Musings from Covid isolation

[Moonlion]

1 hour ago, Twitchly said:

Yup. My husband didn’t give it to me when he had it (at the beginning of the pandemic — no masks, no vaccines), and I didn’t infect him when I had it last year (post-vaccines and boosters). There’s definitely hope.

 

Speaking of which, I hope you feel better soon, SJD117. 

The transmission of this virus is very strange.  I got it last May and didn't infect my husband despite sharing the same bed.  I carefully avoided contact with my brother who lives with us and has health issues.  Despite the precautions, my brother caught it from me.  We both started Paxlovid right away after testing positive and had mild symptoms although it took a few weeks for the fatigue to go away.   

[Earthworm Jim]

6 hours ago, SJD117 said:

Thanks for the message. Linda is out picking up a Paxlovid prescription for me as I write this. Fortunately she tested negative.

 

Obviously, follow your medical professional's advice and don't listen to some random idiot on the internet (me), but with the potential for rebound after taking Paxlovid I'd be worried that might happen around your 13 day mark when you leave. While if let to run it's normal course it would likely be over by then.

 

But better safe than sorry if you're a person who is at greater risk from Covid. (Which is a lot of us cruisers for age reasons alone)  And if you really want to go, without a test to board there is nothing to stop you to be honest. But your fellow cruisers sure hope you don't go that route if still positive.

Edited March 24, 2023 by Earthworm Jim

[LindaS272]

Not infectious after 10 days. Can still test positive but not be infectious.

[SantaFe1]

1 minute ago, LindaS272 said:

Not infectious after 10 days. Can still test positive but not be infectious.

That is exactly what our doctor is telling us, and I believe comes from CDC.  We isolated for five days.  Then we have to go out with masks for five days.  Then, no longer infectious.  She also told us not to even bother testing again after 5-10 days because the virus can still show up for some time.  The up side is that we have “immunity” for 90 days.  At least this is the medical advice we, too, have received.  

[SJD117]

14 hours ago, Earthworm Jim said:

 

Obviously, follow your medical professional's advice and don't listen to some random idiot on the internet (me), but with the potential for rebound after taking Paxlovid I'd be worried that might happen around your 13 day mark when you leave. While if let to run it's normal course it would likely be over by then.

 

But better safe than sorry if you're a person who is at greater risk from Covid. (Which is a lot of us cruisers for age reasons alone)  And if you really want to go, without a test to board there is nothing to stop you to be honest. But your fellow cruisers sure hope you don't go that route if still positive.

 

I'm not concerned about the rebound issue. The FDA found that only a small fraction of patients who took Paxlovid experienced a rebound. Further, Covid patients who didn't receive Paxlovid experienced rebound as well. The agency concluded last week that there wasn't a significant difference in rebound rates between the two groups, and that rebound had no impact on the risk of developing severe illness. 

 

https://www.nytimes.com/2023/03/16/health/fda-paxlovid-covid.html

 

https://www.fda.gov/media/166197/download

[Iloveketo]

On 3/18/2023 at 8:20 PM, CoolBeansVA said:

Fortunately we came prepared with Paxlovid, which we started ten minutes after our positive tests, and we are improving each day.  Unfortunately, we are in mandatory isolation in our stateroom for 6 days, during which we are missing two key ports of our itinerary and, frankly, going stir-crazy.

So, your doctor gave you a prescription you could have filled before your cruise just in case you got COVID?

Had you ever taken it before?

[TayanaLorna]

@Iloveketo It seems it is hit or miss getting a script for Paxlovid without actually having Covid.  Out of 4 friends from the US on our last cruise, only 1 who asked their MD for it got it.  He has very slow growing lung cancer. Here in PR doctors will not prescribe it unless you are really sick.  

[SempreMare]

33 minutes ago, Iloveketo said:

So, your doctor gave you a prescription you could have filled before your cruise just in case you got COVID?

