The Paxlovid Paradox

 Via John

MRU

Zvi at LessWrong rounds up the COVID news including this excellent bit on Pfizer’s anti-Covid pill Paxlovid which looks to be very effective but is not yet FDA approved.

The trial was stopped due to ‘ethical considerations’ for being too effective. You see, we live in a world in which:

1. It is illegal to give this drug to any patients, because it hasn’t been proven safe and effective.
2. It is illegal to continue a trial to study the drug, because it has been proven so safe and effective that it isn’t ethical to not give the drug to half the patients.
3. Who, if they weren’t in the study, couldn’t get the drug at all, because it is illegal due to not being proven safe and effective yet. 
4. So now no one gets added to the trial so those who would have been definitely don’t get Paxlovid, and are several times more likely to die.
5. But our treatment of them is now ‘ethical.’
6. For the rest of time we will now hear about how it was only seven deaths and we can’t be sure Paxlovid works or how well it works, and I expect to spend hours arguing over exactly how much it works.
7. For the rest of time people will argue the study wasn’t big enough so we don’t know the Paxlovid is safe.
8. Those arguments will then be used both by people arguing to not take Paxlovid, and people who want to require other interventions because of these concerns.
9. FDA Delenda Est.