Paxlovid May Reduce Risk of Long Covid in Eligible Patients, Study Finds

"The research looked at patients who qualified for the antiviral through age or health conditions. Those who took it shortly after infection were 26 percent less likely to have symptoms 90 days later.

People who took the antiviral drug Paxlovid within a few days after being infected with the coronavirus were less likely to be experiencing long Covid several months later, a large new study found.

The findings suggest that for people who are medically eligible for the antiviral — older adults or people with certain health problems — Paxlovid not only reduces the odds that they will be hospitalized or die from a coronavirus infection, but also lowers their risk of long-term symptoms.

“The results are quite provocative and suggest that further investigation of antiviral agents and their effects on long Covid is urgently needed,” said Dr. Michael Peluso, an assistant professor of medicine at the University of California, San Francisco, who was not involved in the new research.

The study, which was published online without undergoing peer review, does not indicate whether antivirals might be beneficial for other patients, like younger people or those without high-risk medical conditions. And it does not give any inkling whether Paxlovid might be a treatment for long Covid itself, a question being investigated by other researchers.

The researchers analyzed the electronic medical records of 56,340 patients who had at least one risk factor for a severe response to coronavirus infection. They found that the 9,217 patients who took Paxlovid within five days of testing positive were 26 percent less likely to have a wide range of post-Covid symptoms about 90 days later than the 47,123 patients who received no antiviral or antibody treatment.

The patients were part of the Veterans Health Administration system and tested positive for the coronavirus between March 1 and June 30 of this year, a period when Omicron variants were dominant. Those who took Paxlovid experienced reduced risk of long Covid regardless of vaccination status or whether they had been infected with the coronavirus previously, the study found.

The study authors and other medical experts said the findings provided additional motivation for medically eligible patients to take Paxlovid soon after becoming infected. Though Paxlovid has been proven effective in reducing hospitalizations and deaths in high-risk Covid patients, some people have become wary of the medication because a small percentage of patients experience “Paxlovid rebound” — a recurrence of Covid symptoms or positive test results. Several high-profile rebound cases, including President Biden and his top Covid adviser, Dr. Anthony Fauci, have added to the concern.

“For people who are already qualified for Paxlovid use, to me, really the choice is clear,” Dr. Ziyad Al-Aly, the senior author of the study, said. “Do you get a metallic taste, do you get side effects from Paxlovid, can you get rebound? Yes. But we have proven data suggesting that Paxlovid in the acute phase reduces the risk of severe illness, meaning the risk of death and hospitalization. And now we’re showing in the post-acute phase, there’s also risk reduction.”

Dr. Al-Aly and Dr. Peluso said many medically eligible patients were either not getting access to the drug or were declining it. “This study provides further evidence for treating people who have acute Covid with antivirals, especially if they have risk factors for severe outcomes,” Dr. Peluso said.

Most study participants were male, three-quarters were white, and their average age was about 65, so the findings may not apply to all patients. Still, Dr. Al-Aly said, regardless of race, sex, age or type of previous medical problem, “getting Paxlovid was actually better than not getting it in terms of reducing risk in the acute phase and reducing risk in the post-acute phase.”

One explanation for the findings, Dr. Peluso said, is related to the fact that people who become severely ill in the acute phase of infection are more prone to long-lasting symptoms or to developing new health issues weeks later. So, by helping patients avoid hospitalization and other serious initial consequences, Paxlovid could prevent some post-Covid symptoms “tied to the damage done in the first couple of weeks of infection,” he explained.

He added that another reason a beneficial effect on long Covid seemed logical is that “many of the risk factors for severe Covid are likely to overlap” with risk factors for long Covid.

 Still, many people who experience only mild symptoms in their initial infections develop long Covid, as do people who did not have previous risk factors.

Dr. Al-Aly said it’s possible that “giving your immune system a hand by suppressing that virus initially is really kind of like nipping it in the bud, producing a risk reduction for the acute stage and also in the post-acute phase.”

That would support a theory that one cause of long Covid might be viral fragments persisting in the body, keeping the immune system activated.

