Any update on Paxlovid availability for foreigners in Bangkok?

[Lorry]

1 hour ago, Arkady said:

Apparently Paxlovid is available in pharmacies like Siam Drug.  I don't know their price but it should be cheaper than in hospitals.

Siam Drug doesn't have it, it's only available in hospitals. 

The reasons are the mentioned interactions, which can be deadly. It would be irresponsible to let people by this OTC.

 

2 hours ago, edwardflory said:

Name brand drugs, ( imports ), as well as generic drugs not available in general, are usually available at THAI MILITARY HOSPITALS.  To use a MILITARY hospital you MUST get a hospital ID Card. ( free) 1st. You pay the same cost as Thai civilians using the military hospital.

 

Good point.

Paxlovid is available in the big government hospitals. Of course,  don't expect it to be available in small places like the military hospital in Surin.

Price in the military system is 9961B.

You need (obviously) to see a doctor first.

I don't know,  how willing a doctor there would be to prescribe it for a foreigner,  and I don't know how strictly it is rationed. 

 

 

[Lorry]

12 minutes ago, newbee2022 said:

www will give you all information. End off

Dr Google is NOT recommended for anything. 

And in this specific case, relying on Dr Google can easily kill you.

 

Many people take regular medications they really, really need, but which cannot be combined with Paxlovid. So a doctor has to decide how to handle this: reduce or stop the regular medication for a while? Monitor the patient closely? Don't use Paxlovid?

[Lorry]

16 minutes ago, Letseng said:

And where is a military hospital in Bangkok?

Phramongklutkao.

Good hospital. 

I doubt you will like it, government hospital,  Sheryl has often written what to expect.

[Gottfrid]

21 minutes ago, newbee2022 said:

www will give you all information. End off

This comment is so stupid, when it comes to finding reliable information about treatments and medicine. If a person do not know how to sort different information and what sites they can trust, it can lead to death.

Giving such stupid advise definitely proves you have chosen the right nickname on this forum.

[Sheryl]

A baiting post has been removed.

[newbee2022]

4 hours ago, Lorry said:

 @Arkadyanswered your question. 

 

You misunderstand 2 things: an infectious disease may become rare (covid isn't rare at all) or less serious (covid is usually less serious than 4 years ago), but it may still be deadly  (thousands of Americans died this summer from covid, but they were weak and old, so many people don't care) and may still require treatment

 

Example: the plague (the Black Death) is quite rare nowadays, and rarely deadly (and only people who had contact with animals, so I don't care).

In the US, if you get the plague, you still get treatment. 

 

BTW most members of AN are weak and old, as are many farang in Thailand

"an infectious disease may become rare"

That's true:: around only 700 cases a day. Of 70.000.000 people.

[Letseng]

4 hours ago, Lorry said:

Phramongklutkao.

Good hospital. 

I doubt you will like it, government hospital,  Sheryl has often written what to expect.

Tks. A long way from my area.

May worth checking out as prices at fancy Soi 3 hospital are getting unaffordable.

[TallGuyJohninBKK]

From everything I read, Paxlovid seems to be generally considered UNDER-utilized as a COVID treatment, partly because of the relatively high costs if people are having to pay out of pocket, but also because its recommended use is only within the first 5 days of developing COVID symptoms... And people often just don't move so fast in terms of getting tested, seeing a doctor to get a prescription, etc...

 

Some general background here:

13 Things To Know About Paxlovid, the Latest COVID-19 Pill

June 20, 2024

 

"Paxlovid, an oral antiviral pill that can be taken at home, is the go-to treatment for COVID-19. If you are at high risk for severe disease from COVID, and you take it within the first five days of experiencing symptoms, it will lower your risk of getting so sick that you need to be hospitalized."

...

2. When should I take Paxlovid?

You have to take Paxlovid within five days of developing symptoms.

Like all antivirals, Paxlovid works best early in the course of an illness—in this case, within the first five days of symptom onset, says Jeffrey Topal, MD, a Yale Medicine infectious diseases specialist...

...

6. How well does Paxlovid work?

In November 2022, the CDC reported on a real-world study that showed adults who took Paxlovid within five days of a COVID diagnosis had a 51% lower hospitalization rate within the next 30 days than those who were not given the drug. The study included people who had been vaccinated or had a previous infection, which the CDC said implied the drug should be offered to people who are eligible regardless of their vaccination status.

