Really appreciate your focus on long COVID, as so many millions of us are counting on this research to eventually restore our health. And thank you for sharing about your own recent experience with COVID. I’m glad you made it through okay and very smart to have waited before exercising.
Dr. Topol highlights two remaining tasks: 1. Treatment of long COVID and 2. Inhaled vaccines. Why no mention of masking? A third task would seem to be to help the public (here and internationally) understand how truly effective masking is at reducing risk. It continues to mystify me why bad research like the Cochrane study receives so much publicity while good-quality research (eg Cash-Goldwasser S, Reingold AL, Luby SP, Jackson LA, Frieden TR. Masks During Pandemics Caused by Respiratory Pathogens-Evidence and Implications for Action. JAMA Netw Open. 2023 Oct 2;6(10):e2339443. doi: 10.1001/jamanetworkopen.2023.39443. PMID: 37906187) is ignored.
Thank you, Dr. Topol. As a layperson, I appreciate your substack very much. You and a few others have kept me informed since the beginning of the pandemic. I do have a question though; when you say "monovalent XBB.1.5 booster:" does that include Novavax? I assume yes, but as a still NOVID over 60, I just want to be sure. Thanks!
Thanks. Yes on Novavax for the updated booster. I’d consider it preferred over the others for less reactigenic side effects and likely an added kick in immune response achieved by mixing with prior mRNAs
I wanted so badly to get the Novavax this time around, but I felt strongly I needed to get my booster in early October given that I was going into a risk environment where for a part of the time, I could not mask. I’m a musician, a singer specifically, and I was performing indoors for the first time Since 2019. Talk about nerve-racking. :-) So I went ahead and got the Pfizer, but I’m definitely going to do the Novavax next time around.
This blog has been very helpful over the years, especially with respect to the vaccines. My wife and I have been in almost total isolation for the past four years. We do socialize occasionally with people who test negative twice in 24 hours. This strategy failed us recently. Would you consider doing a blog on tests, both RATs and RT-LAMP based? The RATs do not seem to detect before infectivity.
I’d love to read more about the synthesis of all the studies around the long-term potential for generalized immune dysregulation from repeated Covid infections, outside of long Covid. I do my best to try to keep up, but for many of us who are laypeople, it’s too much to understand without some concatenation and expert interpretation.
My posture since March 2020 has always been to take this virus very seriously. To wit, I have never dropped my mask. Ever. I am both disappointed and completely enraged that here in the US, if only by an absence of correction, the government seems to be going along with “Covid is over“. I don’t wish for this likely coming wave to be a thing, but I’m absolutely expecting it to be a thing.
When do we change course in the messaging around this? People are on their own to try to assess risk and make choices. I find it completely unacceptable, and am looking for any guidance on how to navigate this new, and what I consider most dangerous, phase of Covid where it’s still there, it’s still damaging people terribly, but even those who are cautious are constantly dodging the majority of others who are not.
Thank you for another wonderful article. I also appreciate your candor about getting COVID. My response to those who say just get on with it and don’t be afraid of getting COVID, is the following. First, obviously healthy younger patients almost always fare better than the elderly, but there is no guarantee that will be the case. Also, the same goes with the risk of Long-COVID. But more important, we as health care professionals owe it to our patients, colleagues, other healthcare professionals, and our community, to show that we actually care about the health of others, and will continue to make an effort to protect everyone.
Thank you for the time and consideration you give to all of us who want to stay informed. You are greatly appreciated. Your presence helped me personally get through a bout of Covid last December with a PCP who refused to prescribe Paxlovid. I would have panicked without what I’d learned from you. Here’s hoping you’re over and done with your Covid soon & regain full health.
Thank you for this superb Covid update. I join with others here in gratitude to you for persisting in providing clear, accurate public-facing communications despite the difficulties attendant to that role. I also want to highlight your closing “take-away,” and I do hope those in government and with larger megaphones than mine will take notice and act now to bring about the two things you mention.
Last, by no means least, I am so glad your bout with Covid was a mild one--and so wonderfully typical of you, I appreciate the way you use it to offer larger lessons.