For the study, Dr. Al-Aly, chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis, and colleagues evaluated the records of veteran’s administration patients whose risk factors included being over 60, being overweight, smoking or having conditions like cancer, heart disease, hypertension or diabetes.

After about 90 days, patients who took Paxlovid — three pills twice a day for five days — were less likely to exhibit 10 out of 12 long Covid medical issues, including fatigue, shortness of breath, muscle pain, blood clotting problems, cardiovascular problems and neurocognitive impairments like brain fog. For unclear reasons, Dr. Al-Aly said, there was no significant difference between Paxlovid and non-Paxlovid patients for two post-Covid issues: new-onset diabetes and coughing.

Overall, for every 100 patients treated with Paxlovid, there were 2.3 fewer cases of long Covid, the study found.

Patients with the poorest health before their coronavirus infection — with more than five risk factors for experiencing serious Covid illness — experienced the greatest risk reduction for long Covid. Patients who had received booster doses of vaccines experienced lower risk reduction than those who were unvaccinated or vaccinated without boosters, probably, Dr. Al-Aly said, because boosters had already given them greater immune system protection.

Dr. Al-Aly said many additional questions about antivirals should be explored, such as whether taking Paxlovid for more days or in higher doses would further reduce risk for long Covid.

Dr. Peluso cautioned that in the study the treatment “did not completely eliminate post-Covid conditions” and said that at his hospital, “we have seen cases of people who develop long Covid despite antiviral treatment in early infection.”

So, he said, “much like vaccination, antiviral treatment during acute infection is likely to be one tool in the armamentarium to reduce the risk of post-Covid sequelae, but is unlikely to totally solve the problem.”"

Kaip pasiekti stabilią visuomenės būklę?

Apmokestinkite kiekvieną gramą medžiagų, kurias įmonės išleidžia į kosmosą, orą, vandenį ir žemę.

 

Taikyti vienodus muitus importuojamiems daiktams ir paslaugoms iš šalių, kurios tokių mokesčių netaiko.

 

Ta pačia suma sumažinti kitus įmonių mokesčius.

 

Atvirai skelbkite visus tokius mokesčius, kad žinotume, kokia yra mūsų padėtis, palyginti su kitais, ir kur einame.

How to reach a steady state of society?

Tax every gram of substances that companies put out into outer space, air, water and on land.

Charge equal custom duties on imported things and services from countries that do not use such taxes.

Reduce other taxes of the companies for the same amount. 

Openly publish all our taxes, so we know what our situation is compared with others, and where are we going.

Mirė 84 metų Hermanas Daly, metęs iššūkį ekonomikos augimo evangelijai

„Ko gero, žinomiausias ekologijos ekonomistas, jis kaltino savo bendraamžius, kad jie neatsižvelgė į žalą aplinkai, kurią gali sukelti augimas.

 

Hermanas Daly, kuris daugiau, nei 50 metų tvirtino, kad ekonomikos augimo evangelija, kaip klestėjimo ir pažangos sinonimas, iš esmės ir pavojingai buvo klaidinga, nes neatsižvelgė į su tuo susijusias išlaidas, ypač į gamtos išteklių išeikvojimą ir jos sukeliamą taršą, mirė spalio 28 d. Ričmonde, Va. Jam buvo 84 metai.

 

Mirtį ligoninėje sukėlė smegenų kraujavimas, sakė jo dukra Karen Daly Junker.

 

Dr. Daly, ekologijos ekonomistas, beveik neabejotinai buvo pagrindinis savo srities populiarintojas dėl savo daugiau, nei tuzino, knygų ir daugybės žurnalų straipsnių, dėstytojų pareigų Merilendo universitete ir anksčiau Luizianos valstijos universitete ir, šiek tiek nesuderinamą su aplinka ten, šešerių metų laikotarpį, dirbant Pasaulio banke.

 

Nors tarp tradicinių ekonomistų jis buvo pripažintas eretiku dėl savo teorijų arba, dar blogiau, ignoruojamas, jis turėjo daug šalininkų, kurie jį laikė pranašu, numatantį vis žalingesnį klimato kaitos poveikį ir milžiniškas pinigų sumas, reikalingas jam spręsti.

