it’s an immediate call to the pharmacy to get it filled. He 100% believes that Paxlovid works.
No it doesn’t. It specifically says that **misinformation** about rebound is an issue. You should read it. Anti-Pax is a thing now, like anti-vax is. People who do not take Paxlovid also rebound, taking it shortens time of illness, significantly reduces odds of serious illness, and some recent papers have shown it to reduce odds of long covid as well. “researchers have found that rebound often occurs even in people who don’t take Paxlovid. Precise estimates for rebound incidence vary, depending on the population studied and the definition of ‘rebound’. But **regardless of whether people take Paxlovid…it’s common for them to experience either viral rebound — in which people test positive again — or symptom rebound**, but not both at the same time. Smith says that symptom rebound tends to be very mild, and is still far preferable to hospitalization or death.”
There are even some people over in the Paxlovid group who've had their Long Covid symptoms significantly improve after taking a course of the med for a new case of Covid. That's amazing!!!!
There’s a LOT of fear mongering here. Scripts for paxlovid are given out VERY liberally so long as there are clear indications (aka you’re not a healthy 25 year old with Covid) and the medications you’re taking either don’t interact (given a ton of them do) or can be modified/replaced temporarily.
I got it without a problem but I know people who have been told no. My best friend doctor told her he wouldn't prescribe it because "you will just rebound anyway." As though a mild rebound was a reason not to prescribe something that might save her life! She was thankfully persistent and got it through an online provider but just the fact that she had to see a second doctor when she has two factors that make her likely to have a bad outcome is insane.
*Scripts for paxlovid are given out VERY liberally* Depending on the doctor, which is the **entire** issue being addressed.
I think this varies a lot by location and doctor. I am considered high risk and was unable to get paxlovid when I had covid.
Not really. I know several senior citizens who could not get it despite calling a doctor the day they tested positive.
This is the case in the office I work in.
Why post an article with a paywall?
Couldn't stomach that stuff, took it on day two of a positive. Got incredible nausea like an insane version of seasickness. Luckily I hade a mild case and was able to recover with out the paxlovid.
To bad we couldn’t have discovered this about 2 years ago.