Standardized Covid Treatment Protocols?

[ABQ2015]

Obtaining COVID therapeutics is getting tricky in my area. Our New Mexico Dept of Health (NMDOH) has a weekly press conference on the COVID status that I like to watch or afterwards review the posted slides. Before Christmas, the predominant COVID variant in my flyover state was delta but we are fast transitioning to omicron. Currently the NMDOH estimates omicron as 50-60% of our new cases and expects it to be 100% in a week or two.

Sotrovimab and Remdesivir infusions and the Paxlovid pill are the only effective treatments available in my state for omicron. Remdesivir requires three infusions over three days so uses more medical staff resources and the other two treatments are in short supply. Molnupiravir was listed on the NMDOH slides as just 30% effective. Currently NM is limiting distribution of Paxlovid to rural counties that are not close to infusion centers. So the NMDOH thinks it will be difficult to obtain therapeutics for omicron in the next two weeks until we can get more supplies.

They also stressed during the press conference that if your rapid test is positive, there is no need for a PCR test before seeking treatment although the medical center may perform their own PCR test.

 

[ExFlyBoy5]

Obtaining COVID therapeutics is getting tricky in my area. Our New Mexico Dept of Health (NMDOH) has a weekly press conference on the COVID status that I like to watch or afterwards review the posted slides. Before Christmas, the predominant COVID variant in my flyover state was delta but we are fast transitioning to omicron. Currently the NMDOH estimates omicron as 50-60% of our new cases and expects it to be 100% in a week or two.

Sotrovimab and Remdesivir infusions and the Paxlovid pill are the only effective treatments available in my state for omicron. Remdesivir requires three infusions over three days so uses more medical staff resources and the other two treatments are in short supply. Molnupiravir was listed on the NMDOH slides as just 30% effective. Currently NM is limiting distribution of Paxlovid to rural counties that are not close to infusion centers. So the NMDOH thinks it will be difficult to obtain therapeutics for omicron in the next two weeks until we can get more supplies.

They also stressed during the press conference that if your rapid test is positive, there is no need for a PCR test before seeking treatment although the medical center may perform their own PCR test.

Local media is reporting same issues getting Remdesivir and that they don't expect the next allotment to be enough for projected cases.

Add this to the fact that hospitals are again being overwhelmed and staff are getting sick...well, it's not a good place to be.

Our ambulance providers are also having issues. The "required response time" is below standards and they have reduced coverage for advanced life support which is not good if you have a stroke or heart attack. Time to limit the risky activities.

 

[explanade]

There was a headline this morning on TV that the govt has doubled the order of the Pfizer Paxlovid.

But greater availability not likely until end of year.

Still they were talking about people getting prescriptions from doctors before getting infected, to have in their medicine cabinet just in case.

 

[Koolau]

Ohio's governor has just assigned National Guard troops to help at 35 hospitals around the state for the same reason.
https://www.statenews.org/government-politics/2022-01-06/ohio-national-guard-troops-move-out-to-hospital-mission-and-more-have-gotten-needed-covid-shots

Our State has been talking about bringing in help from the outside. I'm wondering just who has extra to send to us (of course, there are a few fringe benefits, so maybe North Dakota and Minnesota WILL send us some medical personnel.) YMMV

 

[Chuckanut]

Our State has been talking about bringing in help from the outside. I'm wondering just who has extra to send to us (of course, there are a few fringe benefits, so maybe North Dakota and Minnesota WILL send us some medical personnel.) YMMV

You can do what one of our neighboring states did when their cavalier attitude towards Covid resulted in their hospitals overflowing. They sent the overflow across the boarder to my state. Our Guv was not happy about that.

So Hawaii can just send them across the border to !!! Hmm... Another problem with living in Paradise.

 

[Another Reader]

I just spent a day and a half at Stanford Hospital. The ICU is supposedly 87 percent full, mostly COVD. However, the ER was basically empty at 10 AM on Thursday. The night before, the wait was 4.5 hours.

The hospital seemed well staffed and almost everyone had an N95 mask on. Paper mask over the N95. Intake did the "real" PCR, long swab, all the way up to the brain. Results in 90 minutes. The swab included RSV and Influenza A/B. I had no problem getting a CT scan when ordered. Didn't make the cutoff for the stress test so had to stay overnight. ED doctors seemed pretty knowledgeable about Covid for a change.

I think they may be treating some Covid patients in ER without admitting them, but I didn't verify that.

The food was lousy...first time for that.

 

[sengsational]

Sotrovimab and Remdesivir infusions and the Paxlovid pill are the only effective treatments available in my state for omicron. Remdesivir requires three infusions over three days so uses more medical staff resources and the other two treatments are in short supply. Molnupiravir was listed on the NMDOH slides as just 30% effective. Currently NM is limiting distribution of Paxlovid to rural counties that are not close to infusion centers. So the NMDOH thinks it will be difficult to obtain therapeutics for omicron in the next two weeks until we can get more supplies.