 

„Jo idėjos dabar tikrai aktualios, kitaip, nei daugumos kitų ekonomistų, kurių idėjos praranda aktualumą, laikui bėgant ir keičiantis aplinkybėms“, – ekologijos ekonomistas Peteris A. Victoras, 2021 m. išleistos biografijos „Herman Daly's Economics for a Full World“ autorius. “, - sakė interviu telefonu.

 

Vienas iš pagrindinių daktaro Daly principų buvo tas, kad augimas yra „neekonomiškas“, kai jo išlaidos viršija naudą. Ši idėja buvo susieta su kita: Žemė, kadaise buvusi tuščia, dabar pilna – žmonių ir jų gaminamos produkcijos – ir norint nubrėžti tvaresnį kelią, reikia naudoti mažiau gamtos išteklių ir gaminti mažiau atliekų.

 

„Tai tikrai nesunku suprasti“, – 2011 m. vaizdo interviu su WWF Švedija sakė daktaras Daly. „Galiu tai paaiškinti savo anūkams“.

 

Dar viena pamatinė koncepcija buvo ta, kad ekonomika neegzistuoja atskirai nuo Žemės biosferos, o joje, ekonomikos mastą riboja priklausomybė nuo ribotų gamtos išteklių.

 

Tokie pasiūlymai gali atrodyti paprasti, bet ginčytis prieš ekonomikos augimą, daktaras Daly rašė pono Viktoro knygos pratarmėje, prilygsta „didelio širšių lizdo erzinimui trumpa lazdele“.

 

„Tai grubiai sutrikdo labai didelį ir patogų sutarimą“, – pridūrė jis.

 

Jis paragino politikus, vyriausybes ir kitus ekonomistus atsisakyti nepaliaujamo augimo siekimo ir sukurti vadinamąją stabilią ekonomiką, kuri leistų pasiekti stabilią pusiausvyrą tarp žmogaus gyvybės palaikymo ir aplinkos tausojimo. Jis panaudojo orlaivio metaforą, kad paaiškintų savo pageidaujamą požiūrį.

 

„Nesugebėjimas augti augančiai ekonomikai yra katastrofa“, – šiais metais jis sakė žurnalui „The New York Times Magazine“. „Pastovios ekonomikos sėkmė neaugti nėra katastrofa. Tai tarsi skirtumas tarp lėktuvo ir malūnsparnio. Lėktuvas skirtas judėti pirmyn. Jei lėktuvas turi stovėti vietoje, jis nukris. Sraigtasparnis sukurtas stovėti vietoje, kaip kolibris.

 

Jis pasiūlė bendrąjį vidaus produktą pakeisti tokiais rodikliais kaip „tvarios ekonominės gerovės indeksas“, kuris atitiktų ne tik pagamintų prekių ir paslaugų vertę, bet ir proceso metu padarytą žalą aplinkai. Jam „tvarus augimas“ buvo nesąmonė; „tvari plėtra“ buvo tikslas.

 

Viename interviu Joshua Farley, ekonomistas ir knygos „Ekologinė ekonomika: principai ir taikymas“ (2004 m.) bendraautorius su dr. Daly, glaustai apibendrino savo kolegos ekonomikopagyvinimo filosofiją: „Daugiau ne visada yra geriau“.

 

Daktaro Dalio ekonominiai įsitikinimai buvo pagrįsti sunkiais mokslais, tokiais, kaip termodinamikos dėsniai, bet ir etiniais idealais, tokiais, kaip teisingas turto paskirstymas, ir jo, kaip metodisto, matančio Žemę kaip visagalio kūrėjo rankų darbą, tikėjimu.

 

Net kai pastaraisiais metais jo teorijos įgijo aktualumą, jos liko už ekonominio mąstymo pagrindo ribų. Atrodė, kad jis neprieštarauja.

 

„Mano pareiga yra padaryti viską, ką galiu, ir pateikti keletą idėjų“, – sakė jis interviu „The Times Magazine“. „Ar mano pasodinta sėkla išaugs, nepriklauso nuo manęs. Tik aš turiu ją pasodinti ir palaistyti."

