Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85% • Hacker News Board

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#181

Post by sudosysgen » Fri, Nov 05, 2021, 2:15 PM UTC

tmoravec wrote: post #171

mbreese wrote: post #80

Earlier quoted context omitted.

I haven’t read anything about this study, but this is common for highly effective treatments. Let’s say you have a randomized clinical trial with a control arm (placebo) and test arm (drug). If the vast majority of the test cases do significantly better (like 90% of the test cases), at some point it becomes unethical to continue. Why? Because you already have the evidence that the treatment works, so having the contr…

Pardon my naive question, but aren't there more objectives for the clinical trial? Particularly testing for negative side effects? How are those judged if the trial is discontinued?

You don't need people to actually have covid to find side effects. So you don't need sick people in your control arm.

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#182

Post by unanswered » Fri, Nov 05, 2021, 2:15 PM UTC

ralmeida wrote: post #92

tinus_hn wrote: post #44

Earlier quoted context omitted.

That is a valid question but another thing to note is that you wouldn’t be giving this drug to the vast majority of people who do not get any symptoms from a Covid-19 infection. Nor would you be forcing people to take this drug.

Which is a fair viewpoint from the societal level, but not as much for the individual level, which was implied in the parent message - i.e. how can "I'll take experimental treatment B instead of experimental treatment A" be an argument for not taking experimental treatments in general?

For an individual, the antiviral is better because it means they don't need to take the vaccine with any possible risks, however small, up front. Yes once an individual become symptomatic with covid-19, they're forced to be exposed to one of the risks, but at that point the antiviral is the only choice. In short, it allows an individual to delay taking the unknown risk until there's an actual known downside to not taking it; i.e. unmitigated covid symptoms. Most people will never be exposed to that downside anyways.

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#183

Post by peakaboo » Fri, Nov 05, 2021, 2:16 PM UTC

roenxi wrote: post #86

> This is a completely novel molecule... Then do we understand the risk profile of this thing? That sounds like the sort of innovation that people would want to be at the back of the queue for. Side effects don't have to happen in the next 6 months.

I'm not touching any Pfizer drugs with a 10 foot pole. I guess I'm one of the few actually wise humans left.

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#184

Post by Nextgrid » Fri, Nov 05, 2021, 2:16 PM UTC

Fellshard wrote: post #99

RicoElectrico wrote: post #50

We had reports of people who wanted to take weird-ass drugs-of-the-day just to refuse getting vaccinated. And screaming "conspiracy" when their efficacy was not confirmed to be as high as they expected. Good that we have something that actually works, bad that some assholes will use it as an excuse not to get vaxxed, completely missing the point (among others, trying to prevent something worse than Delta).

Genuine question: is it necessary to get vaxxed if - all else held the same - the cost is not significantly higher for the antiviral? Wouldn't that cut the risk down so significantly that we can safely say, "Vaccinate if you're at-risk for your own protection, and have negligible risk otherwise"? This changes the entire risk calculation.

If your reason to not get the vaccine is to avoid yet-to-be-discovered side effects, wouldn't that apply to this drug as well though? Not to mention that the vaccines now have a year-long track record of safety despite widespread adoption, where as this one has yet to be deployed on such a large scale.

Also, the vaccines work on a principle that's somewhat well understood, accepted and deemed safe: training the immune system by giving it something that looks like the virus so it can learn. The only novel part is how this "something that looks like the virus" is created (mRNA as opposed to weakened but real virus). On the other hand this new molecule has a totally different mechanism of action and the potential for side effects may be higher.

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#185

Post by dbsmith83 » Fri, Nov 05, 2021, 2:16 PM UTC

nradov wrote: post #46

ralmeida wrote: post #22

Earlier quoted context omitted.

Comparable individual outcome, worse societal outcome - you still spread it, so no reduction in overall cases, unlike a vaccine.

I encourage everyone eligible to get vaccinated if they can, but it does little to prevent spread. Over the long run we'll all be exposed no matter what we do. The real benefit of vaccines is in reducing the risk of severe symptoms. https://www.nature.com/articles/d41586-021-02689-y https://www.businessinsider.com/delta-variant-made-herd-immu...

