Infirmary Medical Supplies

[CGBanks]

I've been reading about the increased number of passengers getting Covid on cruises.  I was wondering if any guests who tested positive onboard were given paxlovid by the infirmary ?  I've had my shots and booster but these don't help with the latest two variants.  We will actively making up because I am a "high risk" due to meds I take.  Thanks for any responses.

 

 

[canderson]

At this time, Paxlovid is not being administered on any Celebrity ship.

Some higher risk passengers are procuring a supply to take with them 'just in case', but not all physicians will prescribe for 'just in case'.

[mom says]

Previous thread:  

 

[Arizona Wildcat]

Am 74 fully vaxxed and boosted primary doctor sort of laughed when asked about Paxlovid.  Same for DW who has asthma that is under control with occasional meds.  At over $500 hard to justify for a maybe usage.  If you have a serious condition Celebrity has always evacuated you to a shore facility.

[Fuzzy55]

I got Covid a month before our Equinox cruise. I had the two shots plus 2 boosters. I made the mistake of getting Paxlovid after testing positive. Did not like the side effects including constant metal taste. I did get rebound Covid 3 days after testing negative. They report rebound Covid only occurs in 2% of the Paxlovid cases. However, those are only reporting cases. Once I  positive again with a home test, I did not go back to doctor. My husband also tested positive a few days after I tested positive the first time. He was over his within  a week. It took me two weeks to finally test negative for good. Would not recommend Paxlovid unless you are immunocompromised. 

[kearney]

I have a number of concerns about Paxlovid being given by someone other than the passengers physician. From what I have read there are significant drug interactions with many different medications...particularly those for Cardiovascular issues. For example it interacts with some statins, blood thinners, Calcium channel blockers, anti-arrhythmics among them. In some cases you need to stop the drug you are taking, in others the dose has to be adjusted..and in general the patient should be monitored while all this is going on. So do we really expect the ships physicians to be in a position to make the call for you on how to handle your other drugs? What really concerns me is that they are now allowing pharmacists to prescribe Paxlovid... When I first heard this... I wondered if pharmacists were worried about potential malpractice issues should something go wrong... Then I discovered that sometime in 2021 they passed a law protecting groups like pharmacists from liability associated with Covid treatment. So as a patient you should be aware of the issues associated with getting this drug. The irony is the intent of Paxlovid is to prevent poor outcomes among those at high risk... yet it is likely this group is taking a medication that has an interaction with Paxlovid. 

[Kate-in-Canada]

I wish they did have paxlovid on board.  I’m I muncompromised, and while I have avoided a lot of exposure, I didn’t want to stay home from my cruise.

Yes, Pax does have interaction,S but I would be happy to get a letter from my family doc saying we had already consulted and was fine to take of testing positive.  
 

I tested positive for the first time this spring after the gov ended masking in schools.  O still was wearing my mask, but I couldn’t go all day without eating or drinking, and bingo, tested positive.

having gone through radiation for cancer, my lungs are shitty.  They started filling with fluid scary quick.  Luckily I got paxlovid 24 hours  after my positive test.  Stopped Covid I. It’s tracks.  Lungs cleared, negative on day 7. And the only side effect was bad taste.  And bad taste is nothing when you feel your lungs drowning. 
 

if I could get my hands on a preventative set of doses to take with me I would, and pay whatever,  but it’s super hard to get here and def can’t get a just in case dose.

 

im risking it because it seems like Covid will never go away and I don’t want to pause life forever.  But I would feel a lot better if ships had it.  
I will still be masking and distancing as much as possible, but I know the risk is there. 

[TeeRick]

16 hours ago, Kate-in-Canada said:

I wish they did have paxlovid on board.  I’m I muncompromised, and while I have avoided a lot of exposure, I didn’t want to stay home from my cruise.

Yes, Pax does have interaction,S but I would be happy to get a letter from my family doc saying we had already consulted and was fine to take of testing positive.  
 

I tested positive for the first time this spring after the gov ended masking in schools.  O still was wearing my mask, but I couldn’t go all day without eating or drinking, and bingo, tested positive.

having gone through radiation for cancer, my lungs are shitty.  They started filling with fluid scary quick.  Luckily I got paxlovid 24 hours  after my positive test.  Stopped Covid I. It’s tracks.  Lungs cleared, negative on day 7. And the only side effect was bad taste.  And bad taste is nothing when you feel your lungs drowning. 
 

if I could get my hands on a preventative set of doses to take with me I would, and pay whatever,  but it’s super hard to get here and def can’t get a just in case dose.

