HIV and ID Observations

June 6th, 2022

Still More Fun with Old Medical Images

Back in the Before Times, this site would occasionally dabble in lighter fare: Cartoon caption contests Commentaries on doctor attire Thoughts on the first-name “Morgan” Penguins chasing a butterfly (Well, actually, this is a new one!) https://twitter.com/buitengebieden/status/1533022340887486466?s=20&t=ShPbhfDhg-BwCP2bWisXfA And, the subject of today’s post — Fun with Old Medical Images. Here’s how it works: We display an old medical […]

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May 23rd, 2022

In Praise of Dr. Glaucomflecken

Sometimes there is someone so good at something that there is universal agreement we are witnessing something special. Babe Ruth, Serena Williams, and Michael Jordan competing at their peaks. Charles Dickens or Jane Austen creating whole worlds out of invented characters and plots. Vladimir Horowitz performing Rachmaninoff at Carnegie Hall. Bernini creating sculptures from cold, hard […]

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May 12th, 2022

As They Say, “Some Personal News”

This week marks the 14th anniversary of HIV and ID Observations, give or take a few weeks. I started writing this blog* in 2008 — and since then there have been 832 posts, a gazillion comments, and one awful (and ongoing) pandemic. For the opportunity, I sincerely thank Matt O’Rourke, a wonderful and generous editor […]

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May 4th, 2022

More on Relapses after Paxlovid Treatment for COVID-19

Unless you’ve been hiding under a rock, you’ve heard that some people treated for COVID-19 with nirmatrelvir/ritonavir (Paxlovid) experience a relapse in illness shortly after stopping treatment. It’s both a recurrence of symptoms and a positive antigen test — sometimes after the test became negative. One case report published as a pre-print shows that a relapse can have […]

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April 25th, 2022

Yes, Relapses After Paxlovid Happen — Now What?

Around two weeks ago, one of my long-term, very stable patients with HIV called me saying she’d just been diagnosed with COVID-19. Over 60 with hypertension, and overweight, she qualified for nirmatrelvir/r (Paxlovid) under the Emergency Use Authorization (EUA), and took it without problem. (Certain details changed for confidentiality.) In fact, she started to improve within 24 […]

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April 12th, 2022

Should We Prescribe Nirmatrelvir/r (Paxlovid) to Low-Risk COVID-19 Patients?

The top recommended treatment for high-risk outpatients with COVID-19 in the NIH Guidelines is nirmatrelvir/r (Paxlovid). It’s quite clear why. In the EPIC-HR study, unvaccinated people at high risk for severe outcomes had an 89% reduction in the risk for hospitalization or death compared to placebo. If we just look at mortality — another important endpoint, […]

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April 1st, 2022

As the World Around Us Moves On, We ID Docs Just … Can’t

Something quite remarkable happened as Omicron tore through the United States in December and January. Despite triggering a record number of cases — which should have made people more concerned about COVID-19 — Omicron paradoxically did the opposite. It made most of our country decide to move on, even parts famous (or infamous, depending on your […]

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March 22nd, 2022

What Have We Learned from the Pandemic So Far?

Dear Readers, I need your help. Recently one of my colleagues reached out and asked if I could give a talk to his research group. “Just give one of your canned Covid talks,” he said. Ha. Needless to say — but I will say it anyway — he’s not an ID doctor. Otherwise he’d know that, as I’ve said […]

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March 7th, 2022

How to Induce Rage in a Doctor

If you’re wondering how to make a doctor angry — really, really angry — read on. Because asking us to justify treatment decisions to insurance companies and their pharmacy benefit managers must rank right up there with the greatest tortures of practicing medicine in this country. Mind you, this isn’t just about my patient, or about […]

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February 22nd, 2022

A Personal Tribute to Dr. Paul Farmer — Who Made Everyone Feel Important

Paul Farmer’s unexpected death this weekend has all of us who knew him reeling. This just should not happen to someone so generous, so important, and so visionary about helping others — especially others who, due to being born in impoverished life circumstances, can’t help themselves. This is not fair at all. We’re heartbroken. The tributes will […]

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