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 […]

---

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, […]

---

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 […]

---

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 […]

---

January 18th, 2022

Novak Djokovic Thinks He Can Play by His Own Rules — Australia Says Think Again

There was a truly talented kid on my ninth grade basketball team — let’s call him Robbie G. He was a terrific player, fast and confident on the court, always eager to play, and just brimming with enthusiasm for the game. Every time he scored, the team and crowd (small as it was) buzzed with excitement […]

---

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 […]

---

December 6th, 2021

Omicron and the Quest for “Negative Capability”

Wow, that was quite the depressing post-holiday week in ID Land. For that, we can thank the new villainous variant, Omicron, which arrived ironically just as most of us here in the United States sat down to celebrate something approaching a “normal” Thanksgiving for the first time in two years. Oh yes indeed, thank you very much […]

---

November 12th, 2021

Time to Simplify the COVID-19 Vaccine Policy — Authorize a Booster Dose for Anyone Who Wants One

At this point in the post-vaccine era of the pandemic, we all know people who have had COVID-19 despite being fully vaccinated. Patients, coworkers, family, friends. The reason these breakthroughs are so common is now obvious — our initial vaccine strategies did not provide durable protection against infection. And recognition of this fact prompted the FDA […]

---

August 2nd, 2021

Provincetown July Celebration a Challenging Stress Test for the COVID-19 Vaccines

When the complete history of the COVID-19 pandemic is eventually written — and boy oh boy, can’t wait for that — certain events will feature prominently as sites of notable outbreaks. The Diamond Princess cruise ship The Biogen Leadership conference The Skagit Valley Chorale practice The Sturgis motorcycle rally The Amy Coney Barrett White House reception And now: The Provincetown Independence Week celebration […]

---

June 14th, 2021

The Time for Hospitals to Require COVID-19 Vaccination Among Employees Is Now

Imagine you work at a hospital. Patients come and go, admitted through the emergency room, or electively for surgery. Or they arrive for the day — maybe it’s an outpatient visit, or to receive chemotherapy or an infusion of biologic agents, or to undergo various imaging and other tests. Some of them, of course, have weakened immune […]

---