 

However, a study by Pfizer, published in the New England Journal of Medicine in April 2024, suggested that Paxlovid may not be beneficial for people at low to moderate risk who have mild illness and those who have been fully vaccinated.

 

Yale Medicine

https://www.yalemedicine.org/news/13-things-to-know-paxlovid-covid-19

 

[Elkski]

Wife and I contracted COVID over July 4th, 24' .  We are not real social but went out for sushi and to a concert and fireworks on the 4th.  Thursday.  By Sat afternoon wife was feeling funny in her throat. Sunday she just layed around and obviously had something.  I worked alone Mon and Tues while she layed around.   I think on Mon or was it Tues she tested positive using an out of date free test kit we had.  Wed morning I bought fresh test kits and after she tested positive I called the Dr for a script.  I felt a bit warm Wednesday, but it was a muggy 84 and went up to 100f.  By Wed night I had sinus drainage.  I cancelled appointments and didn't work Thur or Fri.  We got notice late Fri that he script was ready.  We both took the first dose Fri night.  So for me day 2, for her day 6-7?    It left a bad taste in your mouth hours later and all night.  She didn't want to take anymore but I finished off the paxlovid.    I layed around thur-sun but  we both went to work Monday.  She was a zombie for 8 days. I for 3-4.    Cough persisted for weeks for both of us.   We seem to be fine now.  Didn't get boosters last fall.   I have no idea how much it cost but my co pay was just 25$ using ACA/ Obama care.   Lol.   I didn't know it was 31,000 bath range?  I'm glad I took it.  It would be best to have it ready so you could take it right away.   I'm disappointed that it took our Dr 50 hours to write the script.  USA healthcare is a mess.   Glad I didn't have a bad reaction.   I do take crestor generic daily but that's all besides recreational Cialis. 

 

This was my 3rd case and her 2nd.  I got COVID Dec 26th 2019 during my flight to Thailand through Shanghai.  That airport and China knew something big was happening.  They were separating all natives from foreigners and we had to walk through a hastily set up array of thermal scanners in the middle of a big room.   A few people were being corralled into one seating area behind a roped off area.  I actually walked over to talk to some Thai women there.  They didn't know why they were separated out.   I was sick as a dog 2 days later and holed up in a condo for 5 days coughing my guts out.  At times I  sat up in bed coughing for 2 hours and wasn't sure I was going to be able to clear the phloem in time for my next breath.  My then GF stayed with me and didn't get sick.  After 5 days I felt like I had been to an ab workout boot camp.   I could see where an  obese or unfit person would have died.   At that time I even had posts on here that Sheryl replied to. Of course at that time hardly  anyone knew about COVID.    I was considering popping my zpac I always travel to Thailand with as I had a couple of sinus infections in my previous Thailand travels.  The consensus was not to take the Zpac

[Lorry]

2 hours ago, TallGuyJohninBKK said:

From everything I read, Paxlovid seems to be generally considered UNDER-utilized as a COVID treatment, partly because of the relatively high costs if people are having to pay out of pocket, but also because its recommended use is only within the first 5 days of developing COVID symptoms... And people often just don't move so fast in terms of getting tested, seeing a doctor to get a prescription, etc...

Correct.

I know Paxlovid is good,  and I make sure I always have fast access to it.

And because it's a race against time, I do test a lot,  starting with an ATK at the first whiff of sickness (it actually was positive once), if negative,  followed by express PCR  on the same day  (it was once positive one day before my flight to  Thailand,  at a time they tested every incoming passenger and put the positive ones in quarantine,  at their own cost. I was glad I did that PCR and didn't fly).

I stop testing after day 5, because I wouldn't take Paxlovid after day 5, so test for what. 

 

[Lorry]

3 hours ago, newbee2022 said:

"an infectious disease may become rare"

That's true:: around only 700 cases a day. Of 70.000.000 people.

You magically invented this number.

It's still a lie. 

Those are the hospitalized patients.

Even patients with the plague are not always hospitalized. 

[TallGuyJohninBKK]

23 minutes ago, Lorry said:

Correct.

I know Paxlovid is good,  and I make sure I always have fast access to it.