 

Mine did. I 

 

- Requested it shortly after the Emergency Use was authorized and the data about the additional significant risk reduction in hospitalization and death became available.  Getting the script definitely required "a conversation" with a doctor at a formal telemed appt.

 

- Explained that Paxlovid availability would be questionable where I am traveling,  and the 86% reduction in hospitalization / death * is compelling, and I have one risk factor.

 

The doctor paused and was quiet for a moment while he looked over my chart.  He finally simply said,  "I think that's smart."  

 

Then, actually finding a pharmacy in Austin Texas that had it in stock took 3-4 days.

I taped a note to the outside of mine, 
"Stop statins on Day 1 through 5 days after taking this."

 

Witnessing what a friend in Florida just went through to get Paxlovid makes me glad I have it. 

He eventually got it, but too late (past day 5) to begin it.   

Moral of the story:  Don't rely on CVS's Test to Treat program to get Paxlovid in time.   Even though he already had multiple antigen tests showing he was positive, CVS requires their own PCR test.  The whole process took longer than 3 days, which put him over the 5 day time clock to begin.   (Initial problem was - His doctor gave idiotic advice, "let's wait and see". )

 

(* Update - Also a possible link to reduction in long Covid. 

Long Covid - the roulette wheel spin that I don't want to win. It's what motivates me to still mask. 

If Covid were simply like a terrible flu or RSV, I would not mask.) 

 

A podcast w/ NYC doctors each week describing the best Covid treatment plans based on latest data  per phase of the disease

 

This week's episode covers (at supersonic speed) possible treatment options for long covid.

 

https://www.microbe.tv/twiv/twiv-994/

 

 

[KBs mum]

34 minutes ago, TayanaLorna said:

@Iloveketo It seems it is hit or miss getting a script for Paxlovid without actually having Covid.  Out of 4 friends from the US on our last cruise, only 1 who asked their MD for it got it.  He has very slow growing lung cancer. Here in PR doctors will not prescribe it unless you are really sick.  

In the UK any medication (other than basic over the counter, such as ibuprofen) is only available after a visit to a doctor who assesses your symptoms, age, any contra indications and then prescribes. The idea of getting prescription medications 'just in case' is bizarre to us. How will the layman know how/when/if required any medication is? 

 

Edit, paxlovid and other medications were/are available if the patients condition will be improved by taking them

Edited March 25, 2023 by KBs mum

[SJD117]

29 minutes ago, TayanaLorna said:

@Iloveketo It seems it is hit or miss getting a script for Paxlovid without actually having Covid.  Out of 4 friends from the US on our last cruise, only 1 who asked their MD for it got it.  He has very slow growing lung cancer. Here in PR doctors will not prescribe it unless you are really sick.  

Linda will be talking with her physician tomorrow about this very issue. Her argument is this -- her hubby (me) has Covid, she doesn't have Covid but might get it from hubby, we're traveling in 10 days, so can the doc prescribe Paxlovid as a precaution?

[SempreMare]

@KBs mum  >> The idea of getting prescription medications 'just in case' is bizarre to us. How will the layman know how/when/if required any medication is? 

 

First, I do my own research (pubmed.com, etc.) 

Then I listen to nationally-recognized experts who interpret large sample size data studies (like what I linked above).  When I hear those doctors describe the harmful treatment plans they learn that other doctors will prescribe, it astonishes me. 

 

Net:  I am occasionally more informed than my primary care physician doctor about possible treatment options of any condition I have.  However, I do NOT try to educate any doctor (that's their job.)   I simply

- Ask questions.   "Are these findings relevant to my treatment options?"    I link to the study or bring in a printout.   

- Ask questions that help me figure out the If-Thens of my plan.  
Ex:  "What pulse oxygenation % level would indicate I should go to the hospital?"

When I
- understand the If-Thens 

- have a plan and that I could actually execute, and listen for changes needed from new research
 

I feel no stress.   Not much remains to be actively concerned about. 

