HIV and ID Observations

April 8th, 2024

The Rise and Fall of Paxlovid

It’s been quite the ride for our “preferred” outpatient therapy for COVID-19, nirmatrelvir with ritonavir — much better known as Paxlovid, so allow me the license to use the licensed name. Let’s recap the astonishing success and now failure of this intervention (some dates approximate): December 2021, the FDA issued an Emergency Use Authorization for Paxlovid:  Action […]

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May 8th, 2023

As the Public Health Emergency Comes to an End, How Are We Feeling About This?

As you no doubt heard, on Friday, May 5, 2023, the WHO declared the end of the global health emergency from COVID-19. Here in the U.S., the federal public health emergency will expire on May 11. That’s Thursday, just a few days from now. These events reflect two realities that, while seemingly contradictory, make these decisions reasonable […]

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March 27th, 2023

Three Effective Treatments for COVID-19 Not in Treatment Guidelines — at Least Not Yet

A few weeks ago, in a patented (and copyrighted and trademarked) Really Rapid Review™, I summarized some of the Greatest Hits from CROI 2023. The conference included new data on not just HIV, but also a grab bag of opportunistic infections, STIs, viral hepatitis — and, as has been the case since 2020, COVID-19. You know, […]

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February 14th, 2023

Interferon Lambda for COVID-19 — Looking Good, but Still Not Available

Way back in the spring of 2022, I was asked to give an update on outpatient treatment of COVID to a group of general internists. The talk featured this slide on the TOGETHER trial of peginterferon lambda: These data came from a press release from the company developing the drug. It’s dated March 17, 2022. I added […]

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January 17th, 2023

After the PANORAMIC Study — Whither Molnupiravir?

We turn now to the second of the controversial papers published in late 2022 on COVID-19 — namely the PANORAMIC study of molnupiravir versus usual care in outpatients with the disease. This one is controversial not because the study was poorly done, or unimportant, but because molnupiravir has, from the start, been a contentious treatment […]

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January 4th, 2023

Medical Masks vs. N95 Respirators for Preventing COVID-19 Among Healthcare Workers

As promised, the end of 2022 saw a trio of controversial COVID-19–related publications. First up is something that always causes a stir — a study on masks! Reviewing a study on masks in the COVID-19 era is like poking a hornet’s nest with a stick, and this one is no exception. But let’s poke away! Aside from […]

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November 7th, 2022

Five Quick Questions from Our Course, “ID in Primary Care”

As noted on this site before, we put on a course called “ID in Primary Care” every year for clinicians doing truly the hardest job in medicine — frontline primary care. Why is their work so challenging? While we can focus on one field, infectious diseases, they have to be aware of everything. Tough task indeed. We’ve […]

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October 25th, 2022

Yes, Even ID Doctors Get COVID — Including Famous Ones

Since the start of the COVID-19 pandemic, various public figures have contracted the disease. Tom Hanks, way back in early March 2020, was arguably the first globally famous person in the world to test positive for the virus. The announcement came right as much of the world prepared to shut down. My friends and I were […]

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October 17th, 2022

Big In-Person Medical Meetings and Cognitive Dissonance for ID Docs

Dissonance: lack of agreement; inconsistency between the beliefs one holds or between one’s actions and one’s beliefs; a mingling of sounds that strike the ear harshly. It started shortly after the chaotic, disruptive, and all together unpleasant Omicron wave of 2021–22. It continued through the BA.2 and BA.5 surges, and now plays on through the swarm of […]

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October 10th, 2022

Molnupiravir Results in PANORAMIC Study — It’s Not All Bad News

Last week, the large PANORAMIC trial of COVID-19 treatment in outpatients with mild-moderate disease appeared in a pre-print. This large (25,783 participants!) randomized, open-label study compared molnupiravir vs. usual care in adults 50 or older, or having comorbidities known to make severe disease more likely. The results? Molnupiravir vs standard of care for outpts with Covid19. No […]

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