The US is in the middle of a quiet, but severe covid wave.
A third of Americans live in areas with such a high concentration of covid that the Centers for Disease Control and Prevention is once again recommending masking up.
Hospital admissions with covid are now up to about 3,000 a day, but people who are vaccinated and boosted are expected to only experience mild cases that can be treated at home. Doctors can prescribe the antiviral paxlovid to qualifying patients in the US, though many are struggling to get prescriptions for the drug. The treatment is free.
The Food and Drug Administration has given emergency use authorization of paxlovid to people with specific conditions, so many might not think they are entitled to the treatment. But this isn’t the case: the qualifying parameters are broad enough that most Americans who test positive for covid should at least be offered the opportunity to take the antiviral.
Paxlovid, a drug developed by Pfizer, is an antiviral treatment consisting of three pills to be taken twice a day for five days. That makes it 30 pills in total. Paxlovid is actually two drugs: two of the three pills are nirmatrelvir, which stops the virus from replicating; the third pill is ritonavir, a drug once used in HIV/AIDS treatment, which boosts the effect of nirmatrelvir.
The earliest a covid patient starts taking paxlovid, the sooner and more easily the infection will clear. The treatment is effective if started within five days of symptoms, after which the antiviral can no longer be effective in stopping the virus from taking over.
The drug is highly effective in preventing severe illness—in the trials, patients were found to be 89% less likely to develop severe covid after taking it.
The antiviral is available for all people over the age of 12 who weigh at least 88 pounds (40 kg). The recommendation is to prescribe the medication to those at high risk of developing severe covid.
The list of conditions linked to higher risk of developing severe covid is long and includes physical inactivity, any history of smoking (those sneaky teenage cigarettes do count), or mental health issues such as depression and anxiety. That means pretty much all Americans qualify.
There are, however, a lot of prescription drugs that interact with paxlovid. Some of them make the treatment contraindicated, while others require temporary adjustments, such as a change in dosage or a suspension of the other medication.
Notably, women who are on hormonal birth control should use other means of contraception while taking the medication and until one menstrual period after the end of the treatment.
Like all medications, paxlovid has side effects, including increased blood pressure, diarrhea, muscle pain, and altered taste. In particular, people report a bitter, metallic taste in their mouths.
In some patients, paxlovid appears to cause a “rebound effect:” people might feel better during the treatment, then experience some symptoms again a few days after the course is done. However, this is still under investigation, and scientists are evaluating extending the treatment period.
Paxlovid is currently available at about 20,000 locations across the country, including community health centers and pharmacies with in-house clinics where the prescription can be filled right after a positive test. More locations are being added, and there is a live map to help patients find the closest to them.
The treatment costs about $530 per course, but it’s free to patients at least until the emergency officially ends. However, some clinics and doctors might charge for the visit and prescription.