With Covid I plan to take paxlovid for 5-10 days, use a nasal saline rinse for local replication disruption, probably try metformin, continue a low dose statin especially in the months after (hopefully) recovering.
Until the investigational pro/prebiotic gains traction, a favorite probiotic is Visbiome (for inflammatory bowel disease and IBS among other uses), as it actually has many studies supporting its use for gut dysbiosis. Previously called VSL#3. No idea if this helps long Covid, but would seem worth an investigation based on the study you’ve referenced.
Dr Topol, I wish to thank you for sharing such important information! And a question: since I had the most current vaccination (Pfizer) > 3 months ago, would it be wrong to consider a Novavax injection soon?
I'd say that a 3rd concern is to widely immunize all areas of the world. I keep thinking about Prof. Hotez's mission to immunize the global South, with vax that is easy to make/distribute. It's in everyone's best interests.
Sorry to hear about your infection, but glad your symptoms weren’t too bad.
Agree about unfulfilled objectives and lack of urgency around inhaled vaccines to induce upper and lower respiratory tract immunity. To some extent, it’s a consequence of the success of injectable vaccines coupled with infection-induced immunity. So the prevailing opinion is COVID no longer presents a threat worth preventive measures.
Still, we are in a far better position than in 2020. And I believe effective therapies for the multiple manifestations of Long COVID will be found.
Grateful for you, Eric Topol. Thank you for your work and for helping lay people understand complex issues, too.
Really appreciate your focus on long COVID, as so many millions of us are counting on this research to eventually restore our health. And thank you for sharing about your own recent experience with COVID. I’m glad you made it through okay and very smart to have waited before exercising.
Thank you!
Dr. Topol highlights two remaining tasks: 1. Treatment of long COVID and 2. Inhaled vaccines. Why no mention of masking? A third task would seem to be to help the public (here and internationally) understand how truly effective masking is at reducing risk. It continues to mystify me why bad research like the Cochrane study receives so much publicity while good-quality research (eg Cash-Goldwasser S, Reingold AL, Luby SP, Jackson LA, Frieden TR. Masks During Pandemics Caused by Respiratory Pathogens-Evidence and Implications for Action. JAMA Netw Open. 2023 Oct 2;6(10):e2339443. doi: 10.1001/jamanetworkopen.2023.39443. PMID: 37906187) is ignored.
Thank you, Dr. Topol. As a layperson, I appreciate your substack very much. You and a few others have kept me informed since the beginning of the pandemic. I do have a question though; when you say "monovalent XBB.1.5 booster:" does that include Novavax? I assume yes, but as a still NOVID over 60, I just want to be sure. Thanks!
Thanks. Yes on Novavax for the updated booster. I’d consider it preferred over the others for less reactigenic side effects and likely an added kick in immune response achieved by mixing with prior mRNAs
That's exactly what I thought but appreciate your affirmation. Sorry about your bout of COVID but glad it was mild. Have a wonderful Christmas!
I wanted so badly to get the Novavax this time around, but I felt strongly I needed to get my booster in early October given that I was going into a risk environment where for a part of the time, I could not mask. I’m a musician, a singer specifically, and I was performing indoors for the first time Since 2019. Talk about nerve-racking. :-) So I went ahead and got the Pfizer, but I’m definitely going to do the Novavax next time around.
This blog has been very helpful over the years, especially with respect to the vaccines. My wife and I have been in almost total isolation for the past four years. We do socialize occasionally with people who test negative twice in 24 hours. This strategy failed us recently. Would you consider doing a blog on tests, both RATs and RT-LAMP based? The RATs do not seem to detect before infectivity.
New study found RATs only detect 48% with latest omicron variants vis-a-viz PCR.
https://x.com/SaiyanBio/status/1738231550607843519?s=20
Hello Dr. Topol. I finally subscribed.
I’d love to read more about the synthesis of all the studies around the long-term potential for generalized immune dysregulation from repeated Covid infections, outside of long Covid. I do my best to try to keep up, but for many of us who are laypeople, it’s too much to understand without some concatenation and expert interpretation.
