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COVID-19 2nd wave - Texas only - Stats and such


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10 hours ago, Gatorubet said:

so - you’re trying to say there is no global warning because you went skiing this year?

I'm saying I don't know of (or even heard indirectly of) a single person in real life that is "low risk" and has had what I would consider a "bad" COVID experience since the OG Delta 2021 wave and the people I'm thinking of that had their ass kicked back then were not vaccinated.   I think for those loaded with Covid antibodies (as almost everyone other than Longhorn94 is, whether natural, vax or for most, both) there is likely material more value to getting a flu vaccine as the flu is much more likely to kick your ass.  Like I said, it was initially an evaluation of some in our society that have seemingly lost the ability to evaluate risks post COVID but have clearly touched a nerve.  

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1 hour ago, Skipper said:

I'm saying I don't know of (or even heard indirectly of) a single person in real life that is "low risk" and has had what I would consider a "bad" COVID experience since the OG Delta 2021 wave and the people I'm thinking of that had their ass kicked back then were not vaccinated.   I think for those loaded with Covid antibodies (as almost everyone other than Longhorn94 is, whether natural, vax or for most, both) there is likely material more value to getting a flu vaccine as the flu is much more likely to kick your ass.  Like I said, it was initially an evaluation of some in our society that have seemingly lost the ability to evaluate risks post COVID but have clearly touched a nerve.  

So you are saying there is no global warming because you went skiing. Got it!   

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21 hours ago, Skipper said:

Just heard the craziest COVID people I know (somewhat friend of my wife and her husband) contracted COVID for a documented 4th (or maybe 5th?) time (I'm guessing they test about 50X per year with every sniffle). Under 40, completely healthy, have gotten every booster within days of it being available, never had an issue with actual COVID beyond a minor inconvenience (including multiple confirmed infections before Paxlovid existed), and I heard they immediately went and got a Paxlovid prescription in a panic.  Just blows my mind how some people loaded with antibodies and actual experience with the disease still fear it like its April 2020.  It just broke some people.

I get the flu shot every year. If I contracted the flu, I'd still go get TamiFlu. 

I generally don't see the issue with going to get an approved prescription that lessons the symptoms/severity of the infection if you contract the virus. 

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5 hours ago, Skipper said:

I'm saying I don't know of (or even heard indirectly of) a single person in real life that is "low risk" and has had what I would consider a "bad" COVID experience since the OG Delta 2021 wave and the people I'm thinking of that had their ass kicked back then were not vaccinated.   

Quote

In the first four months of 2023, the reported COVID-19 death toll was almost 37,000, a number that rivals deaths from drug overdose during the same time period. However, as 2023 continued, COVID-19 mortality declined precipitously from earlier in the year. Through September 9, 2023, the provisional count of all US deaths involving COVID-19 was 48,615 compared to over 200,000 during the same time period in 2022. If current trends continue, the death toll for 2023 should be under 70,000 compared to 246,166 in 2022, 463,267 in 2021, and 385,676 in 2020. 

I’m not sure why you think 70,000 dead people is a nothing burger. I know you talk about low-risk versus high-risk people. Where you swing and miss is your belief that the continued vaccination of low-risk people will have no impact on, or decrease the number of deaths in high-risk people.  

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50 minutes ago, Gatorubet said:

I’m not sure why you think 70,000 dead people is a nothing burger. I know you talk about low-risk versus high-risk people. Where you swing and miss is your belief that the continued vaccination of low-risk people will have no impact on, or decrease the number of deaths in high-risk people.  

Nice red herring in the first sentence.  If you want a substantive response, I don't think I took a position in posts above on low risk vaccinations.  But you are correct in your assumption that I see no real benefit at an individual level (in particular given in many cases negative vaccine reaction is similar to actually contracting the disease).  I'm not sure I agree with your assertion that vaccinating low risk people materially impacts death or severe disease in high risk people.  Do you have any data to back that up? Because I don't recall seeing data that "cases" or "infections" are materially mitigated by a vax since the O.G. vax (i.e., until it mutated via Delta).  It's a big reason why way back in 2021 I was pro vaccine mandate until I wasn't.  Because post Delta the data did not support that vaccination was materially reducing the spread (it was still reducing severity, so it was still a decent debate at the time given hospital capacity issues).   Do you have new data that supports your position? I know how much you hate anecdotal data but most of the (few) people I know who have actually gotten a vax in the past year also got Covid in the past year (both parents, aunt + wife's low risk friend that led to my initial response).  Also observational but Anastasis made the point above he sees no real correlation.   To be clear, I'm entirely supportive of my 70+ parents getting annual vaccinations.

