Two years into the COVID pandemic, as the highly contagious Omicron variant pushes infections to record highs, U.S. physicians have a growing arsenal of therapies to keep mild disease from worsening. At the same time, limited availability and challenging logistics are complicating decisions about which patients receive them. Here is a rundown of what is on hand for hospitalized patients, as well as for people who are primarily recovering at home.
Antiviral pills: Last month the FDA authorized emergency use of two antiviral treatments that can be taken at home as pills: Pfizer’s Paxlovid and Merck and Ridgeback Biotherapeutics’ molnupiravir. In studies of high-risk adults who started these treatments within their first five days of COVID symptoms, Paxlovid cut the risk of hospitalization or death by 89 percent, and molnupiravir cut these sufferings by 30 percent, compared with placebo pills.
As of January 10 Zuckerberg San Francisco General Hospital and Trauma Center, which serves 100,000 patients each year and provides 20 percent of the city’s inpatient care, had received 20 courses of Paxlovid, says Monica Gandhi, an HIV and infectious disease physician at the University of California, San Francisco.
Repurposed drugs: Fluvoxamine, an antidepressant pill that is approved in the U.S. for obsessive-compulsive disorder, can tame inflammatory responses, which typically arise in severe COVID-19. In a randomized trial of 1,497 high-risk COVID outpatients in Brazil, those who tolerated a 10-day course of fluvoxamine suffered about 90 percent fewer deaths, and their need for emergency care fell by 65 percent, compared with patients who were randomly assigned placebo pills.
The best preventative measures and risk reducers, exercise healthy diet, vitamins and sunshine.
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