Currently had wife’s father’s place. We were supposed to go over Thanksgiving, but he got COVID.
The big question mark for me is New Years. Usually I get together with 4 friends from college + their wives + their kids. Didn’t do it last year and as of 3 weeks ago it was still on. But that was 3 weeks ago. Dunno if it’s going to be still on or not.
The White House said it is grateful that former U.S. president Donald Trump received and promoted getting the Covid-19 vaccine booster shot, press secretary Jen Psaki said.
The Republican former president recently said in an interview that he received a booster shot, and called the vaccines “one of the greatest achievements of mankind.”
“We’re grateful that the former president got the booster, and we’re also grateful that he made clear in a recent interview that they work and they’re safe,” Psaki told reporters in a briefing, Reuters reports.
U.S. president Joe Biden’s steps to backstop hospitals and distribute coronavirus test kits, however welcome, are too little too late to stem a surge of Omicron-related coronavirus cases over Christmas and New Year’s, health experts said.
A day after Biden outlined plans to distribute 500 million at-home coronavirus test kits, Anne Rimoin, a UCLA professor of epidemiology, praised his focus on testing, a “critical tool” that the United States was “woefully” behind on.
“Unfortunately, it’s late in coming and will be a small drop in the bucket compared to the tsunami of cases on the horizon.”
Scott Alexander (the Slate Star Codex guy; his day job is a psychiatrist) has a piece on fluvoxamine for COVID, basically in line with my thinking on it. The sub-quote here is from a piece in Vox:
[Professor Ed] Mills, who thinks that fluvoxamine and budesonide are both appropriate to prescribe to patients sick with Covid-19, compares public messaging on fluvoxamine to communications about Merck’s drug molnupiravir. The evidence for molnupiravir is in many ways weaker than the evidence for fluvoxamine, but molnupiravir was produced by a major pharmaceutical company that can shepherd it through the process of becoming a recommended drug. On a call last week, Mills said, the FDA told him “they don’t know how to deal with submissions where there isn’t someone to be responsible for it.”
That is, FDA procedures usually assume there is a pharma company sponsoring a drug. But fluvoxamine is cheap and off-patent and no pharma company is involved in repurposing it for COVID. Nobody has a procedure for a drug without a sponsor, so they won’t do anything.
FDA procedures assume that studies are biased against treatment benefit. That’s especially true in the type of study that found benefit for fluvoxamine, which was a part of a study looking at tons of different things at once. That person is way out over their skis.
Tried to get to liquor store to stock up for the holidays before everyone finished work. About 40-45 people in store. Me and one other person wearing a mask. Holidays going to be cray cray spread.
Fluvoxamine showed around 30% efficacy against hospitalization in an independent trial; molnupiravir showed roughly the same efficacy in a study run by the manufacturer. Fluvoxamine has a long history of usage and the risks (such as they are) are well-known; molnupiravir’s safety is still somewhat uncertain. There are also big concerns around the mutagenic effect of molnupiravir potentially generating new viral variants, I personally think it’s reckless to be using the drug when we have no clue how to quantify that risk. I don’t see how anyone can simultaneously argue that molnupiravir should get an EUA but that it’s unreasonable to prescribe fluvoxamine.
Edit: btw, Ontario now list fluvoxamine as a treatment to consider for COVID:
when including ER stays as hospitalizations with very fuzzy definitions as part of a trial that looked at a lot of different therapies. You can consider using it sure, but the RCT is not compelling evidence.
You’re also saying some factually wrong things.
Risk reduction for fluvoxamine for their weaker primary outcome was 32% reduction.
Risk reduction for molnupiravir for their much stronger primary outcome was 49% in NEJM.
These are not ‘roughly’ equivalent. They are especially not roughly equivalent when you look at the details of the RCT. The fluvoxamine trial includes anyone who stayed 6 hours in an ER in Brazil (I believe on the location). The molnupiravir trial looks at hospitalizations, which they define as staying in a hospital for 24 hours or more. This is a much better proxy for an oxygen requirement or clinical deterioration. Even if the numbers were the same, they wouldn’t be equivalent as they would have different end points.
Preliminary mortality data is better in the molnupiravir trial as well (9 deaths vs 1 compared to 25 vs 17).
No one is arguing that you can’t prescribe fluvoxamine. The evidence for it is not compelling whatsoever though, and saying it’s “roughly the same efficacy” is not supported by the evidence available.
One of the more frustrating things that is repeated is that doctors would somehow avoid drug X, Y, Z because of big Pharma. And I’m sorry if this is rude, but that has been utter horseshit from the beginning of this pandemic. All sorts of generic cheap drugs have been used and trialed from the beginning, including: azithromycin, hydroxychloroquine, dexamethasone, pepcid, ivermectin, vitamin c, fluvoxamine, and more.
If the data truly was compelling for fluvoxamine, it’d be used in a heartbeat. It’s not though, so it hasn’t become popular.