 

It's interesting. I follow, among others, the Washington Post's medical columnist Dr. Leana Wen... who also does regular Q and A columns with readers' questions. And I've seen it crop up frequently where people ask her about difficulties in getting Paxlovid if needed when traveling abroad... And one of the things I've seen her advise to her U.S. audience is for people planning to travel who are concerned can contact their doctor and see about getting an advance prescription, in case it's later needed while they're away on travels. Apparently some doctors will do that, others won't. Though I think that was more back when the U.S. govt was paying for Paxlovid itself.

 

The under-prescribing of Paxlovid may be our biggest covid policy failure

January 16, 2024

 

"The United States suffers from a litany of policy failures in the response to covid-19. Low vaccine uptake in vulnerable populations such as nursing homes remains a major problem, as does the lack of investment in local and state public health infrastructure.

 

But one deficiency stands out above the rest: The antiviral medication Paxlovid is highly effective at preventing severe illness and death, yet the usage rate is staggeringly low. Only about 15 percent of high-risk individuals who contract the coronavirus are prescribed the drug.

...

Finally, the FDA should provide explicit instructions to allow doctors to issue “just in case” prescriptions. High-risk patients who are traveling and are concerned about accessing treatment should be able to take antivirals with them so that they can initiate treatment as soon as they test positive.

 

It’s remarkable that science has delivered exceptional breakthroughs that have dramatically reduced severe illness and death from the coronavirus. The great tragedy is our continuing failure to take advantage of these advances."

 

https://archive.ph/UF3IT

 

https://www.washingtonpost.com/opinions/2024/01/16/paxlovid-covid-under-prescribed/

 

Leana S. Wen, a Washington Post contributing columnist who writes the newsletter The Checkup with Dr. Wen, is an emergency physician, clinical associate professor at George Washington University and author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.” Previously, she served as Baltimore’s health commissioner.

 

 

[Lorry]

30 minutes ago, TallGuyJohninBKK said:

 

It's interesting. I follow, among others, the Washington Post's medical columnist Dr. Leana Wen... who also does regular Q and A columns with readers' questions. And I've seen it crop up frequently where people ask her about difficulties in getting Paxlovid if needed when traveling abroad... And one of the things I've seen her advise to her U.S. audience is for people planning to travel who are concerned can contact their doctor and see about getting an advance prescription, in case it's later needed while they're away on travels. Apparently some doctors will do that, others won't. Though I think that was more back when the U.S. govt was paying for Paxlovid itself.

 

The under-prescribing of Paxlovid may be our biggest covid policy failure

January 16, 2024

 

"The United States suffers from a litany of policy failures in the response to covid-19. Low vaccine uptake in vulnerable populations such as nursing homes remains a major problem, as does the lack of investment in local and state public health infrastructure.

 

But one deficiency stands out above the rest: The antiviral medication Paxlovid is highly effective at preventing severe illness and death, yet the usage rate is staggeringly low. Only about 15 percent of high-risk individuals who contract the coronavirus are prescribed the drug.

...

Finally, the FDA should provide explicit instructions to allow doctors to issue “just in case” prescriptions. High-risk patients who are traveling and are concerned about accessing treatment should be able to take antivirals with them so that they can initiate treatment as soon as they test positive.

 

It’s remarkable that science has delivered exceptional breakthroughs that have dramatically reduced severe illness and death from the coronavirus. The great tragedy is our continuing failure to take advantage of these advances."

 

https://archive.ph/UF3IT

 

https://www.washingtonpost.com/opinions/2024/01/16/paxlovid-covid-under-prescribed/

 

Leana S. Wen, a Washington Post contributing columnist who writes the newsletter The Checkup with Dr. Wen, is an emergency physician, clinical associate professor at George Washington University and author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.” Previously, she served as Baltimore’s health commissioner.

 

 

An American prescription won't help you in Thailand. 

You need to

- know in which hospital to get Paxlovid

- know where to get a test fast, with same-day  results for PCR if needed

- be prepared to pay. During the last 5 days,  I payed 2x3500 for PCR, twice, and 4500 for LAMP test. And, of course, 156 baht for 4 ATK. Everything was negative and I stopped testing now. But I was prepared to pay 25,000 for Paxlovid.  (I will get reimbursed, that helps)

 

I would never dare to advise a patient to carry Paxlovid just in case. 

