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Walensky downplays Pfizer wonder drug: The best way to protect yourself from COVID is to not get it

She’s getting dragged for this by some righties on Twitter today, which I partly agree with. Watch a minute or so of the clip below as the hosts of the “Today” show tee her up for a little rhetorical high-fiving over the wonderful news from Pfizer that its miracle pill continues to look good in trials. If three doses of the vaccine are effective against the new variant and if a highly effective therapeutic is coming soon to pharmacies to treat those who get infected anyway, that’s … good news, right?

Like, “the pandemic’s over, let’s get back to normal”-quality good news.

Meh, says Rochelle Walensky when asked about it. It’s a nice tool in our toolbox — but vaccination remains the only real game in town. Watch.

All of the CDC’s messaging faults are on display there. First, she’s shading the truth from the public in order to achieve a desired behavior. She wants people to continue to get vaxxed and boosted and likely fears that promoting Pfizer’s drug will lead them to slack off, believing that they can just get the pill if they get infected. Second, she probably doesn’t want to say anything that might lead Americans to lower their guard on social distancing and mask-wearing just as Omicron is taking off. Tell people that there’s a miracle drug coming soon and they might hold that crowded Christmas party they were planning after all. And third, her goal here of preventing infection seems hopelessly unrealistic with an insanely infectious new variant spreading globally. We’re never going to reach “zero COVID.” Virtually all of us will catch the virus eventually. Skip the lecture about trying not to get infected and just tell us how to minimize our risk of complications.

But.

On the merits, what she says is true. Paxlovid, the wonder drug, sounds phenomenal but it’s not a one-to-one substitute for vaccination. Pfizer’s CEO was on CNN this afternoon and was asked about the prospect of vaccine skeptics deciding not to get the shot since there’ll soon be a highly effective pill to treat them after they’re infected. Bad idea, said Albert Bourla:

“If people see this news and think, ‘I don’t need to get vaccinated or boosted anymore, I can just take this pill,’ what do you say to that?” CNN’s Kate Bolduan asked Bourla in an afternoon interview.

“I’m afraid that there will be some people who will think like that,” the Greek-American CEO replied. “It’s a very big mistake. In fact, vaccines are needed. Vaccines [are] the primary frontier that you should be using to stop the disease. The goal is not to get sick and then hopefully have a medicine that can save you. The goal is not to get sick. And not only you not to get sick, but to prevent sickness from your kids, even that you get sick and then you transfer that to your mothers, to your fathers, to your parents. It’s very important that people will take the vaccines, and for those that are unfortunate, that despite that or because they didn’t take the vaccines, they’re sick, of course now we have something that will save a lot of lives.”

The vaccine reduces the chance that you’ll get infected and that you’ll pass the virus on to others, which is crucial in controlling the spread as hospitals fill up over the winter. The pill doesn’t do any of that. Medication is an individual solution to a COVID problem; vaccination is a community solution. And if you’re thinking that Bourla’s just saying what he’s saying because he wants to line his pockets on the front end of the infection process with the vaccines and on the back end with Paxlovid, bear in mind that a course of the latter is much more expensive than a course of the former — as in 35 times more expensive. (It’s $700 for a course of Paxlovid versus around 20 bucks for a dose of vaccine.) If Pfizer was strictly out to make a buck here, they’d downplay vaccination in order to encourage infection and then sell their wonder drug as the cure for what ails you. As it is, by pushing vaccines, Bourla’s going to end up shrinking the market for his pill.

There’s another problem with preferring the pill to vaccination. To benefit from the pill you need to take it early-ish during the illness process, within three to five days of the onset of symptoms. But given the steep and soon to be increasing demand for testing in the U.S., it may be days before you’re diagnosed with COVID:

A relative of mine needed to take a COVID test recently and was told to expect to wait three to five days for results. If that wait time doesn’t improve, doctors will be forced to prescribe Paxlovid as a precaution to anyone who presents with flu-like symptoms, before there’s any confirmation of a positive test. And that assumes that Americans with symptoms will hustle to the doctor’s office to get a prescription as soon as they’re sick. If they wait until they’re beyond the five-day window, the drug might no longer work as well for them.

So, strictly speaking, Walensky’s right. None of us will be able to avoid getting COVID in perpetuity, but the best way to protect ourselves is to do what we can — within reason — to avoid getting it. Which means vaccination.