 

 

[LindaS272]

14 minutes ago, SJD117 said:

Linda will be talking with her physician tomorrow about this very issue. Her argument is this -- her hubby (me) has Covid, she doesn't have Covid but might get it from hubby, we're traveling in 10 days, so can the doc prescribe Paxlovid as a precaution?

It’s so I could have Paxlovid with me in case I contract it while abroad (or start showing symptoms from exposure to SJD)—not to take proactively.

[DGHOC]

I think you have a different policy in the US to the UK Linda and SJD. Here Paxlovid is only prescribed to highly vulnerable people and they are on a national NHS register compiled by specialist medical consultants and GPs. Certain conditions qualify as do those who are immunosuppressed or compromised. It's not available to everyone.

 

Once a positive covid test is done, Paxcovid is couriered to the patient. I asked if I could travel with some last year 'just in case' but it's not possible here in the UK. Incidentally I contracted covid last year on the return flight from a Viking cruise as did my husband. We were both pretty poorly so I'm awfully grateful we contracted it on the way back!

 

I hope you bat it off quickly SJD and you manage to avoid it Linda.

[d9704011]

12 minutes ago, KBs mum said:

Is there in the US a recognised body of experts who have access to trial data, are involved in the assessment of the necessary double blind trials and who then issue recommendations as to when/if any medication should be prescribed based on clinical evidence domestically and internationally? 

On a not for profit basis? 

Are there patient information leaflets listing possible side effects and how to take it in the carton with any medication, in addition to anything the doctor may have said during the consultation? 

Do you have a right to seek a second opinion?

 

Advice from the above is that Paxlovid is not necessary for the majority, and taking madications if not necessary increases immunity to medication, a good example being antibiotics being prescribed for viral illness 

Probably several of them but none can be trusted.

[KBs mum]

Just now, d9704011 said:

Probably several of them but none can be trusted.

Oh well, we have universal healthcare and access to data from other internationally recognised clinical trials and organisations 

[Iloveketo]

1 hour ago, TayanaLorna said:

@Iloveketo It seems it is hit or miss getting a script for Paxlovid without actually having Covid.  Out of 4 friends from the US on our last cruise, only 1 who asked their MD for it got it.  He has very slow growing lung cancer. Here in PR doctors will not prescribe it unless you are really sick.  

My husband and I both had COVID at the same time. My doctor didn’t recommend it for me, but prescribed it for my husband. We have some cruises booked that are more than a month in length and involve repositioning cruises with many sea days. 

[CoolBeansVA]

1 hour ago, Iloveketo said:

So, your doctor gave you a prescription you could have filled before your cruise just in case you got COVID?

Had you ever taken it before?

Yes, my husband and I had doctor’s appointments before we left.  Given our ages and health, and the fact that we were going to be on the other side of the world for six weeks, she agreed that it was prudent for us to carry Paxlovid “just in case.” Of course, she ran the appropriate tests (renal panel), discussed alteration of our chronic meds, and told us we’d still have to follow local quarantine rules.

 

We’d never taken it before because we’d never had Covid before.

[SJD117]

1 hour ago, KBs mum said:

Is there in the US a recognised body of experts who have access to trial data, are involved in the assessment of the necessary double blind trials and who then issue recommendations as to when/if any medication should be prescribed based on clinical evidence domestically and internationally? 

On a not for profit basis? 

Are there patient information leaflets listing possible side effects and how to take it in the carton with any medication, in addition to anything the doctor may have said during the consultation? 

Do you have a right to seek a second opinion?

 

Advice from the above is that Paxlovid is not necessary for the majority, and taking madications if not necessary increases immunity to medication, a good example being antibiotics being prescribed for viral illness 

 

See my comment #55 on this thread.

 

According to the linked New York Times article, a panel of expert advisors to the U.S. Food and Drug Administration endorsed Paxlovid last week as a treatment for adults with Covid who are at high risk for progression to severe illness. The endorsement came after the agency released an analysis -- also linked to my earlier comment -- showing that Paxlovid reduced hospitalizations and deaths among both unvaccinated and vaccinated people. Agency researchers estimated that, based on Covid rates in January, Paxlovid could "lead to 1,500 lives saved and 13,000 hospitalizations averted each week in the United States."

