Alexey's Covid notes (September 2022)

not medical advice, etc.

Summary for my future self:

1. Xlear xylitol nasal spray seems to help and I will be using it 2-3 times per day when I get covid again.
2. Take throat swabs, don’t bother with nose swabs.
3. Take antipyretic medication if the temperature keeps increasing when I’m going to bed or if it’s above 38-38.5 degrees and keep it 37.5-38.0.
4. Drink 0.5 liters of water with salt as soon as I get a positive result and a cup of water 30 minutes before going to sleep to avoid dehydration.
   1. I will systematically not drink enough water due to feeling unwell, especially day one. Combined with high temperature and sweating, this will/might lead to not having enough fluids, resulting in potentially losing consciousness.
   2. Drinking water might make me more nauseous, so I will also drink less than I should due to worrying about throwing up, so I should place a pot next to my bed.
5. Remember that I don’t distinguish the feeling like I’m about to throw up and like I’m about to lose consciousness consistently, so be prepared for both.
6. Order more Huel: it’s the easiest way to get calories and I will not want to eat when feeling terrible.

Background on me:

• I’m a 25-year-old male.
• Vaccination
  • January 2021: Sputnik V
  • February 2021: Sputnik V
  • August 2021: Sputnik V
  • October 2021: J&J (had to get it to travel internationally)
• Previous health issues
  • Used to get colds 1-2 times per year but have not had one since late 2019.
  • I don’t do well when my temperature gets >38-38.5, e.g. I lost consciousness once in early 2020 due to a combination of food poisoning and high temperature.
  • Otherwise, no major health issues.

August 2022 Covid infection

• I tested positive after a conference in early August 2022.
  • I started feeling a bit weird, took a throat swab and a nose swab. Throat was positive while nose was negative.
• I took Paxlovid twice a day for 2.5 days, starting several hours after the first positive test. Reasoning was:
  • Biggest damage from Covid is likely when its concentration in the organism is at the peak and it peaks in the first days of the infection.
  • Paxlovid decreases replication of Covid dramatically but makes the organism worse at responding to infection properly often causing rebound later.
  • Paxlovid has negligible side effects given my health background
  • Therefore, I want to take Paxlovid briefly to decrease maximum concentration of Covid in my organism but afterwards let my immune system take over and respond properly.
• My temperature started to increase quickly in the evening of the first positive test, from 36.8 to 37.2 to 37.9 when I went to bed.
  • In retrospect, I should’ve taken an antipyretic drug before going to bed, not assuming that my temperature will remain at 37.9, given that it kept increasing throughout the evening.
• I lost consciousness for several seconds when I awoke during the night of the first positive test and went to the bathroom. I felt like I was about to throw up and tried to stand upright, which in retrospect, was not helpful at all lol.
  • I did not drink water when I woke up despite feeling dehydrated because I was afraid I would throw up. Should’ve just brought a pan next to my bed.
• My blood oxygen saturation was 95-96% when I got the first positive result and it never went lower, usually staying at 96-97%
• My tests were highly positive for the first 3-4 days. By day 6, they became almost completely negative. Then, they started to become highly positive again and I took Paxlovid for 1 more day. I ended up testing positive for 13 days, which I believe indicates a rebound and that my Paxlovid strategy did not work as I expected.
• I was bedridden for the first 2-3 days of the infection but felt mostly ok afterwards and was able to return to work fully after 5-6 days of first testing positive.
• I did not notice any changes to my sense of taste or to brain function either during or after the infection.
• I did not note any long-term effects of the infection.
• Do note that not only did I get a relapse form Covid but there’s ~0 scientific evidence that my Paxlovid strategy is effective for my age or in general and I don’t even know if peak viral load is the bad part of the infection. Might be the case that 6 days with higher peak load is better than 13 days with lower peak load.

Medications

• Paxlovid
  • In Massachusetts, Paxlovid is in excess supply and is trivial to get. You sign up for a video consultation at this link, tell the nurse/doctor about testing positive and your background, and they will prescribe you Paxlovid, based on the list of diseases that increase your Covid risk.
    • I would’ve used Paxlovid for 1.5 days initially, given the information I have now. I do not expect to be using Paxlovid more than once or twice for future covid infections.
• Xlear daily nasal spray.
  • I used it twice a day throughout the infection. I experimented with antigen tests before Xlear and 10-15 minutes after it and tests were noticeably less positive afterwards.
    • I would’ve used Xlear 2-3 per day, given the information I have now.
• Hydrogen peroxide 1.5%
  • I gargled with it 3-4 times per day for most of the infection. I experimented with antigen tests before hydrogen peroxide and 10-15 minutes after it and tests were not noticeably different.
    • I wouldn’t have used hydrogen peroxide, given the information I have now.
• Monoclonal antibodies and Evushield.
  • Monoclonal antibodies are Covid-specific antibodies to be used during the infection. Super effective.
  • Evusheld is monoclocal antibodies designed to stay in the body for months and to prevent infection.
  • I did not try to get either normal monoclonal antibodies or Evusheld but my understanding is that they work super well and, if you can get them, you should. I heard that it’s possible to get them if you pay out of pocket but I don’t know the details.

Vaccines

• I didn’t get an mRNA booster because of myocarditis risk and don’t plan on getting one.
  • UCSF Professor Vinay Prasad: “for a 22 year old man who already had 1 dose of Moderna, it was clear that he had 2 choices going forward (a) breakthrough or (b) breakthrough after the 2nd dose. The latter path certainly has a higher rate of myocarditis than the former.”
• My understanding is that mRNA vaccines are only clearly net positive for women older than 20 or so and for men older 25-30 (depending on number of doses). The younger you go, the fewer benefits they have. Comparing Paxlovid to two doses of the vaccine, I would probably choose Paxlovid.

Masks

• I have not seen convincing evidence that any masks except for well-fitted N95 actually decrease Covid infection risk.

Notes

• Perhaps hydrogen peroxide only good vs bacteria, since it acts on a specific protein? https://www.youtube.com/shorts/8CLmlWlIVFw