HIV and ID Observations

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 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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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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February 12th, 2022

The Rise and Fall of Ivermectin — 1 Year Later

Here’s a confession few board-certified ID doctors will make — there was a brief period when I thought ivermectin could very well be an effective treatment for COVID-19. It wasn’t when the in vitro data first came out. Therapeutic concentrations were not achievable in humans. Nor when the anecdotal reports started pouring in, and sometimes making news. […]

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February 4th, 2022

Prior COVID-19 Is No Guarantee of Immunity

I’m no immunologist — a fact made vividly obvious to me several years ago when asked to teach a weekly medical student section that included cases and problem sets. The challenge was that the course combined immunology and microbiology. I was on much firmer ground with the microbiology than the immunology, the latter often a wonderfully […]

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January 12th, 2022

The Pandemic Life of an ID Doctor — in Graphic Form

Three works of art sit on my father’s desk in his office, gifts from his children from when we were in grade school. From my brother Ben, there’s a little bear, or perhaps it’s some other burly quadruped — easily a B+ in his art class from the 1960s, likely an A- now with grade inflation. A […]

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December 30th, 2021

Omicron and Reduced Severity of COVID-19 — Some Good News We Desperately Need

We’ve been burned so many times making predictions about COVID-19 that I should post this conspicuously by my computer: The famous pundit meant, of course, that “you don’t know anything” — we know his true intentions since he also said “Nobody goes there anymore. It’s too crowded.” The “know nothing” quotation is a reminder that COVID-19 is […]

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December 20th, 2021

Believe It or Not, We Already Have a Highly Effective Outpatient Antiviral Treatment for COVID-19

And that treatment is … (drum roll) … remdesivir. Yes, you heard me right. Remdesivir, the very same antiviral with a checkered history in COVID-19 clinical trials, with some studies showing efficacy (sort of), others not much of anything. What’s the truth here? For that, let’s turn to what gets my vote for the most unheralded highly favorable […]

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