 

Hermanas Edwardas Daly gimė 1938 m. liepos 2 d. Hiustone Edvardo Džozefo Daly, kuriam priklausė degalinė Beaumont mieste, Teksase, kur tuo metu gyveno šeima, ir Mildred (Herrmann) Daly, namų šeimininkės, dirbusios buhaltere prieš ištekant. Vėliau šeima persikėlė į Hiustoną, kur Edas Daly atidarė techninės įrangos parduotuvę.

 

Prieš pat Hermanui sukako 8 metai, jis susirgo poliomielitu, dėl kurio jo kairė ranka tapo nenaudinga. Po kelerių metų nesėkmingų pastangų ją taisyti, jis pasirinko amputaciją, kai ruošėsi stoti į vidurinę mokyklą.

 

„Kad ir kaip tai būtų traumuojanti patirtis, tai neleido man švaistyti laiko, tikintis, kad pasveiksiu ir išgelbėjo mane nuo daug energijos sunaudojimo gydymo metu, gydymo, kuris būtų mažai arba visai nenaudingas “, – rašė jis 2014 metų asmeninėje istorijoje. „Ši skausminga patirtis išmokė mane susikoncentruoti į tai, ką galiu padaryti, ir nešvaistyti energijos dalykams, kurių negaliu padaryti“.

 

Baigęs vidurinę mokyklą 1956 m., jis įstojo į tuo metu žinomą Rice institutą (dabar Rice universitetas) Hiustone. Atėjus laikui paskelbti specialybę, jis pasirinko ekonomiką, nes, jo teigimu, jautė, kad joje susilieja mokslai ir humanitariniai mokslai.

 

„Kaip vėliau atrado, – jo biografijoje rašė daktaras Viktoras, – paaiškėjo, kad tai netiesa.

 

1960 m. daktaras Daly įgijo bakalauro laipsnį, o vėliau įstojo į Vanderbilto universiteto doktorantūros programą, daugiausia dėmesio skirdamas plėtrai Lotynų Amerikoje.

 

Du žmonės, kuriuos jis sutiko būdamas Vanderbilte, vaidins pagrindinius vaidmenis jo gyvenime.

 

Vienas, jo pradinis patarėjas baigiamajame darbe, rumunų matematikas ir ekonomistas Nicolas Georgescu-Roegen, padėjo pagrindus tam, kas tapo ekologine ekonomika, 1971 m. išleista knyga „Entropijos dėsnis ir ekonominis procesas“, kurioje teigiama, kad visi gamtos ištekliai yra visam laikui degraduojami, kai naudojami ūkinei veiklai.

 

Kita buvo Marcia Damasceno, Brazilijos koledžo studentė, kurią jis vedė 1963 m. Kartu su dukra Karen ji išgyvena jį, kaip ir kita dukra Terri Daly Stewart; jo sesuo Denis Lynn (Daly) Heyck, ispanų kalbos ir literatūros profesorė emerita Čikagos Lojolos universitete; ir trys anūkai.

 

1967 m., kai daktaras Daly gavo daktaro laipsnį iš Vanderbilto, jis dėstė L.S.U. Ten jis pradėjo daugiau dėmesio skirti ekonomikos, aplinkos ir etikos sąsajoms, pabrėždamas XIX amžiaus britų ekonomisto Johno Stuarto Millo suformuluotus pastovios būsenos principus. 1973 m. daktaras Daly išleido savo pirmąją knygą „Pastovios ekonomikos link“.

 

Jis liko L.S.U. iki 1988 m., kai mažai tikėtinu žingsniu jis įstojo į Pasaulio banką Vašingtone, kaip aplinkos apsaugos departamento vyresnysis ekonomistas. „Man buvo didelis netikėtumas, kad Pasaulio bankas, kurio pagrindinė politika buvo ekonomikos augimas, pasiūlė man darbą“, – rašė jis.

