Sore throat? Cough? Sniffing? Finally, effective treatments for COVID-19 are available.
But lower your expectations.
The president launched a nationwide “Test to Treat” initiative on March 8 that seeks to simplify COVID-19 treatment: You will be tested at a pharmacy-based clinic. If you are positive and at high risk, you can get antiviral pills on the spot, which can reduce the risk of developing serious illness by about 85%.
“It’s a very exciting time,” said Dr. Annie Luetkemeyer, Professor of Medicine at UC San Francisco, in a recent USC webinar.
But things are never simple, of course.
“The health care system is already set up to make things as difficult as possible,” said Dr. Aaron E. Carroll, Senior Professor at Indiana University, at the webinar.
One-stop-shops are more likely to be in affluent communities than in poorer ones, where the drugs are more likely to be needed, he said. So sick people without pharmacy-based clinics nearby have to find a test site – it gets harder as states scale down efforts – and test results can take a day or two to come back. Then people need to find a doctor to write a prescription for the new drugs, and then find a pharmacy that has them in stock.
And all of this has to happen very quickly – within about five days of infection for some of the oral substances to work magic.
“Most people who get it are people with funds,” Carroll said. “In many ways, COVID revealed and exacerbated health inequalities.”
The federal government controls the distribution of these drugs, which are free, and sends them directly to the states.
In California, health officials then send them to counties, and then they go to local pharmacies, hospitals and medical groups, based on formulas that include equity in the distribution equation, officials said. That therapist is not distributed based on population: Orange County, for example, had 11,869 treatment courses available as of Friday, while smaller Riverside County had much more – 16,528 courses according to data from the U.S. Department of Health and Human Services.
Instead, the substances are sent where they are most neededbased on targets such as current infection rates, hospitalization rates and “Healthy Places Index”Scorer according to the California Department of Public Health. The Healthy Places Index combines data to reflect an area’s poverty level, employment, median income, education level, access to health care and other goals.
Many neighborhoods in Riverside County have much lower scores for healthy places than those in Orange County, which is reflected in the treatment allocations.
Harderly affected communities have received much more stock so far than their more affluent neighbors. Santa Ana, for example, had 1,211 treatment courses available Friday, while Irvine had 583. Inglewood had 1,003 courses available, while Burbank of the same size had 108.
In all, more than 2,300 pharmacies, hospitals and doctors distribute the drugs in California. CVS, Walgreens and Rite Aid stores represent more than half of the stocked locations where Kaiser Permanente, medical groups, hospitals, grocery chains and smaller pharmacies make up much of the rest.
To find a pharmacy near you with the drugs, see https://bit.ly/3wjWZBh. Click on the magnifying glass and enter your city or postcode.
“The treatments are very different now than they were a year ago,” said Dr. George Rutherford, Professor of Epidemiology and Biostatistics at UC San Francisco. They can be game-changers for people who cannot be vaccinated or who have not had a robust immune response after vaccination.
Testing and treatment can be helpful if it can be implemented well, said Dr. Elizabeth Hudson, Regional Director of Infectious Diseases at Kaiser Permanente Southern California, which has 4.8 million members in Southern California.
“However, there are several challenges with it,” she said via email. “First of all, people need to get there early enough in their illness to qualify for this treatment. As we know, many people try to cope with their symptoms at home for a few days before going to seek care, and this can be a stumbling block. If we can get everyone used to going to tests early, this can work, yes.
“There is also a question about the total supply of both COVID tests and Paxlovid. It seems that this summer we should have a sufficient supply of both tests and Paxlovid, so hopefully all of these will work together to allow that this program will be a success. “
What are these drugs?
Antiviral drugs prevent viruses from making copies of themselves, while monoclonal antibodies bind to the virus and help the body get rid of it. Here are a few treatment options:
- Pfizer’s Paxlovid is the new star in the antiviral treatment arsenal. It is a series of pills taken orally. They contain nirmatrelvir, which prevents the virus from replicating, and ritonavir, which helps the main drug to stay longer in the body in higher concentrations. It is three tablets taken together, twice daily, for five days, for a total of 30 tablets. Paxlovid significantly reduced the proportion of people with COVID-19-related hospitalization or death from any cause by 88% compared to placebo, the U.S. Food and Drug Administration said when it issued a emergency use permit In December.
- Also new is Merck’s molnupiravir, an antiviral drug that received emergency use permit also in December. It works by introducing errors in the genetic code of the virus, which prevents the virus from replicating. It is only for patients 18 and older, as molnupiravir may affect bone and cartilage growth, the FDA said. It is a course of four capsules taken orally every 12 hours for five days, a total of 40 capsules.
- Veklury, the antiviral remdevir, has been available since 2020 and is not part of the federal / state effort; clinics can order it directly. The drug should be administered intravenously.
- Monoclonal antibodies should be given intravenously or by injection also within approx. 10 days after symptoms. Sotrovimab is effective against omicron and part of the federal effort; Evusheld is for those who cannot get COVID-19 vaccines for medical reasons, or who did not have robust immune responses to vaccination.
Candidates for these treatments are those at high risk of developing serious illness, including people who are elderly, overweight, pregnant, diabetic or have heart problems and other underlying health problems.
As the transmission of COVID-19 continues to decline and access to effective therapies improves, a fair distribution of COVID-19 treatments is a critical issue, the Los Angeles County Department of Public Health said in an March 17 update.
“As the supply of these drugs increases, we need to make sure that information and access about treatment drugs is available across the county, especially in those communities with residents at increased risk of poor outcomes if they become infected with COVID,” it said. it, and emphasizes that treatment is available to those at increased risk, even if they have mild symptoms, such as runny nose or cough.
People should act as soon as possible, contact their doctors or find a test for treatment at a local CVS or Walgreens, officials said.
“While supplies remain limited, more residents are receiving these treatments through pharmacies, partners, and providers,” the LA County COVID-19 update said. “To date, Public Health has distributed 20,960 doses of Paxlovid, 39,764 doses of Molnupiravir and 13,584 doses of Evusheld, with 73% of Paxlovid doses, 82% of Molnupiravir doses and 66% of Evusheld being allocated to most resources in the home. Communities.”
In San Bernardino County, providers registered in the state health partner’s ordering portal system can request treatments, and the county will send them, spokeswoman Felisa Cardona said. It hopes to earn even more.
“The county has an adequate range of COVID-19 treatments and therapeutic agents available, and we strongly recommend that interested providers and pharmacies contact the county’s therapeutic team at [email protected] and we will help them with the process, ”she said.
While therapeutics are a powerful tool, they are not a substitute for vaccinations, officials said. Being fully vaccinated and boosted provides the strongest layer of protection.