No one is dragging their feet on early therapy. There just hasn’t been one that worked. For every disease there are tons of existing, cheap drug candidates where researchers hypothesize a possible mechanism of action. From there, many still make the cut in vitro. It’s only when you move in vivo at doses that aren’t going to kill the person being treated, that the vast majority are bust. It’s not some conspiracy. It’s how it works. To think otherwise, you have to buy into a bizarre narrative on par with dentists suppressing miracle cures for tooth decay and mind control with jet contrails.
Your solution to treat EVERYONE after a positive test completely ignores the fact that you would be grossly overmedicating the vast majority of people who get this and recover with no sequalae. Talk about a money grab!
The idea that early treatments are being suppressed is ludicrous. It’s spin to help safe face for those who jumped the gun on earlier therapies that showed in vitro effect, but were then worthless (or worse) in vivo.
There’s a narrative out there that first H and then I were magically effective and were then suppressed because there wasn’t money to be made on them. Both have been studied extensively in RCTs and shown to be useless, but the myth won’t die.
And, wanted or not, all medications have potential side effect. Our pharmacology professor used to say “you get the grits.” Well, I don’t want grits. I want hash browns. Sorry, comes with the grits.
There has been a huge uptick in home testing. If one tests positive there really isn’t anything (that I know of) that one should do other than whatever the isolation/quarantine rule of the day might be.
Is there an approach other than - if you test positive, wait and see if it gets bad, then call?
The fact that we’ve done multiple RCTs on multiple drugs doesn’t count? Early treatment for viruses is CHALLENGING. There’s no treatment yet for the common cold. Tamiflu is minimally effective for influenza. People have been working on those for years!
That’s because the vast majority get better. Tincture of time heals most of us.
This applies even more so for newer therapies, drugs etc. In the case of Spironolactone…it’s been tested for decades with very few dangerous side effects.
Spironolactone is not innocuous. Anyone who says so, has had little experience with the drug. It is potassium sparing and can really screw up your electrolytes leading to severe mental impairment. But, there is a RCT already in Phase 3 with dex.
It’s a misconception that only new drugs need to be studied. Look at the ONTT and prednisone, or the beta-carotene lung cancer trial. Both were old medications. Both were deleterious to outcomes.
You don’t wait for symptoms to appear in order to take paxlovid or molnupiravir. If positive test, go to your doctor and get an Rx for paxlovid or molnupiravir, or go straight to the pharmacy (if an option near you) and walk out with a free Rx of paxlovid.
For early treatment to be effective, a person who wants to (potentially) make use of it needs to have quick result testing done frequently, and either an existing relationship with a primary care physician willing to prescribe the needed drug after a positive COVID-19 test or access to a pharmacy with a prescriber who can then prescribe and dispense the drug after a positive COVID-19 test.
So far the government has increased availability of rapid testing, is providing a small number of free tests for anyone who wants them, and now is providing access to covid treatments for free.
You are right that not everyone has a physician. But, many have access to urgent care clinics, where they can test if exposed (if they don’t have home based rapid tests), and receive paxlovid/a paxlovid RX.
For the test to treat initiative, it will take some time to ramp up. The good thing is there’s much less covid circulating right now in most areas, and much less pressure on the healthcare system in many places.
The main barrier, if we want to call it that, is that it’s only available to people at risk for developing severe disease. For those vaccinated and boosted, that are immunocompetent, they won’t likely fall into this category. And that’s OK, because they will almost certainly sail through without developing severe disease.
Unfortunately, most US adults have a condition that makes them at risk of severe covid. The CDC defined conditions of those at risk of severe covid includes those with BMI 25+, which just that condition alone comprises nearly 75% of adults, so most adults qualify for paxlovid treatment. FastStats - Overweight Prevalence
Paxlovid trials included the following patients at risk of severe disease: Eligible subjects were 18 years of age and older with at least 1 of the following risk factors for progression to severe disease: diabetes, overweight (BMI >25), chronic lung disease (including asthma), chronic kidney disease, current smoker, immunosuppressive disease or immunosuppressive treatment, cardiovascular disease, hypertension, sickle cell disease, neurodevelopmental disorders, active cancer, medically-related technological dependence, or were 60 years of age and older regardless of comorbidities. https://www.covid19oralrx-patient.com/files/Final-Emergency-Use-Full-Prescribing-Info-HCP-Fact-Sheet-COVID-19-Oral-Antiviral.pdf
Of course, what it still largely unknown is why some people actually do get severe COVID or long COVID and many others get very mild or asymptomatic cases without long COVID, despite otherwise similar age, gender, and pre-existing conditions.
I have some staff in Switzerland and UK. They were all vaccinated and boosted. Quite a few of them have gotten Covid recently. I just checked Switzerland and UK’s infection rates, and it looks like both of those countries’ numbers are going up again. I asked my colleagues as to why they are getting infected. They think it is because lifting of mask mandate.
