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If you have just tested positive for COVID-19 and have common risk factors for serious illness, there are now extensive treatments available, usually at little or no cost, that could help you avoid the worst and recover more quickly from it. a mild illness. or moderate case of COVID.
Paxlovid, a five-day course of pills from Pfizer, is at the top of the list of recommended treatments. The drugmaker’s studies showed that in unvaccinated people at risk for serious medical risk factors for COVID, Paxlovid was nearly 90% effective in reducing the risks of hospitalization or death from COVID.
People who are vaccinated or have recovered from COVID could still benefit from the drug, says Dr. Priya Nori, an infectious disease physician at Montefiore Health System in Bronx, N.Y., and a professor at the Albert Einstein College of Medicine. . Taking Paxlovid could “help you recover faster, feel better faster, and potentially be less infectious faster,” says Nori.
The Biden administration has been talking about the treatment. “We want everyone to know about this effective drug and to have a conversation with their health care provider about whether they’re eligible and whether they should make a plan” to access the drug if they test positive, says Dr. Meg Sullivan, director Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response.
But some people have struggled to get the drug quickly, when it can make a difference in disease progression, despite the administration’s effort to make it easier to get the drugs after a positive COVID-19 test.
Quick access to Paxlovid can be a challenge
Dan Weissman, 54, tried three different routes to access Paxlovid in the Chicago area when he contracted COVID in April. First, the nearby CVS Minute Clinic had no appointments available. Later, the nurse practitioner at the urgent care clinic he initially went to misunderstood her medical condition and refused to prescribe the pills. Eventually, his wife tracked down his recently retired primary care doctor, who wrote him a prescription. Weissman is glad he got the pills; his condition improved after taking them. But he says it took “an unusual amount of knowledge, connections and assertiveness” to get them. Luckily, Weissman, host of the health podcast one arm and one leg, I had all three.
In upstate New York, after a few days of COVID symptoms, Pamela Coukos’ college-age son tested positive on a recent Friday. “He has one of the risk factors; he seemed pretty sick. And also, it would be better if he didn’t spend like 10 days feeling terrible because he was in the middle of finals,” says Coukos. But the university health service was closing and the nearest “test to treat” place was not open on weekends. She managed to book a telehealth appointment for Saturday with her primary care doctor in her home state of Maryland, who sent a prescription to a pharmacy in upstate New York. A friend drove 26 miles each way to pick it up. The sick student took the pills, recovered on Wednesday and completed her exams. “Ultimately, it was successful, but more complicated than it had to be,” says Coukos.
COVID pills are FDA-approved for people at high risk of disease progression, and in practice, risk criteria have broadened as supply has increased, says Dr. Phyllis Tien, an infectious disease physician from the University of California, San Francisco, who works on the COVID-19 Treatment Guidelines Panel at the National Institutes of Health.
During omicron’s winter surge, pill supply was limited, and many health care providers prescribed Paxlovid only to people who were most vulnerable, due to advanced age or serious underlying medical conditions. Now, health conditions like high cholesterol, depression, smoking-related lung disease, obesity, not being fully vaccinated or boosted — all factors that increase a person’s risk of serious COVID outcomes — could qualify. to a recently infected COVID patient for a course of Paxlovid. . “If someone wants it and is eligible to receive it, they should be able to access it,” says Tien.
A recipe is the key
Antiviral pills require a prescription and must be started within five days of the onset of symptoms. To get a prescription, you will need to test positive for COVID-19 and review your risk factors and any medications you take with a health care provider.
Paxlovid, a combination of two antiviral medications called nirmatrelvir and ritonavir, cannot be taken at the same time as some common medications and supplements, including statins and some birth control pills. “There’s a long list of drug interactions,” says Jacinda Abdul-Mutakabbir, assistant professor at Loma Linda University School of Pharmacy, “you want to make sure you bring any other medications you may be taking” for a medical evaluation before you receive the medicine.
The drug could also be dangerous for people with reduced kidney or liver function.