As you admitted, the death data posted above is not responsive to actual points made that got you worked up.  But since you like to make global warming analogies if anyone makes anecdotal observations, here is hospitalization data for under 40 which is a better reference for what we were actually talking about (i.e., risk evaluation).   Note that this data does not net out high risk under 40 (which I would expect make up the majority of hits) and also doesn't appear to distinguish "with COVID" vs. "for COVID", yet even without those potential (material) differentiators, still proves the point about risk evaluation quite nicely IMO.

CDC COVID Data Tracker: Hospital Admissions

 

 

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On 2/8/2024 at 3:17 PM, Skipper said:

Nice red herring in the first sentence.  If you want a substantive response, I don't think I took a position in posts above on low risk vaccinations.  But you are correct in your assumption that I see no real benefit at an individual level (in particular given in many cases negative vaccine reaction is similar to actually contracting the disease).  I'm not sure I agree with your assertion that vaccinating low risk people materially impacts death or severe disease in high risk people.  Do you have any data to back that up? Because I don't recall seeing data that "cases" or "infections" are materially mitigated by a vax since the O.G. vax (i.e., until it mutated via Delta).  It's a big reason why way back in 2021 I was pro vaccine mandate until I wasn't.  Because post Delta the data did not support that vaccination was materially reducing the spread (it was still reducing severity, so it was still a decent debate at the time given hospital capacity issues).   Do you have new data that supports your position? I know how much you hate anecdotal data but most of the (few) people I know who have actually gotten a vax in the past year also got Covid in the past year (both parents, aunt + wife's low risk friend that led to my initial response).  Also observational but Anastasis made the point above he sees no real correlation.   To be clear, I'm entirely supportive of my 70+ parents getting annual vaccinations.

As you admitted, the death data posted above is not responsive to actual points made that got you worked up.  But since you like to make global warming analogies if anyone makes anecdotal observations, here is hospitalization data for under 40 which is a better reference for what we were actually talking about (i.e., risk evaluation).   Note that this data does not net out high risk under 40 (which I would expect make up the majority of hits) and also doesn't appear to distinguish "with COVID" vs. "for COVID", yet even without those potential (material) differentiators, still proves the point about risk evaluation quite nicely IMO.

CDC COVID Data Tracker: Hospital Admissions

 

 

What is that saying?  Better to be silent and... or something?

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2 hours ago, Skipper said:

Nice red herring in the first sentence.

It's a big reason why way back in 2021 I was pro vaccine mandate until I wasn't.  Because post Delta the data did not support that vaccination was materially reducing the spread (it was still reducing severity, so it was still a decent debate at the time given hospital capacity issues).   

Quote

 I don't know of (or even heard indirectly of) a single person in real life that is "low risk" and has had what I would consider a "bad" COVID experience since the OG Delta 2021 wave 

So, my response was not so much a red herring as my observation that 70K deaths will very likely include some percentage of low risk deaths.  A smaller percentage to be sure.   But I got my Surly on to point out that low risk covid deaths - of whatever numbers - could accurately be seen as a “bad Covid experience.”

To your point, the last time I hit Pubmed up I saw that vaccination reduced alpha variant upper respiratory tract viral load - and led to reduced household transmission by half.     The science is what it is, and if you are telling me that the newest variants do not show a reduced viral load upon vaccination - then I would readily consider a conclusion suggesting that non-vaccination among the low risk group who become infected will not cause a greater risk to high risk members - at least, not a greater risk due to a non-vaccination (thus not subjecting high-risk people to a greater chance of getting infected from a preventable higher viral load)

Now, as we have seen the multiple mutated variants since 2020, it might be naïve to think that future variants will never react In a manner that leads to increased viral load of that strain in the non-vaccinated.    

Given that real possibility, being unvaccinated is playing Covid variant Russian roulette with high risk peoples’ lives.  Which is sorta why we have vaccines

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Look, if you want to chase down every updated booster, do it. If you get COVID and want to take paxlovid, do it. If you want to promote all that to other people with solid data, do it. Just can we please not start up again ever with taking away people's jobs and livelihood and ability to put a roof over their family's head under the guise of improving public health. That part was kinda wild.  

