The antiviral drug Paxlovid has the potential to significantly reduce the mortality rate associated … [+]
The antiviral drug Paxlovid has the potential to significantly reduce the mortality rate associated with Covid-19, but is underused by those who would benefit most. A recent CDC report notes that people over the age of 80 are less likely to receive Paxlovid than those under 65. From April to July this year less than one-third of America’s 80-plus-year-olds infected with Covid-19 ended up taking Paxlovid. A significant issue when those over 65 and especially those over 80 are making up a significant proportion of Covid-19 related deaths.
An independent study published in the New England Journal of Medicine found that Paxlovid reduced hospitalizations and deaths in patients over 65 by 79 percent during the Omicron surge in Israel earlier this year. Pfizer’s own studies found that Paxlovid reduced the risk of hospitalizations and deaths by 88 percent.
There may even be reason to also consider prescribing Paxlovid to younger populations or those without conditions that make them more vulnerable to severe disease. A recent large study found that people who took Paxlovid within a few days after being infected with the coronavirus were less likely to be experiencing Long Covid several months later. With no shortage of Paxlovid available in the US, this is worth exploring.
There are several reasons why patients may hesitate to take Paxlovid, and doctors may be hesitant to prescribe it. We need to address each of these and create targeted outreach and communication to vulnerable groups who would benefit from Paxlovid.
First, there is the issue of access, which is presently being addressed by the Test and Treat initiative, which provides free Covid testing and free immediate access to treatment for those eligible. There are also local hotlines such as New York City’s 212-COVID-19 hotline, which provides free treatment to New Yorkers who don’t have a regular healthcare provider. However, greater efforts need to be made to address the lack of these resources in health care deserts and rural areas.
Second, there is the more complicated issue of public perception. Paxlovid rebound is a common concern for hesitant patients and doctors. However, the high-profile rebound cases of President Joe Biden, First lady Jill Biden and Dr Anthony Fauci and anecdotal evidence spread among communities and on social media may have contributed to a sense that Paxvlovid rebound is more common than it actually is. Regardless of the prevalence of rebound, a recent CDC report found that Paxlovid rebound is very unlikely to progress to severe illness. Paxlovid rebound is most likely due to Paxlovid working as it should but not for long enough. Paxlovid works by stopping viral replication. It is currently given for five days, but some people still have virus in their body after five days. When Paxlovid is stopped, the virus starts replicating again. Paxlovid may need to be given for a longer period of time such as 10 days.
With no monoclonal antibody treatments currently authorized in the US for Covid-19 due to resistant Omicron sub variants. Paxlovid remains a powerful tool against death and hospitalization.