 

im risking it because it seems like Covid will never go away and I don’t want to pause life forever.  But I would feel a lot better if ships had it.  
I will still be masking and distancing as much as possible, but I know the risk is there. 

@Kate-in-Canada although I understand your feelings about not pausing life, there is a very good chance that you might get infected in your travels or on board.  Based on what you describe about yourself, IMO you are very brave to even consider cruising.  Paxlovid or no paxlovid.  Best of luck.

[terrydtx]

Now that Paxlovid is available over the counter in the US, I may ask my pharmacist about taking a supply with us on our cruises next month. In the past my doctor had given me a prescription for a Z-Pac antibiotic to take when I travel out of the country because of coming home many times with bronchitis. 

 

COVID-19 over the counter drug available | 5newsonline.com

[canderson]

40 minutes ago, terrydtx said:

Now that Paxlovid is available over the counter in the US, I may ask my pharmacist about taking a supply with us on our cruises next month. In the past my doctor had given me a prescription for a Z-Pac antibiotic to take when I travel out of the country because of coming home many times with bronchitis. 

 

COVID-19 over the counter drug available | 5newsonline.com

Don't be surprised if your pharmacist's business isn't participating in this program and will continue to fill by prescription only.  It may be hit or miss for a while.

[TeeRick]

3 hours ago, terrydtx said:

Now that Paxlovid is available over the counter in the US, I may ask my pharmacist about taking a supply with us on our cruises next month. In the past my doctor had given me a prescription for a Z-Pac antibiotic to take when I travel out of the country because of coming home many times with bronchitis. 

 

COVID-19 over the counter drug available | 5newsonline.com

This will be very confusing to cruise passengers!  It is not really an Over-The-Counter drug as we normally think about them.  No even close.  First off you must test positive for Covid.  Second you need to provide a lot of recent laboratory blood work to the licensed pharmacist to be evaluated for kidney and liver issues.  This program was set up to get Paxlovid into the hands of COVID-infected, eligible patients quickly and early in their infection.  Not for a just-in-case travel prescription. 

 

https://www.usnews.com/news/health-news/articles/2022-07-07/fda-allows-pharmacists-to-prescribe-covid-drug-paxlovid

Edited July 12, 2022 by TeeRick

[Kate-in-Canada]

6 hours ago, TeeRick said:

@Kate-in-Canada although I understand your feelings about not pausing life, there is a very good chance that you might get infected in your travels or on board.  Based on what you describe about yourself, IMO you are very brave to even consider cruising.  Paxlovid or no paxlovid.  Best of luck.

ya.  I’ve been wavering myself between thinking I’m crazy for taking the risk to thinking it’s silly to sit home waiting for this to enjoy before I start enjoying life again.

 

but I got diagnosed with cancer during Covid, and did all my treatment during Covid and went no where at all except medical appointments for a year and saw almost no one for my whole treatment time to avoid infection.  Once I got my all clear, after a year of isolation, I wanted to enjoy what kind of feels like a bonus.  But with caution.  I’m the only person in my family or at my job who still masks.  I sanitize and keep my distance indoors.  
I don’t want to get a severe Covid infection but I also didn’t go through treatment to stay on my couch.  
it’s hard.  Especially when there isn’t a date to look forward of when things if ever will be “safe”.  Could wait years for the risk to go away, and in meantime, have a cancer recurrence. 
im going, with hopes my hard core masking, 4 vaccines and precautions will be enough.

and the hopes that if I contract Covid again, I can get paxlovid at a port..

 

I read the reports that it’s more wider availability in the states.  I’m going to get a docs note to say I already took it once successfully, and I have my recent bloodwork digitally to show kidney and liver function good, so hopefully I can’t get it if I need it.

 

I wish it was available on board though for those who meet a criteria..

[kearney]

1 hour ago, TeeRick said:

This will be very confusing to cruise passengers!  It is not really an Over-The-Counter drug as we normally think about them.  No even close.  First off you must test positive for Covid.  Second you need to provide a lot of recent laboratory blood work to the licensed pharmacist to be evaluated for kidney and liver issues.  This program was set up to get Paxlovid into the hands of COVID-infected, eligible patients quickly and early in their infection.  Not for a just-in-case travel prescription. 

