According to 'The Science,' Paxlovid's a dud. By the same criteria, so are the shots

Almost three years ago, Paxlovid (nirmatrelvir/ritonavir), Pharma's latest wonder-drug, was being portrayed as just what everyone had been waiting for.

People didn't have to wait long for the drug—it was the clinical trial results showing that it worked that they had to wait for.

Well, now they're here.

We'll allow Dr. Jeremy Faust, Assistant Professor of Emergency Medicine, Harvard Medical School, Editor-in-Chief of Medpage Today, and author of Inside Medicine on Substack, to present them for us.

Frontline News' comments follow in red.

Jeremy Faust MD: Pfizer finally published its study of Paxlovid’s effects on symptoms for standard-risk and high-risk vaccinated patients with Covid-19.

Finally. Pfizer actually commenced this study in August, 2021 and promised to release the results by December of the same year, when public interest in the drug was probably at its peak. By now, most people have forgotten about it.

JF: The upshot of the trial, known as EPIC-SR and published in the New England Journal of Medicine, is that Paxlovid did not reduce the amount of time until patients got symptom relief. For anyone who thinks Paxlovid helps reduce symptoms, we now have high-quality, randomized, blinded, placebo-controlled clinical trial data—from the makers of the drug and published in the most prestigious medical journal in the world—saying otherwise. 

This isn’t actually the first time that the “upshot of the trial” has been published. Another “upshot” appeared in September, 2022 and was hailed by no less than the White House COVID commissar, Dr. Ashish Jha, as “pretty compelling stuff”—despite the fact that the results released back then were not from a “high-quality, randomized, blinded, placebo-controlled” study, but rather, from the unadjusted data. In other words, junk science.

Based on those “findings,” the United States government spent $5 billion on Paxlovid.

JF: Here’s what played out: In the Paxlovid group, 0.8% (5 of 654 participants) were either hospitalized for Covid or died (any cause), compared to 1.6% (10 of the 634 participants) in the placebo group. Though some might see that as a 50% relative reduction, the 0.8% absolute difference (1.6%-0.8%=0.8%) was not statistically significant.

A 50% relative reduction sounds quite impressive to the average Joe. Not quite as impressive as the 95% relative reduction of Pfizer’s COVID shots, of course.

But wait. Dr. Faust is now saying that relative reduction isn’t the thing. It’s absolute difference that matters. For Paxlovid, that was just 0.8%, not statistically significant, and therefore, the science has determined that Paxlovid is a dud.

What was the absolute difference between the Pfizer shots and placebo? Curiously, it was 0.85%.

JF: So, while not a death knell for Paxlovid, this study should profoundly change our “priors” on what to expect from the forthcoming PANORAMIC trial out of the United Kingdom (a massive study of thousands of vaccinated patients randomized to get Paxlovid or not).

Not a death knell? Well... But at least it should “profoundly change our ‘priors’” on the efficacy of the COVID shots. And perhaps a large randomized long-term study would be in order there, too, only unfortunately that is now impossible, because the randomized studies already conducted were unblinded just a few months into the trial, and everyone was given the shots.

JF: Why does this study go against what you’ve heard?

Maybe we can help Dr. Faust out with some answers.

1. Because all the three-letter agencies pushed Paxlovid as the greatest thing since sliced bread (other than the shots themselves)?
2. Because none other than Dr. Fauci, aka “The Science,” promoted it, donating his own body to scientific research when he took not just one but two courses of the drug (because his COVID rebounded after the first dose)?
3. Because the preliminary (albeit worthless) results from the trial were published years ago and gave a highly misleading impression?

JF: We are in a weird moment here. Paxlovid remains the best anti-viral we have, but the data supporting it are not nearly as impressive as they once were. 

It truly is a weird moment when Paxlovid is, despite devastating trial results, still considered “the best anti-viral we have” by a doctor. Many readers may have suggestions for other “best anti-virals” such as ivermectin. But perhaps Dr. Faust still thinks that’s a horse drug.

JF: It’s time to think ahead. The search for better anti-viral options for high-risk Covid-19 patients should start to feel more urgent. I hope the drug companies see an opportunity here.

Don’t worry, Dr. Faust. Drug companies are always seeing opportunities.