For those who cannot take Paxlovid, there are several other early COVID-19 treatments that a health care provider might prescribe, such as remdesivir or monoclonal antibody infusions. Molnupiravir, a five-day pill treatment from Merck, is another option, although it is prescribed much less frequently than Paxlovid. In a clinical trial, Merck’s drug reduced hospitalization by just 30%.
Common side effects of taking Paxlovid include a metallic taste, diarrhea, increased blood pressure, and muscle aches, all of which are temporary. “While these side effects are not ideal, they are definitely better than what we would see if these people developed severe COVID,” says Abdul-Mutakabbir.
Here are three ways to access COVID pills, if you are eligible to get them.
Contact your primary care doctor
For those with health insurance and access to their primary care providers or health care team, you can make an in-person or telehealth appointment to get tested (or share positive test results), discuss risks and medications, and , if eligible, get a prescription for the pills.
I would then get the prescription from a nearby pharmacy.
Having a provider who knows your medical history, as well as the details of your current situation, can be very helpful, says Dr. Ulrika Wigert, a family medicine physician at CentraCare in Sauk Center, Minnesota. “Did you take the test the first day [of symptoms]? Did you take the test on the second day? How sick were you when you got tested?” And, if you start to feel better when you get the drug, do the benefits of taking the drug outweigh any risks?” can help guide you through an appropriate course of care, he says. she.
Visit a trial site to try
Another way to obtain Paxlovid is to visit one of the 2,300 health centers, urgent care clinics, and pharmacies designated by the government as “test-to-treat” sites. These are places that have prescription capabilities on site and pills available.
“For people who don’t have a health care provider, or who can’t get to their health care provider in a short period of time … test-to-treat sites offer testing and evaluation with a health care provider to determine if that medication is appropriate, and you can dispense the medication on site,” says HHS’s Sullivan.
Test locations to try can be found on this map.
Before you go, “check with your health plan to make sure they’re in your plan’s network,” says Sabrina Corlette, co-director of Georgetown University’s Center for Health Insurance Reform, “so that the services you receive there will be completely covered, or at least will be subject only to a nominal copay”.
For those without insurance, some of the Test-to-Treat sites are Federally Qualified Health Centers that can provide low-cost COVID testing and treatment services for the uninsured.
Try online urgent care
For those who prefer telehealth visits, and may not be able to get an appointment quickly through their primary health care provider, virtual health care platforms like Plushcare, eMed, and Truepill offer online visits to test, evaluate, and prescribe COVID medications. Appointments are available around the clock and may have some out-of-pocket costs. A prescription can be sent to a nearby pharmacy or filled and shipped to you, depending on what the service offers.
“The advantage of this approach is that it is designed for just this purpose: to test for and treat COVID,” says Nori de Montefiore. “You will efficiently get the service you need.” The downsides, she says, are that they don’t know your full situation, such as your home context and your medical history. “They rely on you to pass on all their medications, herbal remedies,” she says, but you can provide timely access to treatment.
What you can do ahead of time
If you’re worried about getting COVID and want to make an action plan ahead of time, experts recommend four steps:
- Be prepared to test quickly, if you suspect you may have COVID. “Have testing available at home or know where you can access a testing site,” says Sullivan at HHS.
- Know if you are a person with risk factors. Check to see if you have a condition that puts you at high risk for COVID and talk to your medical provider about COVID treatments to see if you’re eligible and to get your questions answered ahead of time.
- Check what your insurance coversand find out where you can get a timely consultation. In-network services are more likely to be covered by your insurance
- Find pharmacies near you that carry Paxlovidso you know where you can fill a prescription.
And stay up to date on your COVID-19 vaccinations, to help protect yourself and those around you from becoming infected.
Now a word of cost warning: Although the pills themselves are free, there may be some out-of-pocket costs. Testing, getting a health care visit and prescription, and follow-up can cost you, depending on whether you have insurance and what your insurance covers, says Georgetown’s Corlette. To reduce costs, people with health insurance should seek care within the network when possible; For those without insurance, a federally qualified health center can provide free or very low-cost services, she says.