MORE than 240 people in Hunter New England have died of COVID-19 so far this year, but experts question whether more lives could have been saved with early access to antiviral medications.
Up to 15,000 Australians are expected to die of COVID-19 this year. But with the seven-day rolling average currently sitting "stubbornly" at 40 deaths a week across the country, University of Newcastle viral immunologist - Associate Professor Nathan Bartlett - says education and understanding around what antiviral drugs are available, how to access them, and the importance of responding early is "critical".
"People just want to move on, so largely, we seem to becoming a bit desensitised to the deaths. But this number of deaths each week is really not acceptable over the long term," he said.
A/Prof Bartlett said the first oral treatments approved for COVID-19 in Australia - Lagevrio and Paxlovid - are available for people at increased risk of severe illness and hospitalisation.
"If given within a couple of days of symptoms, they are remarkably effective at reducing the chance of developing more significant disease," he said.
"It's reasonable to assume that over a number of weeks where you've got hundreds of people who have died, you'd have to think at least some of them might've survived had they got an antiviral early on in their disease progression. We can do better."
People aged 65 and above with two additional high risk factors for developing severe disease; those 75 and above with one additional high risk factor; Aboriginal and Torres Strait Islander people aged 50 and over; and moderately to severely immunocompromised people - irrespective of vaccination status - could meet the clinical criteria for the antiviral COVID-19 drugs.
But A/Prof Bartlett said the tricky part was accessing them early. People needed to understand what that process involved.
"You need to act quickly - you've got to act from the moment your throat starts to tickle or your nose starts to run or you start to get headaches," he said. "The clock is ticking and you have to jump those hurdles which will take some days to get through."
He said this required a PCR test at the very first sign of symptoms; getting a GP to conduct a risk assessment for developing severe disease; then, if deemed eligible, getting a script filled for the antivirals.
"This all has to happen within five days of your symptoms starting," he said. "If you wait a couple of days you might be too late."
A/Prof Bartlett said PCR testing clinics, such as the one at Honeysuckle, now tested for COVID-19 as well as influenza and RSV (respiratory syncytial virus).
Determining which virus you have is an important step in working out which, if any, antivirals you need.
"Hopefully they will prevent symptoms progressing to a point where you need to go to hospital," he said.
Joanne Wood, a Hunter GP Association committee member, said if you have multiple medical conditions, it would be a good idea to discuss the possibility of antivirals with your GP ahead of time should you catch COVID.
"Everyone who tests positive for COVID-19 on a PCR or registers a positive RAT test with Service NSW is invited to answer some extra questions about their health - a service provided by Healthdirect," she said.
"After answering these questions you might be advised to discuss your situation with your GP to see if you need antivirals.
"If you give permission, your GP will also be notified that you might be eligible and many GP's have systems in place for appointments in these situations - call your GP to find out.
"For people who can't access their GP in time, Healthdirect will help arrange an alternative way for you to discuss your individual situation with a doctor."
In Hunter New England, there have been 259,237 COVID infections reported so far this year, although health authorities say that would be an "undercount" giving a growing reliance on rapid antigen tests and self-reporting.
In the week ending June 11, there were 5,171 cases of COVID-19, and 1,982 cases of influenza.
To date, there has been almost 5000 cases of the flu in the region in 2022.
"Flu is rampant at the moment. It is tearing through the schools," A/Prof Bartlett said. "These viruses are being transmitted at schools and disseminated to the wider community."
What you need to know about accessing antivirals for COVID-19: Joanne Wood explains
Who are antivirals most likely to help in people who catch COVID?
"At the moment antivirals are only able to be prescribed for people who are at risk of severe disease based on a combination of factors including age and comorbidity and vaccination status. If you have multiple medical conditions it is a good idea to discuss with your GP ahead of time whether an antiviral might be something you need to consider if you catch COVID."
I am up to date with my COVID vaccinations, will I need antivirals?
"The good news is for most people antivirals won't be needed if you are up to date with your vaccinations (as per ATAGI guidelines). The exception to this rule is people with immunocompromise. Immune compromise can be caused by multiple conditions or medications and in different ways - your GP has definitions that they use to help determine if you will need antivirals. Talk to your GP or your specialist ahead of time to see if you might need to start antivirals if you catch COVID."
Is there a timeline to start antivirals?
"Antivirals need to start within the first five days of symptoms for them to work, so it is important to get COVID diagnosed as soon as possible. When you have symptoms consistent with COVID-19 a RAT test is useful if it is a positive result, if it is negative a PCR test needs to be done. This should be done as soon as possible for people who may need to start oral antivirals."
I have COVID and think I might need an antiviral - how can I arrange to get assessed?
"Everyone who tests positive for COVID-19 on a PCR or registers a positive RAT test with Service NSW is invited to answer some extra questions about their health (a service provided by Healthdirect). After answering these questions you might be advised to discuss your situation with your GP to see if you need antivirals. If you give permission, your GP will also be notified that you might be eligible and many GP's have systems in place for appointments in these situations - call your GP to find out. For people who can't access their GP in time, Healthdirect will help arrange an alternative way for you to discuss your individual situation with a doctor."
I have tested positive but don't have symptoms for COVID-19 - do I need antivirals?
"No. At this stage antivirals are only for people with symptoms."
Where can I read more about antivirals?
Patient information sheets:
https://www.healthdirect.gov.au/amp/article/covid-19/medications
