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"Starting with the vaccine, vaccine is all about prevention, right? The vaccine trains our immune system to recognize the virus before we're ever exposed. Antivirals are treatments.""So, that's what we use when we're already sick, and they work by stopping the virus from replicating in our body. And this shortens how long we're sick, reduces the severity, and for high-risk people it does a really good job of lowering the chance of hospitalization or death."
"Think of the vaccine as your seatbelt and antivirals as the airbag."
"There's a little nugget of truth—Tamiflu was originally derived from Shikimic acid, which is found in star anise. But ultimately, what's in Tamiflu is very, very different from what's in the tea. Brewing tea is not the same as taking a pharmaceutical with a precise, tested dose."
"It's true that there have been very rare reports of some neuropsychiatric effects. However, flu itself causes delirium, especially in young kids with high fevers. Oftentimes people are conflating the drug's effect with the flu, which is likely what's causing those outcomes."
"These drugs work by blocking viral replication. Early in infection is when the virus is multiplying really, really fast. That's the window where we have the opportunity to really slow it down."
"For people who are hospitalized or high risk, it is still clinical guidance to treat beyond 48 hours because some benefit is better than none when the stakes are very high."
"Get tested. Many pharmacies offer test-to-treat programs—you get a rapid test and if it's positive, they can prescribe antivirals on the spot. If you are high risk—over 65, very young children, pregnant, immunocompromised, or with conditions like asthma or diabetes—you do not want to wait."
"Flu antivirals do come with some side effects. For those where the risk of hospitalization and death is lower, focus on rest, fluids, and treating fever if you're absolutely miserable. Tamiflu, for example, can cause nausea and GI upset, which might not be worth it for lower-risk people."
"That last one could signal a secondary bacterial infection like pneumonia and is absolutely an ER situation," she warns.
"You need a test, a clinician to prescribe antivirals, and a pharmacy with stock. During a surge, all three can break down. Test-to-treat programs and telehealth have been super helpful because they collapse those steps."
"Find out which pharmacies near you offer test-to-treat. If you're high risk, talk to your doctor now about a plan if you get the flu."
"Xofluza is one pill, with less GI upset, and might clear viral shedding faster. But it’s pricier—around $200 out-of-pocket—and availability is spotty. Some groups, like pregnant or severely immunocompromised patients, may not be recommended for it. This is a conversation to have with your healthcare provider."
"We have to really lean into the Swiss cheese model of public health. Vaccines, antivirals, masking, ventilation, and testing are all tools we can use. Even if the vaccine isn’t a perfect match this season, it’s still highly effective at keeping us out of the hospital and preventing death."
"Opening windows, even though it’s chilly, helps prevent respiratory disease transmission."
"Get the flu shot if you haven't already. It’s not too late. Use antivirals if you get sick, especially if high risk. Masking, testing, ventilation—these are all important. This season is brutal, but using all the tools we have helps protect ourselves and our families."
"We're knocking on wood—no flu or COVID in our household yet—but we’re taking good care."
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