Modest benefit, minimal risk

The COVID controversy du jour seems to center firmly around the booster shot.

Last week the Vaccine and Related Biological Products Advisory Committee at the FDA met to review data on the safety and efficacy of a potential third dose of the Pfizer vaccine.

I want to review the data we have available to inform decisions about dose three but first I want to clarify two things.

Number one, the boosters we are talking about are the exact same formulation as the original vaccine that have already been approved for use to prevent COVID-19. We are not talking about a…

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr. F. Perry Wilson of the Yale School of Medicine.

September 11th, 2001 was the day I learned the difference between the French word attaque, which you would use if someone attacked someone else, and the word attentat — for an attack against a building.

The latter was new to me, but blared across every TV screen in Paris, where I had been working as a singing waiter in a gap between college and medical school. …

The antidepressant appears to have some ability to prevent worsening in outpatients with COVID-19

By virtually all metrics, vaccine development for COVID-19 has been an astonishing success. But when it comes to therapeutics, the picture is much more mixed. This means the tip of the spear of the battle against coronavirus is and will remain vaccination, but, as you know, not everyone is getting vaccinated. We need therapeutics.

For nearly two years, the search for existing molecules with activity against COVID-19 has proceeded apace, but the process has been haphazard, and colored by political bias and misinformation. …

The rare condition can be devastating, but fortunately most kids recover.

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr. F. Perry Wilson of the Yale School of Medicine.

Kids are back in school throughout the country now, and, in many locations, the Delta variant of coronavirus is highly prevalent — raising the possibility of an impending epidemic of covid cases among children too young to be vaccinated.

Overall, though, we know that kids do relatively well with COVID — including with the Delta variant, though recent reports — including this one from the CDC — remind us that most kids who become infected…

Kids are getting COVID, and with the highly-infectious Delta variant still surging in the US, I have a lot of concern about outbreaks once all the children are back in school.

Of course, while some kids get very sick from COVID-19, most do not, thankfully. But kids tend to live with adults and so a key question is how often infected kids pass COVID-19 to other family members. And this week, appearing in JAMA Pediatrics, we get the most granular data yet answering that question.

There was a time, not so long ago, when COVID was not a thing. Most of us have resigned ourselves to the idea that we will never again truly be free from SARS-CoV-2. Sure, we might get case rates down very low, or population immunity high enough that the illness becomes relatively mild, but it will always be there, appearing in our electronic health record test results along with the other endemic respiratory viruses — flu, parainfluenza, etc.

Eradication of COVID — the complete removal of the virus from the world, seems like a pipe dream. At least, it does…

Antigen tests are cheap, easy to read, widely available, and importantly, sensitive when viral loads are high.

Somehow, it’s already August. And that means soon millions of children across the country will be heading back to school.

We thought the days of broad school closures were behind us. Though there was a concern last year that reopening schools would lead to a bunch of adorable little viral vectors running around, driving community spread, no such link was found. Schools, especially those that did a good job with masking and ventilation — appeared to pose a relatively low risk to public health.

This school year, things have changed. On the plus side, teachers — who are at substantially…

A new analysis suggests there have been fewer undocumented cases than previously thought. This is bad news.

Possibly the most maddening statistic to find during this pandemic has been one of the simplest — the number of COVID infections.

Let’s just call it a health food at this point.

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr. F. Perry Wilson of the Yale School of Medicine.

There’s a near truism in dietary science that anything that is too pleasurable is probably not good for you. It holds for ultra-processed foods, refined sugars, alcohol. But there is one stubborn hold out to this trend. One thing you can ingest that provides both pleasure, and, in study after study, health benefits. It’s sort of a unicorn. I’m speaking, of course, of coffee.

Coffee has come a long way since being falsely implicated in…

It’s time we talk about ivermectin.

Since the first days of the COVID-19 pandemic, various existing drugs have been touted as near miracle cures for the disease. Often, the discussion of agents like hydroxychloroquine, lopinavir, and their ilk veered into the conspiratorial, squelching reasonable scientific discussion. Boosters would accuse detractors of hiding the truth of a safe and effective treatment at the behest of big pharma, or the deep state. Detractors would accuse boosters of bad data analysis and wishful thinking.

Enter Ivermectin, and this meta-analysis of randomized trials by Andrew Hill and his colleagues in Open Forum Infectious Diseases…

F. Perry Wilson, MD MSCE

Writing about medicine, science, statistics, and the abuses thereof. Commentator at Medscape. Associate Professor of Medicine at Yale University.

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