Amid the increase in the omicron variant, the FDA issued an emergency use permit for the orally administered antiviral combination, which can reduce the number of hospitalizations or deaths by 87% compared to no treatment.
There has been good news recently in the field of COVID-19 treatments. In the midst of the increase in the omicron variant, the FDA issued an emergency use permit for the orally administered antiviral combination of nirmatrelvir / ritonavir (Paxlovid), which, when initiated within 5 days of symptom onset, reduced the number of hospitalizations or deaths by 88%. Similarly, a 3-day course of intravenously administered remdesivir (Veklury) was shown to reduce the number of hospitalizations or deaths in outpatients by 87% compared with placebo.
One would hope that the use of these new tools plus the vaccines previously developed and made available would significantly reduce the death toll that SARS-CoV-2 has inflicted on the world and, disproportionately, our patients with malignant and suppressed diseases . immune systems. Perhaps such a reduction in the death toll will happen soon.
Early in the pandemic, I was able to count exactly how many patients I had lost to COVID-19. After the first 8 to 9 months of the pandemic, the number was about 15 patients. I could even name each one of them for a while. After that, I started losing the count. My best guess is that the number is somewhere between 40 and 50. I can no longer list each patient by memory. This past month alone, I lost 3 more patients due to COVID-19. In fact, I suspect I have lost many more patients to COVID-19 in the last 2 years than I have to the cancer itself.
We need to get these new treatments out to our patients quickly. The rollout and availability of these treatments has been tarnished. For example, even though tixagevimab / cilgavimab was granted an emergency use permit on December 8, 2021, I did not get access to it until February 1, 2022. In conversations with colleagues around the country, some of them have had access to it, while others have not. It has also not been easy to get nirmatrelvir / ritonavir. Where I practice in Colorado, it has only been made available through hospital pharmacies, but not through commercial pharmacies. Some of these hospital pharmacies have quickly run out of medicine and there has been a lack of guidance for doctors on how to get it. And where better to give 3 daily doses of intravenous remdesivir than oncology clinic where infusions are given all day every day? At this point, my patients have only been able to access the strapsivir in the inpatient setting, not in the outpatient setting, where it probably works best. Making these effective treatments more readily available at local pharmacies and infusion centers will go a long way towards reducing the frequency, severity and mortality rate of COVID-19 – a goal that has been a long time coming.