Newly infected Covid 19 patients have two new treatment options that can be taken at home.
But that convenience comes with a catch: The pills have to be taken as soon as possible once symptoms appear.
The challenge is getting tested, getting a prescription and starting the pills in a short window.
US regulators authorised Pfizer’s pill, Paxlovid, and Merck’s molnupiravir last week. In high-risk patients, both were shown to reduce the chances of hospitalisation or death from Covid 19, although Pfizer’s was much more effective.
A closer look:
Who should take these pills?
The antiviral pills aren’t for everyone who gets a positive test. The pills are intended for those with mild or moderate Covid 19 who are more likely to become seriously ill. That includes older people and those with other health conditions like heart disease, cancer or diabetes that make them more vulnerable. Both pills were OK’d for adults while Paxlovid is authorised for children ages 12 and older.
Who should not take these pills?
Merck’s molnupiravir is not authorised for children because it might interfere with bone growth. It also is not recommended for pregnant women because of the potential for birth defects. Pfizer’s pill is not recommended for patients with severe kidney or liver problems. It also may not be the best option for some because it may interact with other prescriptions a patient is taking. The antiviral pills are not authorised for people hospitalised with Covid 19.
What is the treatment window?
The pills have to be started as soon as possible, within five days of the start of symptoms. Cough, headache, fever, the loss of taste or smell and muscle and body aches are among the more common signs. The Centres for Disease Control and Prevention offers a website to check your symptoms.
Dr Cameron Wolfe, an infectious disease specialist at Duke University Hospital, advises getting a test as soon as you have symptoms of Covid 19.
“If you wait until you have started to get breathless, you have already to a large extent missed the window where these drugs will be helpful,” Wolfe said.
Where can I get the pills?
You’ll need a prescription first from a doctor or other authorised health worker. The US government is buying the pills from Merck and Pfizer and providing them for free, but supplies will be limited initially. They will be shipped to states where they will be available at drugstores, community health centres and other places. Treatment lasts five days.
Some pharmacists may be able to administer a quick Covid 19 test and prescribe the pills all in one visit. They already do this in many states for flu or strep throat.
Will the pills work for the omicron variant?
The pills are expected to be effective against omicron because they do not target the spike protein where most of the variant’s worrisome mutations reside. The two pills work in different ways to prevent the virus from reproducing.
Are there other options for new Covid 19 patients?
Yes, but they aren’t as easy to use as a pill: They are given by IV or injection, typically at a hospital or clinic. Three drugs provide virus-fighting antibodies, although laboratory testing suggests the two aren’t effective against omicron. British drugmaker GlaxoSmithKline’s antibody drug appears to work, and officials say they are working to increase the US supply. The only antiviral drug approved in the US, remdesivir, is for people hospitalised with Covid 19.