As cold and flu season approaches, health authorities are warning that cases of Covid-19 may rise during the coming months.
In September, the Centers for Disease Control and Prevention (CDC) released a statement showing projected hospitalisation rates this winter, as Covid, influenza, and respiratory syncytial virus (RSV) start to circulate more.
Experts reacted to the projections by emphasising the importance of taking respiratory viruses seriously this winter. “When a disease is endemic, it means that the levels are mostly predictable. So it’s nice to see the CDC putting out their predictions this fall,” Ellie Murray, ScD, an assistant professor of epidemiology at Boston University School of Public Health, tweeted in response to the outlook. “[On the other hand], it’s not so nice that their best case scenario is almost twice as many respiratory hospitalizations as pre-COVID.”
To minimise the damage done by Covid as colder weather sets in and Americans start spending more time indoors, the public needs to be prepared for a potential exposure to it.
Part of that means keeping home tests on hand so that if you develop symptoms of the virus, especially if you know you were recently exposed, you can test immediately, Thomas Russo, MD, an infectious diseases expert at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences, told The Independent. “The sooner you test and figure out you’re positive, the better,” he said.
But it’s just as important to consider whether you may benefit from treatment with an antiviral like Paxlovid should you be infected with Covid-19, Dr Russo said. Per the CDC, anyone who is “at high risk for progression to severe COVID-19” is eligible for the drug. Given how many people fall into this category, “those individuals that could benefit [from the drug] make up a very wide swatch of the population,” Dr Russo said.
“People older than the age of 50 and people who are unvaccinated or haven’t had the recent vaccine” are eligible for Paxlovid, Sean T Liu, MD, an assistant professor of infectious diseases at Mount Sinai Hospital in New York, told The Independent. “If you have a risk factor—[such as] being overweight where your BMI is greater than 25 or any sort of history of heart disease—those can qualify you” as well.
The CDC says that people with certain cancers, diabetes, chronic kidney disease, asthma, chronic lung disease, HIV, or dementia are high-risk, as are pregnant people, people who smoke, and people who are physically inactive. Some mental health conditions like schizophrenia and depression can also increase a person’s risk.
The drug has been shown to reduce the risk of bad outcomes from SARS-CoV-2, the virus that causes illness with Covid, such as hospitalisation or death, in high-risk populations, per the CDC.
In this photo illustration, Pfizer's Paxlovid is displayed on July 07, 2022 in Pembroke Pines, Florida.— (Getty Images)
The drug can also reduce some people’s chances of developing long-term complications from the virus, Dr Russo said. “Long Covid—it’s quite unpredictable knowing who will develop that,” he explained. “Paxlovid is not all about acute disease—it can decrease the likelihood of long Covid as well.”
Yet some say the drug has been underused since the emergence of Covid-19. A report from The New York Times published earlier this year stated that, in some states, Paxlovid was prescribed in less than 20 to 25 per cent of reported cases.
This could be because Paxlovid can interact with other medications—which may give some physicians pause before they prescribe it—Dr Liu said. “I think there’s a hesitation [among some doctors] in that sense of knowing when to prescribe,” he explained. “[But] most of the time you can get around these interactions by temporarily stopping [another medication] or decreasing the dosage.”
Dr Russo said he often hears of patients who qualify for Paxlovid—and stand to benefit from the drug—but weren’t offered the prescription when they tested positive. “You don’t know how many times I’ve talked to people who’ve said, ‘My 75-year-old mom and dad got Covid. They talked to their doctor, who said they wouldn’t benefit [from Paxlovid].’ This is a very common scenario,” he said. “Why did the physician say that? Because they didn’t know the data? They didn’t want to deal with the interactions?”
He added that many physicians may be reluctant to figure out how to put a high-risk patient on Paxlovid because it may take time to figure out how to adjust their other medications so they can take the antiviral safely. “It involves time and effort, and that discourages, frankly speaking, physicians in this era where time is limited,” Dr Russo said.
There are resources available through the CDC that can help physicians determine whether their patient could benefit from Paxlovid, even if they’re currently taking a medication that may need to be paused or altered for a few days, he added.
Notably, patients don’t need to take Paxlovid very long: “Paxlovid is a short course of treatment,” Dr Liu said. Per the CDC, patients are advised to start the drug within five days of symptom onset; from there, they’re supposed to take the medication twice daily for five days.
If you do test positive for Covid and you’re high risk for severe disease, you should speak with your doctor about whether Paxlovid may help you, even if they don’t bring it up first. “It’s important to have a conversation [about Paxlovid,” Dr Russo said. “You can say, ‘I’m not 100 per cent sure about my medications, but I’d like to explore [my eligibility for Paxlovid].’”
If you feel your medical team isn’t giving you all of your options, it might be necessary to seek help elsewhere. “The buzzword [in healthcare settings],” Dr Russo said, “is ‘shared’ decision making.”