My posture since March 2020 has always been to take this virus very seriously. To wit, I have never dropped my mask. Ever. I am both disappointed and completely enraged that here in the US, if only by an absence of correction, the government seems to be going along with “Covid is over“. I don’t wish for this likely coming wave to be a thing, but I’m absolutely expecting it to be a thing.
When do we change course in the messaging around this? People are on their own to try to assess risk and make choices. I find it completely unacceptable, and am looking for any guidance on how to navigate this new, and what I consider most dangerous, phase of Covid where it’s still there, it’s still damaging people terribly, but even those who are cautious are constantly dodging the majority of others who are not.
Completely agree with the need to take the virus very seriously
Thank you for another wonderful article. I also appreciate your candor about getting COVID. My response to those who say just get on with it and don’t be afraid of getting COVID, is the following. First, obviously healthy younger patients almost always fare better than the elderly, but there is no guarantee that will be the case. Also, the same goes with the risk of Long-COVID. But more important, we as health care professionals owe it to our patients, colleagues, other healthcare professionals, and our community, to show that we actually care about the health of others, and will continue to make an effort to protect everyone.
in complete agreement, John. Thanks!
Thank you for the time and consideration you give to all of us who want to stay informed. You are greatly appreciated. Your presence helped me personally get through a bout of Covid last December with a PCP who refused to prescribe Paxlovid. I would have panicked without what I’d learned from you. Here’s hoping you’re over and done with your Covid soon & regain full health.
Thank you!
Thank you for this superb Covid update. I join with others here in gratitude to you for persisting in providing clear, accurate public-facing communications despite the difficulties attendant to that role. I also want to highlight your closing “take-away,” and I do hope those in government and with larger megaphones than mine will take notice and act now to bring about the two things you mention.
Last, by no means least, I am so glad your bout with Covid was a mild one--and so wonderfully typical of you, I appreciate the way you use it to offer larger lessons.
Thanks for the update!
With Covid I plan to take paxlovid for 5-10 days, use a nasal saline rinse for local replication disruption, probably try metformin, continue a low dose statin especially in the months after (hopefully) recovering.
Until the investigational pro/prebiotic gains traction, a favorite probiotic is Visbiome (for inflammatory bowel disease and IBS among other uses), as it actually has many studies supporting its use for gut dysbiosis. Previously called VSL#3. No idea if this helps long Covid, but would seem worth an investigation based on the study you’ve referenced.
Other studies:
https://pubmed.ncbi.nlm.nih.gov/?term=vsl%203
And PS, thanks for your candid discussion of your own Covid illness, sounds like you are doing fine and I’m happy for that!
Dr Topol, I wish to thank you for sharing such important information! And a question: since I had the most current vaccination (Pfizer) > 3 months ago, would it be wrong to consider a Novavax injection soon?
Good question. There aren’t any data but if you are high risk and out 4-6 months, there may well be added benefit from severe Covid protection
I'd say that a 3rd concern is to widely immunize all areas of the world. I keep thinking about Prof. Hotez's mission to immunize the global South, with vax that is easy to make/distribute. It's in everyone's best interests.
Thanks again for such important work!
agree!
Here's to your good health. Thanks for sharing your experience. Thank you for bringing us important news and perspective.
Dr. Topol, have you revisited data on asymptomatic transmission in the era of Omicron and high population immunity? Thanks for your work.
We haven't looked again at ASx transmission post-Omicron---that's a very good question
Kudos once again Eric for another insightful spot-on update for us all, and just two weeks shy from the end of 2023!
Happy Holidays!
Shannon
Lots of good information. Thanks for sharing.
Sorry to hear about your infection, but glad your symptoms weren’t too bad.
Agree about unfulfilled objectives and lack of urgency around inhaled vaccines to induce upper and lower respiratory tract immunity. To some extent, it’s a consequence of the success of injectable vaccines coupled with infection-induced immunity. So the prevailing opinion is COVID no longer presents a threat worth preventive measures.
Still, we are in a far better position than in 2020. And I believe effective therapies for the multiple manifestations of Long COVID will be found.