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18 minutes ago, Anastasis said:

Look, if you want to chase down every updated booster, do it. If you get COVID and want to take paxlovid, do it. If you want to promote all that to other people with solid data, do it. Just can we please not start up again ever with taking away people's jobs and livelihood and ability to put a roof over their family's head under the guise of improving public health. That part was kinda wild.  

While it is a balancing test, I’m in favor of people not getting vaccinated if the people who don’t get vaccinated wind up dying a whole lot more.  The balancing part was the unfortunate fact that some vaccinated high risk people died because the unvaccinated helped the spread of much more communicable higher viral loads by virtue of their non-vaccination.  

The fact you say “guise of public health” about efforts to prevent the spread of a disease that has killed over a million Americans so far is so - you. 

 

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33 minutes ago, Anastasis said:

Just can we please not start up again ever with taking away people's jobs and livelihood and ability to put a roof over their family's head under the guise of improving public health. That part was kinda wild.  

Has that even been discussed again? What are you even worrying about?

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32 minutes ago, jimmyjazz said:

I'd like to see a study that shows the shutdown had no effect on the death toll in the United States.

I’m not gonna look at 1 billion posts to find it, but I thought there were some studies showing more deaths per capita in MAGA land than in blue states.   I may be early onset something. 

Obligatory:

IMG_2258.webp.85673b71ce56cf10c84136a0d5da7261.webp

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12 minutes ago, Gatorubet said:

I’m not gonna look at 1 billion posts to find it, but I thought there were some studies showing more deaths per capita in MAGA land than in blue states.  

Absolutely true, but I believe that was more correlated with vaccine uptake.  I don't know how one would prove that the shutdowns "worked", but maybe there were local/regional differences that could be parsed.  For one thing, the shutdowns were before vaccines were available, so that would help clear up the data.

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1 hour ago, Gatorubet said:

The fact you say “guise of public health” about efforts to prevent the spread of a disease that has killed over a million Americans so far is so - you. 

 

And I guess it is so - you - to fail to appreciate the fact that public health is a far broader concept than just COVID case counts and tenuous epidemiological justification, and includes cross cutting concepts such as the broad impacts of social determinants of health such as housing, food, and financial security. The whole vax at threat of losing your job/livelihood approach was counterproductive as a public health tactic on many levels.  

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3 hours ago, Anastasis said:

Look, if you want to chase down every updated booster, do it. If you get COVID and want to take paxlovid, do it. 

That's pretty much my stance. The only thing I took issue with was when Skipper started up on his diatribe about his wife's acquaintances, who he claims are "low risk" without any claims to having a background in healthcare or having intimate knowledge of those people's medical backgrounds, getting boosters and taking Paxlovid. The dude was just flat-out ragging on them and questioning their brain functions.

Quotes from the previous page from Skipper. Basically, my response was to mind his own fucking business. Who the fuck is he to say what they do when it doesn't affect him so far as I know in any matter whatsoever?

And why do I care about him taking digs at their mental capacity? Because I don't want some Surly poster (or lurker) to have second thoughts for whatever reason about whether they should go ahead and just get the damn booster just to be on the safe side.

 

See Skipper's posts below:

Quote

Just heard the craziest COVID people I know (somewhat friend of my wife and her husband) contracted COVID for a documented 4th (or maybe 5th?) time (I'm guessing they test about 50X per year with every sniffle). Under 40, completely healthy, have gotten every booster within days of it being available, never had an issue with actual COVID beyond a minor inconvenience (including multiple confirmed infections before Paxlovid existed), and I heard they immediately went and got a Paxlovid prescription in a panic.  Just blows my mind how some people loaded with antibodies and actual experience with the disease still fear it like its April 2020.  It just broke some people.

Quote

I don't "care" per se.   It's an evaluation that COVID has completely broken some people's brains (i.e., Exhibit A of absolute "lowest" risk (young, healthy, 10+ combined natural/vax antibody and T cell memory creating exposures with no remotely concerning impact to date) yet still fear it as though they are high risk without any ability to differentiate or analyze that distinction). I can't imagine a well informed Dr. would actually prescribe a prescription drug targeted at high risk individuals in this scenario (but any doc in the box quack can obviously if you ask for it). 

 

 

 

Addressing you now, Skipper.

6 hours ago, Skipper said:

Nice red herring in the first sentence.  If you want a substantive response, I don't think I took a position in posts above on low risk vaccinations. 

Yeah, you did. See your remarks above that I quoted for Anastasis.