People will take it without testing, because they feel "sure it's covid".

And people won't  check the interactions. These really can kill you, e.g. Rivaroxaban.

[john donson]

On 3/14/2024 at 9:53 PM, Lorry said:

Bumrungrad has Paxlovid, 31000 baht (plus cost for doctor and test)

 

wow that sure beats the 100 baht or less horse dewormer

 

might have same effect...

[newbee2022]

11 hours ago, Lorry said:

You magically invented this number.

It's still a lie. 

Those are the hospitalized patients.

Even patients with the plague are not always hospitalized. 

Paxlovid indeed is meant for these cases. Sometimes. The others not hospitalized might not realized to be infected.

No magic.

[Sheryl]

An off-topic  post with link to a disreputal  anti-vax conspiracy publication has been removed.

 

Please also note that the topic in availability/source of Paxlovid  not vaccination

 

[Lorry]

4 hours ago, newbee2022 said:

Paxlovid indeed is meant for these cases. Sometimes. The others not hospitalized might not realized to be infected.

No magic.

Paxlovid is meant for light or moderate cases.

This does not necessarily mean hospitalization, not at all.

 

Of course, if you don't test positive,  don't take Paxlovid.

 

Just saying for others who might read your maliciously  misleading post.

[Lorry]

5 hours ago, john donson said:

 

wow that sure beats the 100 baht or less horse dewormer

 

might have same effect...

The effect of your horse medicine has been extensively studied.

The effect is zero.

Paxlovid does have a very measurable effect.

 

But, of course, you are free to eat horse medicine. Bon appetit!

[newbee2022]

2 hours ago, Lorry said:

Paxlovid is meant for light or moderate cases.

This does not necessarily mean hospitalization, not at all.

 

Of course, if you don't test positive,  don't take Paxlovid.

 

Just saying for others who might read your maliciously  misleading post.

As someone who insists to be "I know all better" I prefer not to communicate any further with you.

[jayboy]

On 9/7/2024 at 11:09 PM, Lorry said:

 

I would never dare to advise a patient to carry Paxlovid just in case. 

 

Not sure about that.I would have thought for vulnerable groups including the over 65s it would make sense to hold  a stock of Paxlovid. I don't think, given the ease of self testing, that anybody would take Paxlovid just in case.I can envisage myself if having tested positive and experiencing Covid symptoms (they would have to be worse than normal) taking Paxlovid.The barrier is not so much the cost but getting hold of the stuff in the first place.

[Lorry]

5 minutes ago, jayboy said:

 

Not sure about that.I would have thought for vulnerable groups including the over 65s it would make sense to hold  a stock of Paxlovid. I don't think, given the ease of self testing, that anybody would take Paxlovid just in case.I can envisage myself if having tested positive and experiencing Covid symptoms (they would have to be worse than normal) taking Paxlovid.The barrier is not so much the cost but getting hold of the stuff in the first place.

Sorry, sounds good but 2 mistakes:

 

"Covid symptoms (they would have to be worse than normal)"

Paxlovid is meant for light and moderate cases. It's not meant as a treatment once things have gotten bad.

The approach is not "let's wait and see, maybe it will get better by itself".

The approach is "It is decided a priori: if I get Covid I will take Paxlovid. So, if I have symptoms,  I test for Covid asap, and often, because Paxlovid needs to be taken early in the course of covid."

Paxlovid is a bet on the future course of the illness. It's an insurance. 

 

Second, you didn't even mention you would check for interacting medications. This is more than just reading a leaflet. 

If there are, how would you know how to manage them? Reduce their dosage,  stop them,  substitute others, just observe, refrain from taking Paxlovid?

There are a lot of interactions with heart-related medications,  which many old men aka AN members take. 

[jayboy]

1 hour ago, Lorry said:

Sorry, sounds good but 2 mistakes:

 

"Covid symptoms (they would have to be worse than normal)"

Paxlovid is meant for light and moderate cases. It's not meant as a treatment once things have gotten bad.

The approach is not "let's wait and see, maybe it will get better by itself".

The approach is "It is decided a priori: if I get Covid I will take Paxlovid. So, if I have symptoms,  I test for Covid asap, and often, because Paxlovid needs to be taken early in the course of covid."

Paxlovid is a bet on the future course of the illness. It's an insurance. 

