By Dr. Mark Satterfield
Plumas County Public Health Officer
Plumas County Public Health wants the public to know about four new anti-viral medications available to treat people with COVID-19 infection who are at increased risk for severe symptoms. To be effective, each of these medications has to be started within 5-7 days of a person’s first COVID symptoms, which usually means before a person has begun to feel very bad. A 5-day course of pills or one of the latest IV infusions can prevent hospitalization or ICU level care for higher risk individuals.
People who have any of the following situations are at substantial risk of having to be hospitalized if they get COVID-19:
- not vaccinated
- over age 65
- more than 30 pounds overweight
- any ongoing medical problems that have caused hospitalization in the past
If you have one or more of the above and you notice symptoms such as sore throat or stuffy nose — or maybe just a cough, headache, or low fever — you need to get tested for COVID-19 within a day. That can be either a home test or a test at the local hospital or clinic. This is even more important if you’ve been around someone whom you know has COVID-19.
If your test is positive and you are at higher risk, please arrange a visit with your provider or doctor (virtual, in-car, or in clinic) within a day. They can help you determine if one of the new medical treatments might be appropriate for you. Of course all people who test positive for COVID-19 need to isolate away from others for at least 5 days so they don’t spread the infection. Also, let people who you have been in close contact with know about your infection.
People can also have a false negative home test early in the infection, so they should repeat the test in 1-2 days if their symptoms persist or worsen. Getting started on medication right away is really important to keep high risk people from ending up in the hospital.
The new medicines are Paxlovid, sotrovimab, remdesivir (repurposed for outpatient infusion), and molnupiravir.
Paxlovid is the most exciting. It is 3 pills taken twice a day for 5 days and reduces the chances of hospitalization in high risk COVID-19 patients by 88 percent (from 6.3 percent down to 0.8 percent). There is a limited supply of this drug, but so far there’s been enough for all Plumas County residents who need and want it. Side effects are minor but there are drug interactions and other medical problems which need to be considered. So a person needs to see a provider to make sure the prescription is safe and will work for them.
Sotrovimab is the newest monoclonal antibody treatment. It is highly effective against both omicron and delta as a 1-hour IV outpatient infusion at one of the hospitals. It’s helpful for high risk people who can’t take Paxlovid and it can be used as late as 10 days after first symptoms or positive test. Supply is very limited but currently adequate for those who need it. It’s just as effective as Paxlovid.
Remdesivir is another antiviral medicine that has been used for almost 2 years to help people hospitalized with COVID-19. Recent trials of its use for those who don’t yet need hospitalization have shown it can be even more effective when given as an outpatient IV infusion on three successive days. The chances of being hospitalized or dying are reduced 87 percent (from 5.3 percent to 0.7 percent. It’s useful for people who don’t have the other options above for one reason or another.
Finally, molnupiravir and fluvoxamine are also pills that may help some people. Most of these medications are in limited supply, so that’s also a reason a person needs to see a medical provider virtually or face to face in order to be prescribed these medicines.
Finally, please remember, the best protection against hospitalization or death from COVID-19 is to be fully vaccinated and boosted. A person’s chances of getting hospitalized with omicron are reduced by 15 times, and of dying of it by 30 times if they are fully vaccinated. Vaccines have shown themselves to be amazingly safe and effective. So be sure to get vaccinated and get a booster if you are eligible. There are still more than 1,200 people dying of COVID-19 in California every week! It’s time we stop that.