 

Quote

But you are correct in your assumption that I see no real benefit at an individual level (in particular given in many cases negative vaccine reaction is similar to actually contracting the disease).  I'm not sure I agree with your assertion that vaccinating low risk people materially impacts death or severe disease in high risk people.  Do you have any data to back that up? 

Do you have any data to back that bolded claim up?

Look, man, I haven't kept track of any of this shit since my first "booster," which I think would've been in October/November 2021, around six months after the initial jab. I can't recall because I lost that card a good while ago.

I just don't know why you decided to come in here and start talking shit about people getting shots they think/feel might help them if they come down with it again. If there's data that shows that the "many cases negative [of] vaccine reaction is similar to actually contracting the disease," I'll back off. Also, please specify what you mean. Is it the share of negative reactions to vaccinations versus the share of negative reactions to the virus for "low-risk" adults (e.g., for every 100 vaccines given, there are five negative reactions)?

Or is it that you've just heard of some people having negative reactions? Again, I haven't followed this in a very long time and could've missed something. Please, cite sources.

Edited by bolverk
My browser gets glitchy sometimes and adds these strike-thrus. No idea why.
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God damn, make one fly by statement about a nutty person (in my opinion which I stand by) and the fucking Covidian Cloak Roomers swarm. Made my points but out of this convo.  You guys have fun.

Edited by Skipper
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8 minutes ago, Skipper said:

God damn, make one fly by statement about a nutty person (in my opinion which I stand by) and the fucking Covidian Cloak Roomers swarm. Made my points but out of this convo.  You guys have fun.

So, you were just talking shit out of your ass. Got it.

And because you apparently can't/won't back anything up, you just wave your hands and dismiss any potential criticism as coming from a "Cloak Roomer" rather than actually providing evidence. 

Skipper: "I'll spout opinions in 'News' all I want! Any request to provide empirical data will be deamed political!"

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And I guess it is so - you - to fail to appreciate the fact that public health is a far broader concept than just COVID case counts and tenuous epidemiological justification, and includes cross cutting concepts such as the broad impacts of social determinants of health such as housing, food, and financial security. The whole vax at threat of losing your job/livelihood approach was counterproductive as a public health tactic on many levels.  

The only reason that was even an issue is because somehow, we became utterly broken when it comes to vaccinations. They’re fucking vaccines. We’ve got a huge chunk of the population that opposes them with a wild-eyed zeal at a level that they couldn’t muster to oppose Satan if he appeared right in front of them. It’s amazing. It’s stupid. And everything else cascaded from that.
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28 minutes ago, Brisketexan said:


The only reason that was even an issue is because somehow, we became utterly broken when it comes to vaccinations. They’re fucking vaccines. We’ve got a huge chunk of the population that opposes them with a wild-eyed zeal at a level that they couldn’t muster to oppose Satan if he appeared right in front of them. It’s amazing. It’s stupid. And everything else cascaded from that.

And yet that still doesn't make covid vaccine mandates in the form they were implemented a good public health tactic. It only reinforces anti-vax sentiment among those people, and spills over into wrong-headed perspectives wrt other well established vaccines. But hey, we'll figure out a way to fucking politicize absolutely everything in our dysfunction.   

Edited by Anastasis
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And yet that still doesn't make covid vaccine mandates in the form they were implemented a good public health tactic. It only reinforces anti-vax sentiment among those people, and spills over into wrong-headed perspectives wrt other well established vaccines. But hey, we'll figure out a way to fucking politicize absolutely everything in our dysfunction.   

If your point is that we’ve devolved to a damned if we do, damned if we don’t “dichotomy” with regard to functionally every social act or public policy, I won’t disagree. We’re at a point where if someone from what is perceived to be “the other side” said “maybe you shouldn’t eat human shit,” there’d be a massive uprising of people publicly gobbling up turds in idiotic defiance.
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On 2/7/2024 at 5:41 PM, Incredulity said:

Only when they are masked alone in their car on the freeway.  That is a bridge too far.

Even this is fucking stupid because I can tell you personally I found myself driving several miles or even all the way home with a mask on without noticing. Because they literally weren't a big deal or uncomfortable unless you were making a point to be a giant fucking cunt about them. Or if you weren't a giant fat ass with a fat fucking head and fat fucking face stretching them to their limits. It killed me every time I heard some dumbass comment on what somebody else was doing in their own car like it was some great protest, never pausing to think they might have literally just forgot they had it on.