 

https://www.usnews.com/news/health-news/articles/2022-07-07/fda-allows-pharmacists-to-prescribe-covid-drug-paxlovid

I had a short conversation with my pharmacists about pharmacists being allowed to prescribe..not just dispense, Paxlovid. He was on a call about this...the pharmacists were not enthusiastic because it takes a lot of time to determine which patients can take it. Often the patients aren't that familiar with the drugs they are taking and as I noted earlier and he confirmed... with many Cardio related drugs the patients need to either stop taking their meds or in some case doses need to be adjusted and in all cases the patients need to be monitored..for what he called a small benefit. He told me that the pharmacists were concerns that the screening process alone would take all day and take the time away from the regular jobs. I just can't see this ever being handled on a ship.

[canderson]

28 minutes ago, kearney said:

He told me that the pharmacists were concerns that the screening process alone would take all day and take the time away from the regular jobs. I just can't see this ever being handled on a ship.

As noted above, it's not just the pharmacists, it's the companies for whom they work.  I would expect any number of them to opt out for a variety of reasons, especially staffing.

[Kate-in-Canada]

34 minutes ago, kearney said:

I had a short conversation with my pharmacists about pharmacists being allowed to prescribe..not just dispense, Paxlovid. He was on a call about this...the pharmacists were not enthusiastic because it takes a lot of time to determine which patients can take it. Often the patients aren't that familiar with the drugs they are taking and as I noted earlier and he confirmed... with many Cardio related drugs the patients need to either stop taking their meds or in some case doses need to be adjusted and in all cases the patients need to be monitored..for what he called a small benefit. He told me that the pharmacists were concerns that the screening process alone would take all day and take the time away from the regular jobs. I just can't see this ever being handled on a ship.

I think there are two in accuracies in this.  First, calling it a small benefit.  When it has shown to reduce hospitalizations and severe outcome in 98% of people who take, most of which are all high risk patients, that is the opposite of small benefit.  That’s fact.  And anecdotally as someone who took it after watching thier pulse ox levels drop steadily in the 24 hours from testing positive to getting my hands in the pills, it was a huge lifesaver for me.  
 

also, saying the screening process will take all sounds like an alarmist exaggeration.  It took me a10 minute phone call appointment with a pre-screening admin to confirm my high risk status and possible eligibility, who then passed my number onto the tele doc who called me for a 20 minute consult where she looked up my recent bloodwork online and my medication list online and Determined was little risk of interaction, and went through the how to use directions with me. This is possible for a pharmacist who isn’t looking for an excuse to be stubborn about paxlovid.

 

if your pharmacist is basing opinions on inaccuracies, I would suggest a new one who has peoples best interest, including the high risk for Covid complications people at heart.

 

obviously there would be some folks who wouldn’t be able to do this.  Those who don’t have digital records available, for example, who would have to wait it out if it stays mild or end up in hospital if it gets bad, but there are a lot of people it could help and who could easily show they meet eligibility. It is crazy to me for a blanket statement of refusing a drug to everyone only because there are some it would be not appropriate for.

[canderson]

1 minute ago, Kate-in-Canada said:

...who then passed my number onto the tele doc who called me for a 20 minute consult where she looked up my recent bloodwork online...

While for good reason you have regular blood work taken, most do not.  That throws a wrinkle into the time equation. 

[Kate-in-Canada]

10 minutes ago, canderson said:

While for good reason you have regular blood work taken, most do not.  That throws a wrinkle into the time equation. 

Most regular folks don’t.  But it’s not regular folks in need of pax.  High risk people need it, and chances are, whatever causes thier high risk probably means they get fairly regular blood work. 
 

and that’s fine. If celebrity decided thier ships docs could prescribe and they carried a supply on board, they could easily put out a notice saying for any high risk travellers who would like to be considered for pax if testing positive while on board should have a recent set of bloodwork and medication list with them in order to be considered, easy.  Those who are serious about it will.  Those who aren’t serious and don’t bring those things don’t get considered for it. Easy. It would show they care about offering the best for thier high risk travellers and willing to take steps.

my point was denying everyone and high risk folks because some can’t get it is silly.  We don’t do or shouldn’t medicine like that.

[Covepointcruiser]

I was told by my physician that I would have to stop blood pressure medicine and blood thinners.   Since I am vaccinated and doubled boosted I would only have a mild case if I were to catch an Omicron variant.   He definitely would not recommend taking Paxlovid.   If I had lung disease he said I would be mad to put myself at risk.

