FDA advisory panel votes in favor of EUA for molnupiravir for treatment of COVID. @Merck
Molnupiravir is a pill taken twice a day for 5 days starting within 5 days from onset of symptoms. @Merck
The main issue with this drug is that in the interim analysis there was a 50% reduction in risk of hospitalization and death. In full analysis the benefit narrowed to 30%.
Is a 30% decrease in risk of severe Covid good enough? Yes in my opinion.
This was enormously difficult & is not sustainable. Coz if you lead trials some small amount gets invariably reported.
$0 is possible only for people who don't lead therapeutic trials. #MedTwitter
2/ I had to go through all kinds of contortions to get to $0, including taking my name off many papers even though I was an investigator. Ride separately from other investigators to meetings. Avoid drinking even bottled water in long meetings to get zero dollars reported.
3/So we have a problem. If you want experts with zero $ conflicts you will end up with people who don't lead clinical trials.
The $ amounts reported do not mean that investigators are enriching themselves: it can be meetings, being authors on papers. Actual cost to do the trial
People are counting waves differently. Some say we are in our 5th wave.
We are a big country so as a wave spreads it looks like 2 waves, but it's one wave sequentially in 2 places.
Initial 2 peaks is first wave Apr-Sep 20.
2nd wave Nov 20-May 21.
3rd wave is the current one.
Easier to appreciate when you look at deaths because with cases, numbers over time have been affected by test availability.
So looking at deaths, the first two peaks are one wave, affecting separate parts of the country as COVID spread initially. We are now in end of 3rd wave.
When you look at individual states easier to appreciate 3 waves. New York and Texas below.
Here are my Top 5 #ASH21@ASH_hematology myeloma abstracts. #ASH21VR
Links to the full abstract. As in the past, I left out studies where similar results were already presented or published before. Top 5 based on new data, clinical impact & methodology
I was just thinking of flying to see family. #OmicronVariant threatens plans because we have no idea what countries and airlines will do at the last minute.
The last thing you want is to be stuck for days in a quarantine hotel.
Like what happened to passengers on these two flights.
People are rightly confused how is it that we have another wave when 60% or more are vaccinated, & 40-50% of the population has probably had COVID.
Where is immunity?
Thread.
1/ How strong and durable immunity is following infection or vaccination depends on many factors.
2/ The strength and durability of the immune response depends on the nature of the antigen, how it is presented to the immune system, number of exposures, etc.
3/ With Covid we also got a bad deal: A new serious virus that we were not immune to, that spreads easily, & mutates.
4/ The immune response is more durable with repeated exposure: generation of a true secondary immune response. microbiologynotes.com/differences-be…
With natural infection sometimes one infection is long enough to trigger a durable secondary response. Sometimes its not, & you are susceptible.
Just like anti vaccine folks found Gibraltar, another place they keep pointing to is Vermont, the most highly vaccinated state.
Best for people know the facts.
1) No state has done as well as Vermont in this pandemic: fewest lives lost. They know what they are doing.
2) Vermont is the best vaccinated state and vaccinations have kept deaths low. Since June 1 by which data everyone had an opportunity to be vaccinated, deaths have continued to stay low in Vermont. But have increased in many less well vaccinated states.
3) Even Vermont is not as well vaccinated as it should be. So 72% while #1 in the US is lower than many countries. There are vulnerable people and unvaccinated people, so with delta cases will occur.