 

 

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2 hours ago, BearMace said:

Even this is fucking stupid because I can tell you personally I found myself driving several miles or even all the way home with a mask on without noticing. Because they literally weren't a big deal or uncomfortable unless you were making a point to be a giant fucking cunt about them. Or if you weren't a giant fat ass with a fat fucking head and fat fucking face stretching them to their limits. It killed me every time I heard some dumbass comment on what somebody else was doing in their own car like it was some great protest, never pausing to think they might have literally just forgot they had it on.

 

 

Great Job Reaction GIF

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16 hours ago, hornian said:

I get the flu shot every year. If I contracted the flu, I'd still go get TamiFlu. 

I generally don't see the issue with going to get an approved prescription that lessons the symptoms/severity of the infection if you contract the virus. 

There is zero isuue with it.  The issue with it is mandating it as if we are eradicating smallpox.

and "approved" is a freaking awesome descriptor.  In the beginning, it was much more, "We don't know shit, but this is what we have, so push it through.  What could possibly go wrong? Oh you don't believe our science?  Then fuck you.  You can't keep your job any more."

Yeah.  I don't understand why people pushed back on that at all...

There is zero issue at all with the vaccine being available for those who want it.  The flags are unnecessary. They were then too.

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1 hour ago, slorch said:

There is zero isuue with it.  The issue with it is mandating it as if we are eradicating smallpox.

and "approved" is a freaking awesome descriptor.  In the beginning, it was much more, "We don't know shit, but this is what we have, so push it through.  What could possibly go wrong? Oh you don't believe our science?  Then fuck you.  You can't keep your job any more."

Yeah.  I don't understand why people pushed back on that at all...

There is zero issue at all with the vaccine being available for those who want it.  The flags are unnecessary. They were then too.

I think you missed the point.
 

Why does it matter if someone gets Paxlovid when they test positive? How is that a sign they are acting irrationally?

therapeutics aren’t a cure, they aren’t a prophylactic, they don’t try to “eradicate”, they simply treat/lesson symptoms. 
 

It’s akin to saying someone who takes ibuprofen for a headache is crazy, because a headache won’t kill them, so why should they try to alleviate the symptom?

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Glad to see the tilting at windmills of covid denial is still there.  Look, for some reason this virus has the added benefit of breaking people’s brains, but I don’t think any rational person thinks it’s a bigger deal than the flu or RSV right now.  It’s anecdotal but in the groups that I’m in contact with, those two are much worse for two reasons.  One the symptoms are hitting harder, and two, people seem to think they should be careful if they pop for covid, but don’t think twice about going to work and mingling if they’re under the weather.  
 

As a result my office (I’m remote, fuck that) has had a wave of respiratory illness come through about a quarter of the dummies because they thought it was “allergies”.  These are college educated people.   
 

Our public health messaging sucks.

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1 hour ago, Hefeweizen said:

As a result my office (I’m remote, fuck that) has had a wave of respiratory illness come through about a quarter of the dummies because they thought it was “allergies”.  These are college educated people

Ughhh. I’m  hybrid but I don’t miss the quarterly office flu aka “it’s just allergies” 

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When my elementary school age kids got older, and absolutely since they both left home to go to college, my health increased dramatically. I would get flu at least once every flu season when they were kids. I have not had the flu for maybe 15 years since they left home. 

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22 minutes ago, Neonmoon said:

Ughhh. I’m  hybrid but I don’t miss the quarterly office flu aka “it’s just allergies” 

In my office, I see people don and doff masks regularly when they aren’t feeling great, or just returned from travel, or whatever reason. It’s nice to see folks thinking about being courteous to their coworkers. I hope it’s more common throughout the country now, and persists. 

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2 hours ago, hornian said:

I think you missed the point.
 

Why does it matter if someone gets Paxlovid when they test positive? How is that a sign they are acting irrationally?

therapeutics aren’t a cure, they aren’t a prophylactic, they don’t try to “eradicate”, they simply treat/lesson symptoms. 
 

It’s akin to saying someone who takes ibuprofen for a headache is crazy, because a headache won’t kill them, so why should they try to alleviate the symptom?

Totally cool with taking the Paxlovid.  100%.

I don't have a problem with what someone else decides to do for their own health.  I don't feel my posts have been inconsistent with that.

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9 hours ago, BearMace said:

Even this is fucking stupid because I can tell you personally I found myself driving several miles or even all the way home with a mask on without noticing. Because they literally weren't a big deal or uncomfortable unless you were making a point to be a giant fucking cunt about them. Or if you weren't a giant fat ass with a fat fucking head and fat fucking face stretching them to their limits. It killed me every time I heard some dumbass comment on what somebody else was doing in their own car like it was some great protest, never pausing to think they might have literally just forgot they had it on.

