The Road goes ever on and on ... Day 435 (935)

Evidently, hundreds of people may be dying each day because Paxlovid and monoclonal antibodies that reduce the severity of a case of covid aren't given. There are two main reasons. First, public discussion of the therapies focuses on caveats and concerns rather than on risk reduction. Second, many Americans, especially Republicans, still don't take covid seriously. The White House response coordinator noted that if every American aged 50 and older with covid got treatment with Paxlovid or monoclonal antibodies, daily deaths in the US could fall to around 50 from the current around 400. 

Paxlovid is said to be one of the most effective anti-virals ever. The covid death rate for people under the age of 50 is so close to zero that reducing it in any statistically significant was is difficult. For people 50 and older, the case is very different. In a not-yet-peer-reviewed study of 560,000 patients 50 and older, 0.016 percent of the patients who received Paxlovid died. The death rate for patients not getting Paxlovid was frighteningly higher at 0.07 percent. It seems, however, that only about a fourth of the patients eligible to get Paxlovid actually got it despite its availability and no cost. Results were pretty much the same for both vaccinated and unvaccinated patients. 

The White House response coordinator called it "shocking" that a smaller share of American 80-year-olds (fewer than 30 percent) with covid were getting Paxlovid than American 45-year-olds. Many doctors say that they worry about possible side effects or rebound cases. While there are studies showing that patients who got Paxlovid were more apt to have a rebound cases, another found that one out of eight patients not getting Paxlovid also had rebound cases. A physician at the University of California, San Francisco explains, "Medicine is about weighing costs and benefits. The recommendation should be clear and unambiguous for people at high risk: The benefits of the drug outweigh the downsides."

It's been shown that there are concentrations of covid deaths in Republican communities, a phenomenon known as "red covid." It was thought that Republican communities would end up with more natural immunity because more people would get covid there. The gap between deaths for each political party did narrow for a while, but is now widening again. Paxlovid use is much lower in these areas. Of 20 states with the least Paxlovid use between late August and late September, looking at a per 100 diagnosed cases figure, 18 were won by the former president in 2020. People in these states need to be informed, possibly multiple times, that covid is not the same as influenza, and needs to be taken seriously. Really.