[Haqdeluxe]

1 hour ago, d9704011 said:

Probably several of them but none can be trusted.

 So where in the US do you live? Your profile appears to indicate you live in Canada.

[Pushka]

Australia is the same as UK. Cannot get a Covid script just in case. A Dr has to see the positive PCR test, plus you have to meet other criteria, which is age of 70+ or severely compromised by other health conditions. To provide a script otherwise renders them liable for medical investigation. Each script costs the Govt $1000 AUD. I can't take it anyway as I'm on blood thinners. 

[SJD117]

10 minutes ago, Haqdeluxe said:

 So where in the US do you live? Your profile appears to indicate you live in Canada.

Because @d9704011 lives in Canada, he or she may not know that a panel of expert advisors to the U.S. Food and Drug Administration endorsed Paxlovid earlier this month (see my comments #55 and #68 to this thread). I'm sure the panel can be trusted.

[SempreMare]

 

@KBs mum>> Advice from the above is that Paxlovid is not necessary for the majority, 

100% agree, based on best data I've read and seen interpreted by the board certified MDs and epidemiologists.

 

- Most people with Covid do not need hospitalization.
- Most people with Covid do not die.

If that were not true... wow, the world would look like a very different place today.

 

The beneficial endpoint of Paxlovid is:     86% reduction in risk of hospitalization or death. 

 

If the majority of people don't die or need hospitalization, 
Then the majority of people don't need Paxlovid to achieve that validated endpoint.

True.

 

-----

Related example:  

 

From my gynocologist:

"The majority of women who have had 2 negative Pap smears in a row

will not show a problem on the 3'rd year.  Congratulations, you can skip this year's test!" 

 

I 100% agree that is a true statement. 

 

I managed to suppress a laugh as my first response.

 

My next questions: 

"Is part of your compensation based on reduction of medical test costs per woman you treat?  
[ eventually,  Yes ]  

What is that exact cost target for this year?   
[ non-answer ] 

 

Do you think someone with a family history of X should be included in this Congratulations? 

[ ... probably not... ]

 

I ended the appointment, and requested it not be billed to my insurance as my annual well-woman appt.
 

[vslparis]

On 3/21/2023 at 3:38 PM, SantaFe1 said:

Thank you all for well wishes.  I have had a very mild case, as did my husband.  Just got off the phone with my doctor who says I am free to go on Thursday, but must wear a mask everywhere for another five days.  Easy enough to do.  She also told me that we would have immunity for about another 90 days (long enough to get us through our upcoming Alaska cruise).  We will also take a couple of tests and some Paxlovid.  

Oh no , sorry to hear about you being sick . This is what happens when you put “boys and beer “ together 🤣. I hope you are both feeling better soon.

[SantaFe1]

14 minutes ago, vslparis said:

Oh no , sorry to hear about you being sick . This is what happens when you put “boys and beer “ together 🤣. I hope you are both feeling better soon.

Thank you, Valerie!  We are good. Pierre is off Paxlovid, and and I finish tomorrow.  It is truly the cure worse than the disease.  I am so tired of Paxlovid mouth!

 

I remember two years ago when we all went to Iceland on the inaugural cruise.  That was scary, but we all made it!  And I’m so glad we did it!  We are off to Alaska the end of May for a big anniversary. Where are you going next, before the WC?

Edited March 26, 2023 by SantaFe1

[SJD117]

1 minute ago, SantaFe1 said:

Thank you!  We are good. Pierre is off Paxlovid, and and I finish tomorrow.  It is truly the cure worse than the disease.  I am so tired of Paxlovid mouth!

 

I was just telling Linda about the bitter aftertaste from Paxlovid. Fortunately I had chocolate at hand to make it all better!  😀