 

 

Don't forgot that the people who found the most comedy in others having a mask on in their car are the EXACT same people who were quick with the "What good is a mask if you touch your face, readjust, or take it on and off 100 times a day?" 

The reality of other people not ripping off their masks in disgust the millisecond that they're out of the public eye doesn't compute with them.

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10 minutes ago, slorch said:

Totally cool with taking the Paxlovid.  100%.

I don't have a problem with what someone else decides to do for their own health.  I don't feel my posts have been inconsistent with that.

The post I originally quoted from @Skipper (the one that you quoted when responding to me) was calling the people he knew irrational for taking Paxlovid after they had been vaxxed, boosted, etc.

And since you were commenting about on that and talked about irradiating covid instead of using a therapeutic to treat symptoms, it sure seemed like you either missed the point (intentionally or unintentionally), or were supporting the original comments that I was responding to. 

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10 hours ago, Brisketexan said:


If your point is that we’ve devolved to a damned if we do, damned if we don’t “dichotomy” with regard to functionally every social act or public policy, I won’t disagree. We’re at a point where if someone from what is perceived to be “the other side” said “maybe you shouldn’t eat human shit,” there’d be a massive uprising of people publicly gobbling up turds in idiotic defiance.

Our former first lady wanted people to eat healthier and drink less sugary shit. People were outraged because no one can tell them not to become obese diabetics.  Mostly because, team. 

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50 minutes ago, hornian said:

The post I originally quoted from @Skipper (the one that you quoted when responding to me) was calling the people he knew irrational for taking Paxlovid after they had been vaxxed, boosted, etc.

The RCTs that supported Paxlovid authorization included only non-vaccinated and previously uninfected individuals. The data for populations post vax or with prior infection are very limited, largely observational data. So if you want to take Paxlovid, go for it. I haven't had COVID, but if I did I might consider it. But understand that the data in seroconverted individuals is not particularly compelling. The data particular to vaxxed/boosted/updated etc. are basically on the same evidence level as the observational ivermectin garbage. Everyone appreciates the irrationality that revolved around the latter without much debate except on the fringes. 

Edited by Anastasis
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23 minutes ago, Anastasis said:

The RCTs that supported Paxlovid authorization included only non-vaccinated and previously uninfected individuals. The data for populations post vax or with prior infection are very limited, largely observational data. So if you want to take Paxlovid, go for it. I haven't had COVID, but if I did I might consider it. But understand that the data in seroconverted individuals is not particularly compelling. The data particular to vaxxed/boosted/updated etc. are basically on the same evidence level as the observational ivermectin garbage. Everyone appreciates the irrationality that revolved around the latter without much debate except on the fringes. 

WhO CaRes WhAt OthErS TaKeS to SToP CoViD??!!!11!!!!

 

HOrSEPaASteE!!1!!!111

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4 hours ago, Anastasis said:

The RCTs that supported Paxlovid authorization included only non-vaccinated and previously uninfected individuals. The data for populations post vax or with prior infection are very limited, largely observational data. So if you want to take Paxlovid, go for it. I haven't had COVID, but if I did I might consider it. But understand that the data in seroconverted individuals is not particularly compelling. The data particular to vaxxed/boosted/updated etc. are basically on the same evidence level as the observational ivermectin garbage. Everyone appreciates the irrationality that revolved around the latter without much debate except on the fringes. 

Are you living in 2021?

The FDA fully-approved Paxlovid in May 2023 (about 2 years after the original EUA) for "the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. FDA has determined that Paxlovid is safe and effective when used in accordance with the FDA-approved labeling."

And there was clinical trials for both patients with a previous Covid infection and vaccines prior to the full FDA approval. From the FDA's website:

Quote

Benefit of Paxlovid was observed in patients with prior immunity to the virus that causes COVID-19. Among patients in EPIC-HR who were antibody positive at trial enrollment, the risk of COVID-19-related hospitalization or death from any cause during 28 days of follow-up was 0.2% among the 490 patients treated with Paxlovid compared with 1.7% of the 479 patients receiving placebo. EPIC-SR was another clinical trial that enrolled vaccinated patients with at least one risk factor for progression to severe COVID-19. 

