It's not clear how well they work

An article in my newsfeed today from one of the main Australian newspapers, Sydney Morning Herald, regarding the antiviral Paxlovid:

Unfortunately, it’s behind a paywall, a shame because it is important information. The article states recent studies show that the expensive medication does “little” to prevent hospitalisation and death.

Giving medications just for the sake of it seems a dangerous route, given that all medications have side effects. Let’s take a quick look at the DAEN reports for Paxlovid.

Certainly, orders of magnitude less adverse events than other covid medicines. 303 reports and 3 deaths. The most common side effect is dysgeusia, which I had to look up and is a metallic taste sensation. As we found with adverse events to covid vaccines we can’t find the cases and medical terms linked with the deaths. We can try to reverse engineer it, but the only way is through freedom of information requests.

I downloaded the DAEN data, found by looking for the smallest button on the dashboard. The DAEN is a design guide for how to make a bad dashboard. I noticed a bunch of 13-year-olds. Not sure why they would be getting this drug? Filtering on the children, we find adverse events for children under 1 given this drug! Leading to pain in extremity, diarrhoea and vomiting. The 13-year-olds had drug interactions. snippet of the spreadsheet of the child adverse events:

Why this drug would be given to children is beyond me. Pfizer initiated trials in children under 18. I recall hearing somewhere that that trial has still not been reported.

I found this Queensland Health guide with information on administration of antivirals.

There is specific guidance. Apparently paediatric use is off label. Only considered aged 12 and over and weighing at least 40kg. It also notes risk of drug interactions which is seen in the adverse events.

For those who had the time to go through in detail my two previous articles, Data Chaos Parts 1 and 2, on an Australian Institute of Health and Welfare (AIHW) report, we went into the limitations of the analysis relating to vaccination effectiveness. To put it very simply taking averages over groups that have widely varying composition leads to nonsense results.

Rebekah Barnett did an excellent article on the AIHW report.

Useless Covid data analysis riddled with basic flaws

Along the way we found that in fact we have no idea how many people are in the unvaccinated group, particularly in the older ages where the number of unvaccinated is relatively small.

The headline of the AIHW report also makes claims of effectiveness of antivirals (top right box)

I didn’t have the time to look at the antivirals section of the report but suspected the same flaws.

The Herald article tells us close to a Billion dollars has been spent on the antiviral drugs. A course costs approximately $1,000. From the article:

“I’m much less confident than I was [that] they still are having an effect on outcomes,” said Professor Allen Cheng, formerly a top COVID adviser and Victoria’s deputy chief health officer, who co-authored the study. “Whether antivirals are still worth their cost is not clear.”

I noted in my original articles that the Paxlovid clinical trials were in unvaccinated people and Vinay Prasad had written about the fact that there was no evidence that there was benefit in vaccinated people and it appears that this latest research finds there is no benefit in unvaccinated people.

A positive is that legacy media has picked up on this. At a time when health budgets in Australia are stretched, spending a billion dollars on a drug of doubtful value needs scrutiny.

We have people dying due to ambulance ramping:

We have nurses being attacked, because security won’t intervene as soon as they are off hospital grounds going to their cars to get home.

That’s Kara Thomas in the image representing the Nurses Professional Association of Queensland (NPAQ) on this issue. Kara is also secretary of AMPS. Details of the NPAQ campaign can be found here.

Summary

There are clear conflicts of priorities in Health. A billion dollars is being spent on a drug of questionable value. The adverse events are highlighting that the drug is being used in young children, not recommended for use. Agencies are producing reports using simple averages to justify a narrative. At the same time basics like:

• people not getting to hospital in time and

• our health care workers getting attacked

are low priority. Not good enough.