 

Ten būdamas, jis sukūrė savo „tris tvaraus vystymosi taisykles“ ir bendradarbiavo su kitais bandydamas pakeisti banko BNP matavimo sistemą. kad atspindėtų aplinkosaugos išlaidas. Jis rašė, kad pastangos buvo „mažos arba bevaisės“. 1994 m. jis persikėlė į Merilendo universiteto Viešosios politikos mokyklą, o 2010 m. gavo emerito statusą.

 

Kita žymi daktaro Daly knyga yra „Už bendrą gerovę: ekonomikos nukreipimas į bendruomenę, aplinką ir tvarią ateitį“ (1989), parašyta kartu su teologu Johnu B. Cobbu jaunesniuoju.

 

Johnas Fullertonas, buvęs komercinis bankininkas, dabar vadovaujantis „Capital Institute“, tyrimų organizacijai, įsikūrusiai Stoningtone (Conn.), kurio darbas atitinka knygos nurodymus, yra tarp tų, kuriems įtakos turėjo „Už bendrą gėrovę“.

 

Viename interviu F. Fullertonas sakė, kad vienas iš svarbiausių daktaro Daly indėlių buvo jo dėmesys „vystymosi, kuris nebuvo fizinis, pageidaujant gerovės“, siekis. Kitas, pasak jo, buvo teigti, kad tradiciniai požiūriai į finansus ir ekonomiką „numeta mus nuo uolos į bedugnę“."

 

Herman Daly, 84, Who Challenged the Economic Gospel of Growth, Dies

"Perhaps the best-known ecological economist, he faulted his mainstream peers for failing to account for the environmental harm growth can bring.

Herman Daly, who for more than 50 years argued that the economic gospel of growth as synonymous with prosperity and progress was fundamentally, and dangerously, flawed because it ignored its associated costs, especially the depletion of natural resources and the pollution it engenders, died on Oct. 28 in Richmond, Va. He was 84.

The death, at a hospital, was caused by a brain hemorrhage, his daughter Karen Daly Junker said.

Dr. Daly, an ecological economist, was almost surely his field’s chief popularizer through his more than a dozen books and many journal articles, his faculty positions at the University of Maryland and, earlier, Louisiana State University, and his somewhat incongruous six-year stint at the World Bank.

Although he was branded a heretic for his theories — or, worse, ignored — among traditional economists, he had plenty of adherents, who saw him as prophetic for anticipating climate change’s increasingly harmful impact and the vast sums of money needed to address it.

“His ideas are really relevant now, unlike most other economists, whose ideas tend to lose relevance as time passes and circumstances change,” Peter A. Victor, an ecological economist and the author of the 2021 biography “Herman Daly’s Economics for a Full World,” said in a phone interview.

One of Dr. Daly’s key principles was that growth is “uneconomic” when its costs outweigh its benefits. That idea was tied to another: Earth, once empty, is now full — of people and what they produce — and charting a more sustainable path requires the use of fewer natural resources and the making of less waste.

“That’s not really hard to understand,” Dr. Daly said in a 2011 video interview with WWF Sweden. “I can explain that to my grandchildren.”

Yet another foundational concept was that the economy does not exist apart from the Earth’s biosphere but within it, and that its scale is limited by its reliance on finite natural resources.

Such propositions might seem simple, but arguing against economic growth, Dr. Daly wrote in a foreword to Mr. Victor’s book, was like poking “a big hornets’ nest with a short stick.”

“It rudely upsets a very large and comfortable consensus,” he added.

He urged politicians, governments and other economists to abandon the relentless pursuit of growth in favor of a so-called steady-state economy, which would achieve a stable balance between supporting human life and preserving the environment. He employed an aircraft metaphor to explain his preferred approach.

“The failure of a growth economy to grow is a disaster,” he told The New York Times Magazine in a profile of him this year. “The success of a steady-state economy not to grow is not a disaster. It’s like the difference between an airplane and a helicopter. An airplane is designed for forward motion. If an airplane has to stand still, it’ll crash. A helicopter is designed to stand still, like a hummingbird.”

He proposed replacing gross domestic product with metrics like an “index of sustainable economic welfare,” which would tally not just the value of goods and services produced but also the ecological harm done in the process. To him, “sustainable growth” was nonsensical; “sustainable development” was the goal.

