Molnupiravir Mutations in the Wild
From near the end:<p>&quot;Actually, I think the same thing about Paxlovid treatment. In that case, the worry is the rise of mutated forms of the coronavirus that are also Paxlovid-resistant. That’s more or less inevitable, but we should not accelerate it by handing out the drug to populations where it won’t make much difference.&quot;<p>We have a real mismatch of incentives here.  In order for Paxlovid to remain effective, it would need to not be used very often (so that a resistance to it doesn&#x27;t constitute a big advantage for that variant).  This is ok, if we only give it to elderly or otherwise high-risk populations.  But how high-risk?<p>Many individuals want to consider themselves &quot;high-risk&quot; in order to get a prescription, but would be better off if everybody else besides themselves is not considered high-risk.  It&#x27;s a classic Prisoner&#x27;s Dilemma.<p>Add to that the fact that the makers of Paxlovid (or Molnupiravir, for that matter) have an incentive to want it to be prescribed as much as possible, and we have both individuals and corporations pressuring the system to do exactly what it should not do, which is hand out the anti-viral to way more people than it should.<p>This cannot be fixed without changing the system (e.g. paying drug developers by a bounty system rather than with a patent).