If a doctor prescribes it, they obviously think there is a potential benefit to their patient. These aren't people going to Tractor Supply and buying ivermectin, these are presumably people who go to a doctor, test positive for Covid, and getting prescribed a treatment, and then following the advice of their doctor. 

Again, substitute "flu" for Covid, and "TamiFlu" for Paxlovid, and no one would bat an eye. 

Edited by hornian
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2 hours ago, hornian said:

Are you living in 2021?

The FDA fully-approved Paxlovid in May 2023 (about 2 years after the original EUA) for "the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. FDA has determined that Paxlovid is safe and effective when used in accordance with the FDA-approved labeling."

And there was clinical trials for both patients with a previous Covid infection and vaccines prior to the full FDA approval. From the FDA's website:

If a doctor prescribes it, they obviously think there is a potential benefit to their patient. These aren't people going to Tractor Supply and buying ivermectin, these are presumably people who go to a doctor, test positive for Covid, and getting prescribed a treatment, and then following the advice of their doctor. 

Again, substitute "flu" for Covid, and "TamiFlu" for Paxlovid, and no one would bat an eye. 

EPIC-HR enrolled "high risk" (hence HR) patients from July - December 2021. If you had a previous covid infection or a vaccine, you were excluded**.  The drug worked and the study was published in the NEJM. I'm not sure this result generalizes to 2024. A second trial, EPIC-SR (standard risk) enrolled people who had a vaccine.  In preliminary results dribbled out by Pfizer, it was a no results study - there was no significant effect.  The full study has not been published anywhere that I can tell.  

**The numbers regarding antibody positive quoted in the FDA release, which came from Pfizer, appear nowhere in the NEJM article, nor the online appendix (that I can tell).  I'm not even sure how they would be collected since the trial specifically excluded folks with prior infection or vaccine uptake.  

 

 

Edited by bschoolprof
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IIRC, there was no statistically significant difference in primary endpoint among vaccinated individuals in EPIC-SR. EPIC-HR reported a statistically significant difference among the seroconverted subgroup, but it wasn’t a compelling clinically meaningful differentiation from placebo. The subgroup analysis showed quite clearly that the serologically negative were driving the outcome in the overall group. I’ll post the figure later, but suffice to say I could have tuned out in 2021 and woken up in 2024 and the evidence regarding contemporary use of paxlovid is no more compelling than it was in 2021. But again, do what you want. It don’t mean shit to me. Just don’t try running any number needed to treat or cost effectiveness analyses on the data, or you might stroke out. 

ETA: Here is the table from the NEJM paper on EPIC-HR. See the segmentation of results by serology status. Lower limit of the confidence interval for serologically positive individuals is -0.24% reduction compared to placebo, point estimate is -1.34%. While statistically significant, this is not a compelling clinically meaningful difference. The serologically negative new cases is where the effect is (-10.24% reduction, LLCI -7.21%. 

image.thumb.png.f55d5329f2d283ca7ece2f64769702ee.png

 

EPIC-SR results were not statistically significant, overall or for the vaccinated subgroup. Low event rates across the board caused them to stop the trial. Not sure where the peer reviewed manuscript can be found, but results from PFE website at https://www.pfizer.com/news/press-release/press-release-detail/pfizer-reports-additional-data-paxlovidtm-supporting:

An updated analysis from 1,153 patients enrolled through December 2021 showed a non-significant 51% relative risk reduction (treatment arm: 5/576; placebo: 10/569). A sub-group analysis of 721 vaccinated adults with at least one risk factor for progression to severe COVID-19 showed a non-significant 57% relative risk reduction in hospitalization or death (treatment arm: 3/361; placebo: 7/360).

 

Again, the data are not compelling. Is what it is. Do what you want with it. 

 

 

Edited by Anastasis
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1 hour ago, Anastasis said:

IIRC, there was no statistically significant difference in primary endpoint among vaccinated individuals in EPIC-SR. EPIC-HR reported a statistically significant difference among the seroconverted subgroup, but it wasn’t a compelling clinically meaningful differentiation from placebo. The subgroup analysis showed quite clearly that the unvaxxed were driving the outcome in the overall group. I’ll post the figure later, but suffice to say I could have tuned out in 2021 and woken up in 2024 and the evidence regarding contemporary use of paxlovid is no more compelling than it was in 2021. But again, do what you want. It don’t mean shit to me. Just don’t trying running any number needed to treat or cost effectiveness analyses on the data, or you might strike out. 

