Doctors find obstacles to the use of pills to treat COVID-19

Patients with high-risk COVID-19 can now take new medications at home and stay out of hospital if they are able to get them to them quickly.

Doctors find obstacles to the use of pills to treat COVID-19

The nation's health systems are now rushing to deliver prescriptions the same day. Some clinics are now able to test and treat patients in just one visit an initiative President Joe Biden recently highlighted.

Patients should be able to start either Pfizer's Paxlovid tablets or Merck's Molnupiravir capsules as soon as symptoms appear . This can help people at high risk of becoming sicker or filling hospitals with more patients if another surge occurs.

However, the deadline is presenting many challenges. Patients are delaying testing because they believe they have a cold. Some patients are unable or unwilling to take the new medication.

Dr. Bryan Jarabek, who leads COVID-19 treatment for Minnesota Health Fairview, said that vaccines and treatments are now available. "We can make this much easier in the future, but people have to be willing to take care themselves."

Last year, the Food and Drug Administration approved the drugs. The convenience of the pills compared with other treatments that require injections or infusions was a major advantage for COVID-19 fighters, according to doctors.

Patients can still miss the pill's short window of effectiveness if they ignore symptoms such as a headache or sniffles, and wait to see what happens before seeking medical attention.

Stanford's Dr. Thomas Lew stated that he has seen people with high-risk who are unvaccinated and have had to wait more than a week. He has heard from patients in hospital who are on oxygen that they didn't think anything of their first symptoms.

He said, "They claim everyone in the family thought it was a cold or allergy season coming up. But it was COVID all along."

Lew observed that people delay seeking treatment for many other health issues than COVID-19. The doctor is concerned that patients might not know the strict deadline when it comes to the virus.

Doctors say that even those who are tested quickly sometimes refuse to take the pills.

Jarabek estimates that 30 to 50% of patients who were eligible for antiviral medication turned down treatment in his health system.

He stated that some people don't feel at risk, or don't believe they are sick enough to require the free pills. The side effects and interactions of the drug with other medications were also concerns.

Jeff Carlson was unable to try Paxlovid in January when COVID-19 struck him. This is because it could interfere with his heart medication. The suburban St. Paul resident, aged 61, has Type 1 diabetes and heart diseases.

Three days after Carlson began feeling the symptoms, a doctor suggested that he try molnupiravir. Carlson was unable to get up from his couch by that point. He was now struggling to breathe because his fever had reached epidemic proportions.

Carlson's wife took the prescription, and Carlson was able to shovel snow a few days later.

He said, "It turned my around basically in a matter... pretty much 18hrs after I took the initial dose."

Some health care providers offer free delivery for Paxlovid and molnupiravir.

New York City has a hotline that patients can call to report a positive test for coronavirus. If they're a good candidate, they can speak to a doctor or have their pills sent to them.

A similar program was started by the Mass General Brigham hospital in Boston that shipped pills via FedEx to some patients.

Raymond Kelly received a Paxlovid package within three hours of receiving it from his doctor. According to the 75-year old resident of Needham, Massachusetts, he contracted the virus even though he had been vaccinated and received a booster shot.

Minutes after the health system informed him that he had been tested positive, his doctor called him to discuss the matter.

Kelly stated, "It was all kind of blur because it was moving so fast."

Mass General Brigham's goal is to quickly treat patients and resolve transportation issues with its program. Dr. Scott DrydenPeterson pointed out that COVID-19 patients might not be able pick up their pills, particularly since they should avoid ride-sharing and buses.

He stated, "Transportation in our society is not equally distributed."

CVS Health, a drugstore chain, has launched "test to treat” programs in its 1,200 stores that are MinuteClinic locations. The program will not be offered at all locations because pharmacists are not qualified to test and treat.

Kroger and other retailers plan to also test and treat in some locations. The Biden administration had called for federally-qualified community health centers to perform the same. However, Health Secretary Xavier Becerra recently stated to The Associated Press that Congress could block the "test and treat" initiative.

Since the outbreak of the pandemic, Chicago's Cook County Health has conducted drive-through COVID-19 tests. It plans to pilot a program that includes additional treatments. Dr. Greg Huhn explained that patients will be able drive to the tents to get tested and wait for their results. Then, they can talk to a doctor via telemedicine.

Doctors and public health officials agree that now is the right time to stockpile at-home testing because there are more options for quick care.

According to Neil J. Sehgal (University of Maryland) a University of Maryland expert in health policy, testing supplies that were shorted during the omicron surge are now back on track. However, he said that future supplies will also depend on federal funding.

Doctors advise that people who are at high risk for developing health problems due to COVID-19 should be vigilant for signs and seek immediate medical attention, particularly if there is a second surge.

Huhn stated that "it may not be the right time to let down your guard,"


 

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