"Widely available."
That's how Dr. Ruth Lynfield, Minnesota's respected state epidemiologist, sums up the current supply of antiviral treatments — in other words, pills or outpatient therapies prescribed soon after a positive test for those at risk for severe COVID-19.
Good news has too often been a rare commodity during this long, exhausting pandemic. But one medication in particular — dubbed Paxlovid — delivers a welcome double shot of that. It's plentiful and potent, being close to 90% effective against hospitalization and death when taken during a limited window of time.
But Paxlovid and other antivirals don't do anyone any good if they're gathering dust on a clinic or pharmacy shelf. While these may have been in short supply temporarily after they were cleared for use in the United States — Paxlovid's emergency authorization for those ages 12 and up came in December, for example — there's now a healthy inventory of them here and elsewhere.
Other treatments include remdesivir, bebtelovimab and molnupiravir. The first two are given as outpatient infusions; the last is taken by mouth. The age range and other eligibility criteria vary from treatment to treatment. The issue now is ensuring that Minnesotans are not only aware of these options, but understand who should use them and when.
The list of conditions that elevate risk for severe COVID-19 is likely more expansive than many realize. It includes older adults, particularly those 65 and over. Also on the list: Type 1 and 2 diabetes, chronic lung conditions such as asthma, as well as heart, liver and kidney disease. Mood disorders, including depression and schizophrenia spectrum disorders, are risk factors as well. A full list is available from the U.S. Centers for Disease Control and Prevention at tinyurl.com/Risk042522, but when in doubt ask a doctor or pharmacist.
Antivirals need to be given as soon as possible, which is why prompt COVID-19 testing remains critical. These treatments prevent people from becoming severely ill and needing hospitalization. Thus, patients need to take them before that level of care is required. For example, Paxlovid must be prescribed for use "within 5 days of symptom onset," according to the U.S. Food and Drug Administration.
There's urgency to understanding all this. On Friday, the Star Tribune reported that COVID-19 cases have exceeded the state's high-risk threshold again, even with many infections likely going unreported due to the use of at-home rapid tests.
The Minnesota Department of Health (MDH) has excellent online resources (tinyurl.com/MNHealthCovidmeds) for those wanting more information about antiviral treatments and where to find them.
Additional points that are helpful to understand:
Vaccinated people with breakthrough COVID-19 infections are eligible for antiviral treatments, providing they have risk factors and meet other prescribing guidelines. Social media has sowed confusion about this.
There are multiple pathways to access antiviral treatments. Some pharmacies with on-site urgent care clinics have joined the federal "Test to Treat" program, which provides testing and prescriptions for antiviral pills. But that is not the only way to access antivirals. Regular medical providers can also prescribe them and help find a pharmacy to fill the prescription if it's not in stock locally.
A mild case of COVID-19 can still turn severe. If you're at elevated risk, seek out antivirals even if you don't feel that sick initially.
A "key message" right now is having a plan in place in case you're infected, said Dr. Sarah Lim, an MDH medical specialist. Understand if you're at high risk, and then know what to do if symptoms develop, she said, because the timeframe for antivirals to work is so tight.
The pandemic continues to wax and wane. Vaccines remain the most powerful weapon against the virus, but medicine's war chest against it has expanded and is well-stocked. Make good use of it or help someone else do so.
