So far, I haven't needed Paxlovid. I think I've had Covid twice, both very mild cases — one, in fact, I didn't even test positive for, though I'm pretty sure it happened. (I felt pretty awful right after going to an August journalism conference that turned out to be a superspreader event, if we're still using that phrase.)
But after reading Lindsay Karp's persuasive First Opinion essay, which went live this week, I really wish I could have some of it in my medicine cabinet, just in case.
Karp, a freelance writer who has multiple sclerosis, was recently preparing for an international trip. "I asked my doctor, the one who prescribes my immunosuppressant for multiple sclerosis, 'Can you prescribe Paxlovid for me to bring on vacation?' With regret, she said no — she can only prescribe it to someone who tests positive." Next, Karp writes, "I called two local pharmacists and confirmed that despite the FDA lifting the need for a positive test and providing pharmacists with the ability to prescribe the drug, there were still limitations in prescribing the treatment to those without current symptoms."
As Karp points out, physicians prescribe Tamiflu for patients to keep on hand. If you're traveling to certain parts of the world, your doctor may offer you antibiotics to bring just in case. If Covid is becoming just a regular part of life, that means it should be offered to keep on hand — especially for immunosuppressed people who have largely been left behind as the rest of the world seems increasingly inclined to shrug at Covid.
Ultimately, Karp points out, "until it's available preemptively, [Paxlovid] is not fully accessible to those who need it most." I'm not even someone who needs it most, but after reading Karp's piece, I sure would like to keep it on hand. First, of course, I want to be sure that those at highest risk can stock up.
Also in First Opinion this week: Jordan Dworkin of the Federation of American Scientists explains how the use of AI in biomedicine could spell trouble: "Rapid, complex, and technically sound data analysis is insufficient — and sometimes antithetical — to the generation of real knowledge." Once Congress gets this whole "shutdown" thing straightened out, it needs to protect public access to government-funded science. Also on Congress' must-do list: The presidents of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, the American Osteopathic Association, and the American Psychiatric Association call on Congress say we need changes to address the physician shortage. Amgen's Leah Christl warns about threats to the biosimilar regulatory framework. Medical student Amelia Mercado and professor of psychiatry and medical ethics J. Wesley Boyd explore how medical school student insurance plans fall short on mental health coverage.
My recommendation of the week: I'm quite late on this, but I finally started watching "Dopesick" on Hulu and am really enjoying it — particularly because I also recently watched Netflix's "Painkiller," which I found to be cartoony and not particularly helpful in thinking through the systemic issues behind the dawn of the prescription opioid crisis.
Got a submission for First Opinion? Email me!
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