Yeah, I see my misunderstanding now.  I assumed they excluded you if you were seropositive.  But it looks like they only excluded you if you had a confirmed covid infection (I'm assuming a positive PCR test).

The numbers from the FDA don't tie out to the published study, which confused me, but I see now in the NEJM study they do list the results by serology status (i.e., antibody positive or negative). There is a significant effect for antibody positive patients, but it is small, which is probably why the EPIC-SR was a no results study.  There are two other RCTs I know of on Paxlovid that are null results beyond EPIC-SR.   

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4 hours ago, hornian said:

Again, substitute "flu" for Covid, and "TamiFlu" for Paxlovid, and no one would bat an eye. 

Recent meta-analysis of studies examining oseltamivir effectiveness at prevention of hospitalization: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2805976

 

Conclusions and Relevance

In this systematic review and meta-analysis among influenza-infected outpatients, oseltamivir was not associated with a reduced risk of hospitalization but was associated with increased gastrointestinal adverse events. To justify continued use for this purpose, an adequately powered trial in a suitably high-risk population is justified.

 

Another: https://www.bmj.com/content/348/bmj.g2545

 Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments

Results From the European Medicines Agency and Roche, we obtained clinical study reports for 83 trials. We included 23 trials in stage 1 (reliability and completeness screen) and 20 in stage 2 (formal analysis). In treatment trials on adults, oseltamivir reduced the time to first alleviation of symptoms by 16.8 hours (95% confidence interval 8.4 to 25.1 hours, P<0.001). There was no effect in children with asthma, but there was an effect in otherwise healthy children (mean difference 29 hours, 95% confidence interval 12 to 47 hours, P=0.001). In treatment trials there was no difference in admissions to hospital in adults (risk difference 0.15%, 95% confidence interval −0.91% to 0.78%, P=0.84) and sparse data in children and for prophylaxis. In adult treatment trials, oseltamivir reduced investigator mediated unverified pneumonia (risk difference 1.00%, 0.22% to 1.49%; number needed to treat to benefit (NNTB) 100, 95% confidence interval 67 to 451). The effect was not statistically significant in the five trials that used a more detailed diagnostic form for “pneumonia,” and no clinical study reports reported laboratory or diagnostic confirmation of “pneumonia.” The effect on unverified pneumonia in children and for prophylaxis was not significant. There was no significant reduction in risk of unverified bronchitis, otitis media, sinusitis, or any complication classified as serious or that led to study withdrawal. 14 of 20 trials prompted participants to self report all secondary illnesses to an investigator. Oseltamivir in the treatment of adults increased the risk of nausea (risk difference 3.66%, 0.90% to 7.39%; number needed to treat to harm (NNTH) 28, 95% confidence interval 14 to 112) and vomiting (4.56%, 2.39% to 7.58%; 22, 14 to 42). In treatment of children, oseltamivir induced vomiting (5.34%, 1.75% to 10.29%; 19, 10 to 57). In prophylaxis trials, oseltamivir reduced symptomatic influenza in participants by 55% (3.05%, 1.83% to 3.88%; NNTB 33, 26 to 55) and households (13.6%, 9.52% to 15.47%; NNTB 7, 6 to 11) based on one study, but there was no significant effect on asymptomatic influenza and no evidence of a reduction in transmission. In prophylaxis studies, oseltamivir increased the risk of psychiatric adverse events during the combined “on-treatment” and “off-treatment” periods (risk difference 1.06%, 0.07% to 2.76%; NNTH 94, 36 to 1538) and there was a dose-response effect on psychiatric events in two “pivotal” treatment trials of oseltamivir, at 75 mg (standard dose) and 150 mg (high dose) twice daily (P=0.038). In prophylaxis studies, oseltamivir increased the risk of headaches on-treatment (risk difference 3.15%, 0.88% to 5.78%; NNTH 32, 18 to 115), renal events with treatment (0.67%, −0.01% to 2.93%), and nausea while receiving treatment (4.15%, 0.86% to 9.51%; NNTH 25, 11 to 116).

Conclusions In prophylactic studies oseltamivir reduces the proportion of symptomatic influenza. In treatment studies it also modestly reduces the time to first alleviation of symptoms, but it causes nausea and vomiting and increases the risk of headaches and renal and psychiatric syndromes. The evidence of clinically significant effects on complications and viral transmission is limited because of rarity of such events and problems with study design. The trade-off between benefits and harms should be borne in mind when making decisions to use oseltamivir for treatment, prophylaxis, or stockpiling.

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