DEAR DR. ROACH: My friends do not believe in the COVID vaccines and take ivermectin instead. They seem to have frequent colds. Shouldn’t ivermectin help prevent these colds? — Anon.
ANSWER: You should not listen to those friends about the COVID vaccine or ivermectin. The COVID vaccine is the major reason that the number of deaths per week in the United States due to COVID-19 went from over 26,000 per week in January 2021 to about 1,500 per week at the time I write this.
The data on ivermectin are now very strong that it is ineffective at reducing illness, hospitalization or death. Moreover, there was no reason to suspect that ivermectin would be helpful with viral diseases like COVID-19 or other respiratory viruses; the dose needed to be effective against viruses could not be obtained at nontoxic levels. Ivermectin toxicity became a problem, as some people took medication that was designed for animals or for external use at toxic dosages.
To be fair, people who are vaccinated against COVID-19 still get colds. Many of the non-COVID respiratory viruses that cause colds are not amenable to vaccination. There are so many of them, and they frequently change. In some cases, the body doesn’t respond well to the vaccine. Perhaps these issues will eventually be overcome.
DEAR DR. ROACH: I have heard comparisons of long COVID to chronic fatigue syndrome (CFS). My question is, are you more susceptible to long COVID if you’ve previously had CFS? Thirty years ago, I developed CFS following a bad case of the flu. I went from running marathons to being bedridden. Over the course of seven years, I gradually recovered, and eight years after my diagnosis, I was back to running marathons.
I am now 75 and have so far avoided getting COVID. I have received all of the vaccines and boosters, and I have been careful to limit my exposure as much as possible. But I fear if I do get COVID, which is apparently inevitable, I may lapse into a chronic condition again. — A.W.
ANSWER: I think you are very insightful, as the syndrome of persistent symptoms after a COVID infection shares many characteristics of CFS, which is now generally called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). People with a history of ME/CFS are, indeed, at a higher risk for developing long COVID symptoms.
The most effective way of preventing long COVID is not getting COVID in the first place. This means vaccination, social distancing, wearing masks in high-risk situations, and practicing hand hygiene. Getting vaccinated provides additional benefits because even if you get COVID, your risk of developing long COVID is decreased. Studies have shown that the number of vaccines you get correlates to your degree of protection from long COVID. You are wise to get all the vaccines you are recommended for, including the newest monovalent vaccine.
Treatment of COVID with Paxlovid has shown mixed results, with some studies showing benefit and others showing little to none. I still recommend it to a 75-year-old with COVID, but it unfortunately does not seem to protect people very well against long COVID symptoms.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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