It looks like Paxlovid is the most effective thing yet, but the number of patients in the trials is small, and I think it's just a press release so far (not peer reviewed). But if it holds-up, it looks like the best thing yet (top of the list). Note that in the graphic, only Casirivimab, Bamlanivimab, Molnupiravir, Sotrovimab, Remdesivir and Conv. Plasma are approved in the US for treatment of Covid-19.

ETA: I should also note that the studies showing effectiveness of all this stuff is pre-Omicron, of course, and so you can ignore Bamlanivimab/Eteseviman and Casirivimab/Imdevimab as they're not effective any more. There's only two that work: bebtelovimab (LY-CoV1404 in the graphic below) and sotrovimab (VIR-7831 not part of the study so not in the graphic below).

 

[Koolau]

You can do what one of our neighboring states did when their cavalier attitude towards Covid resulted in their hospitals overflowing. They sent the overflow across the boarder to my state. Our Guv was not happy about that.

So Hawaii can just send them across the border to !!! Hmm... Another problem with living in Paradise.

So very true. We have exactly just-so-many beds in ER, intensive care and general care. Beyond that, we have to put up tents. I think that's why in our state we've been so schizo about prevention - shutting things down every other week, masks on the beach with cops hiding in the mangroves (back in the day), bars open but churches closed, etc. etc. We don't quite now what to do so we DO something. Hospitalizations are now the key parameter here - not the number of deaths which, mercifully, have not gone up dramatically. YMMV

 

[Sangiovese]

The treatments with the highest efficacy are at the top of the list. Efficacy is reduced as you drop down the list. The least efficacious treatment is at the bottom. The recommended treatments are found at the very top of the list, the very bottom of the list and everywhere in-between. There is no correlation between treatment effectiveness and treatment recommendations. There is a strong correlation between treatment cost and treatment recommendation, independent of whether the treatment is efficacious or not. For example, one of the least effective treatments, Remdesivir, is recommended at $3120 per treatment. One of the most studied and most effective treatments, Ivermectin, is not recommended. It costs $1.

 

[sengsational]

... There is a strong correlation between treatment cost and treatment recommendation, independent of whether the treatment is efficacious or not. ...

I did notice that. The process to get recommended for treatment of Covid-19, and probably other conditions, seems to require a well-funded and/or well-connected company to push it through. Too bad our governmental bodies that are supposed to be protecting the public health as their primary goal operate in such a manner.

 

[explanade]

No if you like the cheap treatment, nothing stopping you from getting it.

Most reputable doctors won't have anything to do with it but apparently thousands are using it.

 

[MichaelB]

<mod note>

Speculation into government/business/regulatory processes and intentions is not appropriate discussion and will cause thread closure.

Posts were deleted that were not in compliance with this.

 

[eytonxav]

Early research suggesting milk protein + benadryl as potential Covid treatment. However, I suspect this would be a cheap one to make available, so its chance of success may be limited.
https://news.yahoo.com/early-stage-research-suggests-milk-002425317.html

 

[Gumby]

Early research suggesting milk protein + benadryl as potential Covid treatment. However, I suspect this would be a cheap one to make available, so its chance of success may be limited.
https://news.yahoo.com/early-stage-research-suggests-milk-002425317.html

Why does it need to be "made available"? If that's what you want to use to treat yourself for Covid, you can get them at any drug store and the GNC. Personally, I used Dayquil and Nyquil to treat my Covid symptoms, and it seemed to work just fine. Nobody had to "make them available" to me. I just bought them.

Please don't try to start more conspiracy theories. There are enough already.

 

[ExFlyBoy5]

...Personally, I used Dayquil and Nyquil to treat my Covid symptoms, and it seemed to work just fine. Nobody had to "make them available" to me....

Although I don't know *if* I had COVID or not (many symptoms pointed to yes but next blood donation should tell me for sure) but copious amounts of NyQuil and some ibuprofen to keep my fever in check did me good. Oh, and I am thinking that sleeping for nearly 48 hours straight didn't hurt, either.

 

[SD-455]

In regard to treatments once someone is sick enough to enter the hospital or ICU... inhaled Nitric Oxide is proven vasodilator used around the world and in the U.S. It helps to open restricted blood vessels and increases oxygen flow to the lungs and vital organs. If you or a loved one is at the point of entering the hospital with breathing issues from Covid, speak to a respiratory specialist on staff about it's possible benefit. It is a long standing, safe treatment for adults with diseased lungs and pre-mature babies to help their lungs develop. It has been studied in numerous Covid trials and is now used frequently for Covid patients with breathing issues.

