RE: RECOVER Trial...30 Oct 2022 10:17
Algy of course that's logical and correct and it's the reason why all successful vaccines and therapeutics should reduce Long Covid to a greater or lesser extent. Omicron is not producing the same LC effects that Delta did - so it's reasonable to suppose that most of the Recover trail will be looking at the long term existing effects - the ME end of the LC spectrum, rather than viral clearance. But the significance is that Paxlovid is the first selected trialist and its been chosen for viral clearance so NIH has shown where it sees the priorities. It's inclusion is entirely due to the accident of not working properly with the first 5 day dose but then patients recovering well when given a second dose. (which they might well have done anyone 10 or 15 days after first inffection. Fauci was much sicker when he had the rebound infection )
It's significant that the NIH realises there will be no single "cure" as such for the long term effects, and those poor Delta long haulers will be treated with the drugs that come closest to treating the symptoms they present with, and with whatever extrsa help can be unearthed in trials - but the NIH is rightly saying - ok bad luck to all that - but we're starting with a therapeutic that clears out any residual virus first, so that we at least know it's not continuing to do damage.
Maybe you might use the analogy that's been used many times in relation to Covid - and in relation to SNG. The idea of a fire raging. RM was talking abourt the cytokine storm when he talked about the drug loving a fire to put out - and if you consider viral clearance you'd maybe think of it as a fire department continuing "damping down" long after a fire appears to be out. Dexa was authorised for this purpose but it has no impact whatsoever on viral clearance and can of course be daming to the immune system at the same time as calming down the storm.
Damping down gets down into the hot heart of the embers and makes sure they can't reignite. That's what this is about - and there's plenty of reason - as I posted before, to believe that SNG would do a better job than Paxlovid.