How do I get antiviral pills for Covid-19?

NYT "Well" Section

Alex Merto

Updated 

March 25, 2022, 9:37 a.m. ET

First, you must test positive with a P.C.R. or rapid test. This can be done at home, at a regular health care provider’s office, at a testing site or at one of the pharmacy chains, community health centers, long-term-care facilities or Veterans Affairs clinics participating in the “test to treat” program.

If you test positive at a participating location that dispenses antivirals and has an authorized medical provider, you can get a Covid-19 pill prescription (if eligible) and fill it on the spot. If you test positive at a different testing site or through an at-home testing kit, you can schedule an online or in-person visit with a provider at a “test to treat” location to get and fill a prescription as well.

And just like with other medications, your regular health care provider can call in a prescription to a pharmacy for you, said Kuldip Patel, the senior associate chief pharmacy officer at Duke University Hospital in North Carolina. A federal “test to treat” website, expected to go live soon, will include locations that test for the coronavirus and dispense antiviral treatments on the spot. For now, the drugs are free until the Federal Supply runs out.

 Who is eligible for antiviral pills?

NYT "Well" Section

Alex Merto

Updated 

March 25, 2022, 9:37 a.m. ET

Not everyone who tests positive for Covid-19 will get a prescription for antiviral pills, said Dr. Annie Luetkemeyer, a professor of infectious diseases at the University of California, San Francisco. To be eligible, you must test positive and have symptoms that started within five days or fewer. You must also be at increased risk of developing severe Covid-19.

Those who are asymptomatic, or who have symptoms but are not higher risk, will not be eligible.

While this may seem like very specific criteria, many people in the United States have medical conditions that would qualify them for the high-risk category, Dr. Luetkemeyer said. That includes all adults 65 and older, as well as those of any age with certain health conditions like heart disease, cancer, diabetes or obesity, she said.

It’s important, though, that you get treatment within five days of the start of your symptoms. “That’s pretty soon because people often don’t test the first day they have symptoms,” Dr. Luetkemeyer said. “You might feel a little bit lousy and think maybe you just have a cold that’ll go away.” But if you wait more than five days, you will no longer be able to take the oral medicines, she said.

And while federal guidelines prioritize treatment for those who are unvaccinated or who are not fully vaccinated and boosted, your vaccination status will not affect your eligibility.

 How effective are Covid antivirals?

NYT "Well" Section

Alex Merto

Updated 

March 25, 2022, 9:37 a.m. ET

Both Paxlovid and molnupiravir have been shown to reduce hospitalization and death from Covid-19 if taken early on in the course of an infection. “They are most effective when used within a few days of the onset of symptoms,” Dr. Gandhi said.

In a Pfizer trial published in December and conducted before the Omicron wave, Paxlovid reduced the risk of hospitalization and death in high-risk, unvaccinated people by 88 percent when given within five days of symptom onset.

Molnupiravir, however, has been shown to be less effective. One analysis from Merck, also published in December, showed that it reduced the risk of hospitalization and death in high-risk, unvaccinated adults with Covid-19 by only 30 percent if taken within five days of symptom onset.

Because of this lower efficacy, Dr. Gandhi said that “most clinicians, including myself, prefer Paxlovid if it’s available and if a person doesn’t take any other medications that make Paxlovid a problem for them.”

 What are antiviral drugs and how do they work?

NEW YORK TIMES " Well" Section

Alex Merto

Updated 

March 25, 2022, 9:37 a.m. ET

Tamiflu, one of the most well-known antivirals, can minimize flu symptoms and shorten the course of illness when taken within a few days of getting sick. It can also be used prophylactically (in nursing home residents, for example) to prevent viral spread during outbreaks. Other antiviral therapies, like those for H.I.V. and hepatitis C, can be taken chronically, even in the absence of symptoms, to prevent the disease from progressing and to curtail symptom flares.

Most antivirals work by suppressing a virus’s ability to infect and multiply in your cells, said Dr. Rajesh Gandhi, an infectious diseases physician at Massachusetts General Hospital. This helps the body fight off an active infection by easing the symptoms and shortening the length of the illness.

But the exact way an antiviral does this depends on the treatment you use. Some antivirals prevent viruses from spreading to healthy cells by blocking the receptors on cell surfaces. Others inhibit the machinery that a virus needs to make copies of itself once it has already barged inside your cells. Because of this, it has been notoriously difficult for researchers to develop antiviral medicines that blunt viral replication without harming the human cells they hide inside, Dr. Gandhi said.

Social Security offices, closed in the pandemic, are expected to reopen in March.

 The agency, whose offices were closed nearly two years ago, and the unions representing its work force agreed to reopen more than 1,200 offices.

New York Times

By Mark Miller

• Jan. 21, 2022

The national network of Social Security customer service offices, which were closed nearly two years ago at the start of the pandemic, is on track to reopen on March 30.

The Social Security Administration and unions representing the agency’s work force agreed this week to reopen more than 1,200 offices, contingent on changes in pandemic conditions and further negotiations. Bargaining is set to conclude by March 1, which would allow 30 days to plan for the office re-entry.

“This agreement will allow all the parties to wait and see what happens with the latest wave of the pandemic,” said Rich Couture, chief negotiator for the American Federation of Government Employees, one of three unions representing the agency work force involved in the talks. “Hopefully it subsides, but if it doesn’t, we can take further action to postpone the reopening if necessary.”

Social Security field offices handle benefit claims for retirement and Medicare. But they also assist with applications for Social Security Disability Insurance and Supplemental Security Income, the benefit program for low-income, disabled or older people. Since the pandemic began, nearly all public service has been available only online, and by phone and mail, and the agency work force of nearly 60,000 has operated virtually. Office visits are available only by appointment and only for a limited number of critical issues.

Processing of Social Security retirement benefits and Medicare claims has not been impaired during the office shutdown, agency records show. But there were sharp drops in 2020 in benefit awards for Supplemental Security Income and disability insurance.

Social Security had earlier announced a tentative plan for employees to return to the offices on Jan. 3. But that date was postponed because of disagreements between the agency and unions over specifics of the plan.

The new agreement calls for all employees and visitors to wear masks while at Social Security facilities, regardless of their vaccination status. Under the agency’s original plan, visitors who stated that they were vaccinated would have been permitted to forgo masks. The agreement also calls for negotiations between the agency and various segments of the work force over the specifics of each group’s reopening plan.

“Our main concern is to keep employees and the visiting public safe and healthy,” Mr. Couture said.

The details on office reopenings, including hours of operation, are still being negotiated, but are expected to be announced in March. The agency also plans to continue to allow telework to varying degrees for different jobs.

During the transition, the agency advises people to use its website wherever possible or to call its national toll-free number, 800-772-1213, as a starting point to receive assistance.