We’re Nearing the End of Summer... Here’s Where We Stand With COVID-19.
Is Paxlovid rebound real? Should you get the new Moderna booster? Dr. Jeremy Faust is here to answer these questions (+ more!) and provide a well-rounded COVID-19 update...
I’m back with more questions for Dr. Jeremy Faust.
Source: Jeremy Faust
Top ER Doctor, fellow Bulletin writer and my go-to doctor on all things medical.
Here, I wanted to talk very specifically about two important questions I think a lot you may have…
If you test positive for COVID, should you take Paxlovid? What about those rebound cases we’ve been hearing about?
Also, there’s a new Moderna COVID booster. Should you get it? And when?
THE REAL DEAL ON PAXLOVID
ALINA CHO: If you get COVID, how do you determine whether you should ride it out or take Paxlovid given the risks of rebounding and testing positive again?
Source: NPR
Because it’s an aggressive pill series.
DR. JEREMY FAUST: Technically, if you're at high risk for severe disease, you should take Paxlovid. What I think interesting is that the CDC doesn't really distinguish between vaccination and not when it comes to those questions.
ALINA CHO: Interesting.
DR. JEREMY FAUST: So, for example, if you're a 50-year-old, who's deemed high risk because you've got, I don't know, diabetes, I would certainly think you'd be high risk for COVID. For severe COVID, the question is, are you still high risk once you've been vaccinated and boosted? That person, I don't necessarily think they would be, so there's no playbook for this.
ALINA CHO: Right.
DR. JEREMY FAUST: And that's why your question is a great one because no one really knows what anyone means by high risk anymore.
ALINA CHO: So, what’s the bottom line?
DR. JEREMY FAUST: I think that if you're vaccinated and young, I don't see a benefit [to taking Paxlovid]. If you're vaccinated and older, there might be some benefit, but it's obviously much smaller because, thankfully, you're vaccinated. So, basically people older than the age of 50 with a significant risk factor, they may want to take Paxlovid.
ALINA CHO: But…
DR. JEREMY FAUST: ... but the flip thing is, Alina, is that we don't know whether this rebound thing is — how common it is.
ALINA CHO: Exactly.
DR. JEREMY FAUST: We don't know how much of it is happening even without Paxlovid. If you are, let's say 60 years old, you live with someone who's immune compromised. The last thing you want to do is be contagious for longer. So, that rebound could really be harmful to your housemate or your spouse, whoever it is.
ALINA CHO: Of course.
DR. JEREMY FAUST: Because you just suddenly went from being not contagious to being contagious again. So, it’s really on a case-by-case basis. I think that, between my parents and in-laws, I might give a different guidance to each of them, depending on the situation.
THE NEW BOOSTER — WHO SHOULD GET IT AND WHEN?
ALINA CHO: As you know, the UK recently approved a new Moderna booster that is a mix of the original recipe and the one that fights the original Omicron [variant].
Source: Google search
And it's said to give you not just longer, but better protection. And the thinking is that it's going to be approved in the US very soon. So, the question is who should take it and when?
DR. JEREMY FAUST: I think it will be approved or authorized in the United States. I think that anyone over the age of 50 probably should get it.
Source: Star Tribune
ALINA CHO: But when?
DR. JEREMY FAUST: I assume it'll be authorized in the United States sometime in September. They're probably going to authorize it for everybody. And they're probably going to authorize it for everyone sort-of on the thought process of like, "Oh, it's like a seasonal flu vaccine."
ALINA CHO: So, you and I have talked at length about how, to a certain degree, if you watch the waves, COVID does tend to get worse in the wintertime. So, the thinking would be, well, maybe the time to get it is in November.
DR. JEREMY FAUST: Yeah. The question is whether you should game it. There are some people who will tell you that it’s bad policy to try to game something. But I've said for a long time, everyone's got different reasons to avoid infection.
ALINA CHO: Exactly.
DR. JEREMY FAUST: If, for example, you really, really want to go to that Thanksgiving that you always have, and it's with older relatives or you yourself just don't want to get it and be stuck at home, it makes total sense to wait until November to get that boost. Because that added protection probably is only going to serve you for a couple of months. Maybe a couple of months longer with the new recipe, who knows. But it's not like, oh, you get it in September. And from September on you have permanently better immunity. I just don't buy that.
ALINA CHO: Right. Which is why, for me, that's an argument to wait.
DR. JEREMY FAUST: Yeah. I'll probably wait for as long as I can.