 

[sengsational]

Ensovibep is an IV treatment that showed efficacy against Covid-19 in a phase 2/3 trial, data just released. Adults with mild disease saw a 78% relative risk reduction in hospitalization and death. Ensovibep can block the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein.

https://www.novartis.com/news/media...-mp0420-darpin-antiviral-therapeutic-covid-19

 

[sengsational]

Early research suggesting milk protein + benadryl as potential Covid treatment. However, I suspect this would be a cheap one to make available, so its chance of success may be limited.
https://news.yahoo.com/early-stage-research-suggests-milk-002425317.html

Readers here should make a big distinction, IMO, between things that have been tested in human trials and things in cell culture (as this news story is reporting). Both components mentioned have a very long history of safety, though, so not much risk, but also very, very low evidence that any effect against Covid-19 will be observed.

 

[Koolau]

In regard to treatments once someone is sick enough to enter the hospital or ICU... inhaled Nitric Oxide is proven vasodilator used around the world and in the U.S. It helps to open restricted blood vessels and increases oxygen flow to the lungs and vital organs. If you or a loved one is at the point of entering the hospital with breathing issues from Covid, speak to a respiratory specialist on staff about it's possible benefit. It is a long standing, safe treatment for adults with diseased lungs and pre-mature babies to help their lungs develop. It has been studied in numerous Covid trials and is now used frequently for Covid patients with breathing issues.

I recently heard a news account that some doctors are giving Viagra to Covid patients. Apparently Nitirc Oxide produced in the body is the mode of action for the pill's usual indication - and (according to the news) it was effective in treating the symptoms of Covid. I have no reference and have not google'd it so YMMV.

 

[SD-455]

I recently heard a news account that some doctors are giving Viagra to Covid patients. Apparently Nitirc Oxide produced in the body is the mode of action for the pill's usual indication - and (according to the news) it was effective in treating the symptoms of Covid. I have no reference and have not google'd it so YMMV.

I heard about that today as well on the Viagra having a similar effect. Not sure if it is as controlled/measured as the NO delivery systems but I saw a couple of stories about people that where in rough shape with Covid with serious breathing issues that say the Viagra really helped them a lot

 

[tmm99]

I think that the Viagra thing kind of makes sense? I read a while back that some people who get COVID end up suffering erectile dysfunction as COVID is a vascular disease, so maybe there is a connection...

 

[eytonxav]

Why does it need to be "made available"? If that's what you want to use to treat yourself for Covid, you can get them at any drug store and the GNC. Personally, I used Dayquil and Nyquil to treat my Covid symptoms, and it seemed to work just fine. Nobody had to "make them available" to me. I just bought them.

Please don't try to start more conspiracy theories. There are enough already.

Made available as in how do these two things need to be combined/administered. The research is not there yet, but suggesting some promise. And there was no conspiracy theory being advocated by my post

 

[Chuckanut]

Viagra? Who needs that? Try some L-arginine which is widely available as a suppliment. From the Mayo Clinic:

https://www.mayoclinic.org/drugs-supplements-l-arginine/art-20364681

Because L-arginine acts as a vasodilator, opening (dilating) blood vessels, many people take oral L-arginine to treat heart conditions and erectile dysfunction.

 

[sengsational]

The only outpatient therapeutics that are federally approved and stand much of a chance against Omicron are probably just Paxlovid and Sotrovimab, but they might not be easy to get, and would only be distributed to high-risk patients. I'm not sure if Evusheld is approved or not.

Healthy people probably don't need to bother with treatment, as it's highly likely you'll fight it off with a day or two of feeling crummy. Clinicians have some basics you can try, such as the OTC portion of the FLCCC early outpatient protocol. But if you've got a lot of risk factors, you might be able to access one of these early treatments.

This is a locator for the two pharmacy treatments:
https://covid-19-therapeutics-locator-dhhs.hub.arcgis.com/

This is a locator for the infusion:
https://infusioncenter.org/infusion-prescribers-covid-antibody-treatment-resource-page/

The data on Sotrovimab shows a signal, but the paper I saw didn't have statistical significance. But I've heard a few front line clinicians talk about it, and they didn't mention any weakness in the data, so I'm probably missing something.

Also, as to safety of these, obviously you'd be running all this through your own doctor, but Paxlovid is not super safe, from what I've come up with. It's a combination of two drugs, and each has contraindications with other drugs, and of course if you've got your own health risk factors being treated with other drugs, that becomes a problem. But if you do have a lot of risk factors and your current prescriptions don't preclude it, the Paxlovid combo might be a good idea.

 

[explanade]

Omicron breakthrough infection may not provide "great Omicron-specific immunity."

https://twitter.com/x/status/1488321416755761154