 

Second, you didn't even mention you would check for interacting medications. This is more than just reading a leaflet. 

If there are, how would you know how to manage them? Reduce their dosage,  stop them,  substitute others, just observe, refrain from taking Paxlovid?

There are a lot of interactions with heart-related medications,  which many old men aka AN members take. 

 

Thanks for the corrections which I completely accept, and both your points are very well made.

 

So I suppose it's a question of subjective judgement if one is over 65 and without the kind of ailments that would make the decision more straight forward.

[Lacessit]

I have just contracted COVID for the second time. I am in a high risk group.

 

I have kept up with the vaccinations. My symptoms this time around were low grade fever, runny nose, sore throat, muscle aches.

 

Fever and muscle aches are gone, still have the runny nose and sore throat. Dosing up with three paracetamols a day.

 

I was over my first bout of COVID in three days, hoping this one is the same.

 

How long should I wait before testing again to confirm I am negative for COVID? I am self-isolating.

[Lorry]

3 hours ago, Lacessit said:

I have just contracted COVID for the second time. I am in a high risk group.

 

I have kept up with the vaccinations. My symptoms this time around were low grade fever, runny nose, sore throat, muscle aches.

 

Fever and muscle aches are gone, still have the runny nose and sore throat. Dosing up with three paracetamols a day.

 

I was over my first bout of COVID in three days, hoping this one is the same.

 

How long should I wait before testing again to confirm I am negative for COVID? I am self-isolating.

5 days at least 

[Lorry]

4 hours ago, jayboy said:

So I suppose it's a question of subjective judgement if one is over 65 and without the kind of ailments that would make the decision more straight forward.

Yes, but 2 things to remember:

 

The danger of covid for the elderly doesn't just grow in a linear way with age. 

It gets a exponentially more dangerous the older you get, 65, 70, 75, 80 are not the same risk at all. 

 

And we all think like @Lacessit: I had it once or twice,  it wasn't so bad,  it won't be so this time around.  Wrong. Every course of covid can be completely different from the last one.

My family doctor (70y.o.) treated his first bout of covid successfully with a couple of dark beers.

Unfortunately,  the second time it didn't work.  He was bedridden for 3 weeks.

 

 

 

[Lacessit]

4 minutes ago, Lorry said:

Yes, but 2 things to remember:

 

The danger of covid for the elderly doesn't just grow in a linear way with age. 

It gets a exponentially more dangerous the older you get, 65, 70, 75, 80 are not the same risk at all. 

 

And we all think like @Lacessit: I had it once or twice,  it wasn't so bad,  it won't be so this time around.  Wrong. Every course of covid can be completely different from the last one.

My family doctor (70y.o.) treated his first bout of covid successfully with a couple of dark beers.

Unfortunately,  the second time it didn't work.  He was bedridden for 3 weeks.

 

 

 

IMO the risk for the elderly is co-factors. Obesity, smoking, drinking etc.

 

You may be right. However, I am optimistic because (a) I don't drink or smoke (b) I am normal BMI (c) I was recently told by a physio I am in the top 10% of my age group for physical fitness.

 

No guarantee, but I feel I have the odds in my favor.

 

[Lacessit]

My COVID symptoms are rapidly receding. Nose has dried up, coughed once during the night.Almost back to full exercise.

 

I credit regular boosters.

[edwardflory]

NAVY HOSPITAL in BKK, Google it

[Lorry]

16 hours ago, edwardflory said:

NAVY HOSPITAL in BKK, Google it

Thx

Just for clarity: you mean the one in Samut Prakan, right?

I would think they have it

 

[Arkady]

On 9/7/2024 at 2:14 PM, Lorry said:

Dr Google is NOT recommended for anything. 

And in this specific case, relying on Dr Google can easily kill you.

 

Many people take regular medications they really, really need, but which cannot be combined with Paxlovid. So a doctor has to decide how to handle this: reduce or stop the regular medication for a while? Monitor the patient closely? Don't use Paxlovid?

 

That's an important point. You need to stop statins, such as Lipitor, while taking it or the side effects can be quite serious and there may be other common meds that clash with it.  My brother-in-law was not allowed to take Paxlovid at all due to the cancer medication he was on and couldn't stop. He was given Molnupiravir instead.