[canderson]

1 hour ago, Kate-in-Canada said:

Most regular folks don’t.  But it’s not regular folks in need of pax.  High risk people need it, and chances are, whatever causes thier high risk probably means they get fairly regular blood work.

Disagree.  There are all kinds of respiratory ailments that stand solo, do not require any regular blood work to be done, and yet can move a person right into higher risk.

[Algebralovr]

I’m currently recovering from Covid.  Didn’t get it on a ship, I went out for lunch for the first time locally, and people were coughing.   I took 5 cruises successfully and felt safer on board the ships.

 

I was not a candidate for Paxlovid.  My primary, rheumatologist and oncologist discussed it and my primary decided against it.  I did end up taking Molnupiravir, which is from Merck and has fewer issues.  
 

I still wouldn’t take it “just in case”.  I finished it this morning.  We will see over the next few days if I get a bounce back case.  

[Kate-in-Canada]

Which is irrelevant to my point about how they could safely implement if there was a desire to. Want paxkovid in case of positive test. Get blood work before going.  This is not complicated. 
 

[kearney]

Talk with your doctor... not cc. They know your history and they know what adjustments should be made to your medication..if necessary. From what I read the initial studies done for approval were done on unvaccinated. So they assume the impact will be the same on vaccinated. I assume those tests are being done...The point I clumsily was trying to make is that Paxlovid is not Tamiflu and should not be treated as just something OTC you take at the first sign of symptoms. Once you are on the ship it is a bit late to discuss your options with your doctor.

[Kate-in-Canada]

25 minutes ago, kearney said:

Talk with your doctor... not cc. They know your history and they know what adjustments should be made to your medication..if necessary. From what I read the initial studies done for approval were done on unvaccinated. So they assume the impact will be the same on vaccinated. I assume those tests are being done...The point I clumsily was trying to make is that Paxlovid is not Tamiflu and should not be treated as just something OTC you take at the first sign of symptoms. Once you are on the ship it is a bit late to discuss your options with your doctor.

Actually first sign of symptom is when it’s most effective for the people it’s appropriate for. 
 

it won’t help me talking to my doc if it’s not available on board.  
and I’ve already taken a course of it once, so my comments are based on actually experiencing it as a high risk cancer survivor.  In all my comments I never suggested passing it out to everyone like OTC.  My point was availability and what could be done to make sure those who need it snd it’s appropriate for have the option. 
 

people who aren’t interested in taking it can just not take it without commenting on how it should be limited for those who need it. 

[TeeRick]

12 minutes ago, Kate-in-Canada said:

Actually first sign of symptom is when it’s most effective for the people it’s appropriate for. 
 

it won’t help me talking to my doc if it’s not available on board.  
and I’ve already taken a course of it once, so my comments are based on actually experiencing it as a high risk cancer survivor.  In all my comments I never suggested passing it out to everyone like OTC.  My point was availability and what could be done to make sure those who need it snd it’s appropriate for have the option. 
 

people who aren’t interested in taking it can just not take it without commenting on how it should be limited for those who need it. 

Are there different rules for Paxlovid in Canada than the US?  You of course must know since you got it once before.  But can you get it in Canada if not infected already, as a precaution to getting infected when you travel and cruise?  The recent FDA announcement about getting it from registered US pharmacies would not apply to you.  I have found the following from Health Canada.  Again, best of luck with all of this.

 

https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/symptoms-transmission-treatment/oral-treatment-against-covid-19-paxlovidmc

[TeeRick]

15 hours ago, kearney said:

I had a short conversation with my pharmacists about pharmacists being allowed to prescribe..not just dispense, Paxlovid. He was on a call about this...the pharmacists were not enthusiastic because it takes a lot of time to determine which patients can take it. Often the patients aren't that familiar with the drugs they are taking and as I noted earlier and he confirmed... with many Cardio related drugs the patients need to either stop taking their meds or in some case doses need to be adjusted and in all cases the patients need to be monitored..for what he called a small benefit. He told me that the pharmacists were concerns that the screening process alone would take all day and take the time away from the regular jobs. I just can't see this ever being handled on a ship.

Maybe eventually when fully approved by the FDA then it could be kept on ship for well defined, emergency situations.  Not for giving out like Advil or Tylenol.