In an interview, Joshua Farley, an economist and co-author with Dr. Daly of “Ecological Economics: Principles and Applications” (2004), boiled his colleague’s animating philosophy down concisely: “More isn’t always better.”

Dr. Daly’s economic beliefs were grounded in hard sciences like the laws of thermodynamics, but also in ethical ideals, like the fair distribution of wealth, and in his faith as a Methodist who saw the Earth as the handiwork of an almighty creator.

Even as his theories gained currency in recent years, they remained outside economic thinking’s mainstream. He did not seem to mind.

“My duty is to do the best I can and put out some ideas,” he said in The Times Magazine interview. “Whether the seed that I plant is going to grow is not up to me. It’s just up to me to plant it and water it.”

Herman Edward Daly was born on July 2l, l938, in Houston to Edward Joseph Daly, who owned a service station in Beaumont, Texas, where the family lived at the time, and Mildred (Herrmann) Daly, a homemaker who had worked as a bookkeeper before marrying. The family later moved to Houston, where Ed Daly opened a hardware store.

Shortly before Herman turned 8, he contracted polio, which rendered his left arm useless. After unsuccessful efforts to repair it over several years, he opted for amputation when he was about to enter high school.

“As traumatic as this was, it stopped me from wasting my time hoping I would recover and saved me from using lots of energy going through treatment that would be of little or no benefit,” he wrote in a 2014 personal history. “This painful experience taught me to concentrate on what I am able to do and not waste energy on things that I can’t do.”

After graduating from high school in 1956, he entered what was then known as the Rice Institute (now Rice University) in Houston. When the time came to declare a major, he chose economics because, he said, he felt it merged science and the humanities.

“As he later discovered,” Dr. Victor wrote in his biography, “that turned out not to be true.”

Dr. Daly earned his bachelor’s degree in 1960 and then enrolled in a doctorate program at Vanderbilt University with a focus on development in Latin America.

Two people he met while at Vanderbilt would play major roles in his life.

One, his original thesis adviser, the Romanian mathematician and economist Nicolas Georgescu-Roegen, helped lay the groundwork for what became ecological economics with his 1971 book “The Entropy Law and the Economic Process,” which argued that all natural resources are permanently degraded when used for economic activity.

The other was Marcia Damasceno, a Brazilian college student whom he married in 1963. Along with his daughter Karen, she survives him, as do another daughter, Terri Daly Stewart; his sister, Denis Lynn (Daly) Heyck, professor emeritus of Spanish language and literature at Loyola University Chicago; and three grandchildren.

By the time Dr. Daly received his doctorate from Vanderbilt in 1967, he was teaching at L.S.U. There, he began to focus more closely on the interconnections between the economy, the environment and ethics, with an emphasis on the steady-state principles articulated by the 19th-century British economist John Stuart Mill. Dr. Daly published his first book, “Toward a Steady-State Economy,” in 1973.

He remained at L.S.U. until 1988, when, in an unlikely move, he joined the World Bank in Washington as a senior economist in the environment department. “It was a big surprise for me that the World Bank, whose basic policy was economic growth, offered me a job,” he wrote.

While there, he developed his “three rules for sustainable development” and worked with others to try to change the bank’s system for measuring G.D.P. to reflect environmental costs. The efforts, he wrote, were “to little or no avail.” He moved to the University of Maryland’s School of Public Policy in 1994, taking emeritus status in 2010.

Dr. Daly’s other notable books include “For the Common Good: Redirecting the Economy Toward Community, the Environment, and a Sustainable Future” (1989), written with the theologian John B. Cobb Jr.

John Fullerton, a former commercial banker who now leads the Capital Institute, a research organization based in Stonington, Conn., whose work is aligned with the book’s prescriptions, is among those who have been influenced by “For the Common Good.”

In an interview, Mr. Fullerton said one of Dr. Daly’s most important contributions was his focus on “a pursuit of development that was not physical to achieve prosperity.” Another, he said, was to argue that traditional approaches to finance and economics “lead us off a cliff.””