> ...but it does little to prevent spread.

Actually it does reduce transmission

https://www.nbcnews.com/health/health-news/vaccinated-people...

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#186

Post by jjuel » Fri, Nov 05, 2021, 2:16 PM UTC

roenxi wrote: post #86

> This is a completely novel molecule... Then do we understand the risk profile of this thing? That sounds like the sort of innovation that people would want to be at the back of the queue for. Side effects don't have to happen in the next 6 months.

Pretty sure we don't understand the long term risk of getting COVID either right? I mean it has not even been around for 2 years. Plus we do know it is possible only 1 infection would kill you.

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#187

Post by switchbak » Fri, Nov 05, 2021, 2:16 PM UTC

stronglikedan wrote: post #125

RicoElectrico wrote: post #50

We had reports of people who wanted to take weird-ass drugs-of-the-day just to refuse getting vaccinated. And screaming "conspiracy" when their efficacy was not confirmed to be as high as they expected. Good that we have something that actually works, bad that some assholes will use it as an excuse not to get vaxxed, completely missing the point (among others, trying to prevent something worse than Delta).

> some assholes will use it as an excuse not to get vaxxed Well, they've succeeded in holding out long enough, now that there's no longer a good reason to get vaxxed. Because, as most people are starting to realize, the pandemic is over (at least in the US).

1500 deaths a day, how is the pandemic over?

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#188

Post by rory » Fri, Nov 05, 2021, 2:17 PM UTC

RicoElectrico wrote: post #50

We had reports of people who wanted to take weird-ass drugs-of-the-day just to refuse getting vaccinated. And screaming "conspiracy" when their efficacy was not confirmed to be as high as they expected. Good that we have something that actually works, bad that some assholes will use it as an excuse not to get vaxxed, completely missing the point (among others, trying to prevent something worse than Delta).

> some assholes will use it as an excuse not to get vaxxed, completely missing the point (among others, trying to prevent something worse than Delta).

It's still quite unclear whether vaccinated or unvaccinated people pose a greater risk via viral evolution (especially w/r/t risk to people that are already vaccinated). Basically comes down to a comparison of a higher level of spread with "normal" genetic drift vs. a somewhat lower (but still fairly high) level of spread with selection for immune escape of the current vaccine versions.

It's still a good idea to get vaccinated to help your own reaction to the virus, and to keep hospitals at sustainable capacity, but the "UNVACCINATED ARE MAKING THE VIRUS MORE EVIL" claim is, at this point, more propaganda than fact.

Here's some discussion: https://journals.plos.org/plosone/article?id=10.1371/journal...

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#189

Post by peakaboo » Fri, Nov 05, 2021, 2:17 PM UTC

matsemann wrote: post #106

roenxi wrote: post #86

> This is a completely novel molecule... Then do we understand the risk profile of this thing? That sounds like the sort of innovation that people would want to be at the back of the queue for. Side effects don't have to happen in the next 6 months.

If the consequence of not taking it is death, I think people would run to the front of the queue, though.

If you watch the mass media, that's the impression they love to give, yup. :)

Re: Pfizer's oral Covid-19 antiviral cuts hospitalization, death by 85%

#190

Post by DanHulton » Fri, Nov 05, 2021, 2:17 PM UTC

noir_lord wrote: post #142

chadash wrote: post #111

Earlier quoted context omitted.

Unfortunately, it's expensive. The cost of R&D to bring a new drug to market is around $1 billion, and this doesn't include the cost of marketing (though it does include the cost of drugs that fail the approval process)(see https://jamanetwork.com/journals/jama/fullarticle/2762311 ). At these numbers, it's hard to raise the money unless you think the drug is gonna be profitable.

On the one hand, yep absolutely. However on the other hand I look at https://en.wikipedia.org/wiki/HMS_Queen_Elizabeth_(R08) which cost $4 billon to build. A billion is a lot of money but not for governments, it's kinda tragic when you look at what we spend on some things that we haven't figured out a more sensible way of allocating resources.

The problem, as it ever seems to be, is capitalism.