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You were one of those four-dose people.

That’s true, and I was also able to get a prophylactic monoclonal antibody. That’s probably why I think I caught a relatively mild illness. But it lasted 17 days and I had to take Paxlovid twice.

BTW, I don’t think we should call that a rebound. In other words, we don’t have a correct dosing schedule. It’s possible that Paxlovid will probably need a seven or ten day cycle.

So if I get Covid can I ask my doctor to give me Paxlovid for seven or ten days instead of five? [Note: The official guidance is that Paxlovid should be administered for five days, although some physicians have argued for the need for clearer guidance.]

Not yet. When people say they follow the science, they should say they follow the published science, which is always based on a study based on something that happened before. you are always behind

Sometimes it seems like politics, not science, drives politics. Biden said he would remain in isolation for longer than the recommended five days if he continued to test positive. Who is right?

Biden models very good behavior. This is really refreshing as the last president modeled the worst.

Sure, but it’s odd that the President has to disregard his own agency to do the right thing. [Note: Following this interview, Biden exited isolation after five days of testing negative, and then re-entered isolation after experiencing a rebound case.]

This is partly because Trump attacked the CDC when he was president. There was so much political interference that there was an exodus of CDC leaders and a loss of their institutional memory. But there was also a failure by the CDC to communicate well and update its recommendations.

Also, the CDC is slow. In a way, you want that to be the case—you want your doctor to be judgmental. But not too slowly. While her advice might have been perfect a year ago, it’s not perfect now. So now the government is talking about moving pandemic preparedness to what used to be a small agency – ASPR [Administration for Strategic Preparedness & Answer].

The CDC’s mandate goes well beyond pandemics. It works on health promotion, prevention. It is responsible for investigating heart disease and diabetes, international relations with other countries, conducting all health programs – all public health units of all different countries. But of course right now we are necessarily focused on the pandemic and infectious diseases and we are really dealing with Covid and monkeypox.

I wanted to mention monkeypox. What’s going on there?

Going back to 1967, WHO came up with the idea that the whole world should work together to eradicate smallpox. But what about other smallpox? The smallpox vaccine also protects against monkeypox. If you eradicate smallpox and then stop vaccinating, what will happen to the other smallpox that continued vaccination kept in check? We could have kept vaccinating. But we didn’t, and now nobody under the age of 40 has a vaccination scar.

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