Covid-19 treatments are widely available to at-risk New Yorkers, but many who may benefit from them may not even be aware they exist.
One such treatment, an antiviral drug called Paxlovid, is very effective, said Dr. Ted Long, the head of New York City’s Test and Trace Corps, is a city program that provides free testing and support to New Yorkers with Covid-19.
“For every 20 New Yorkers that we treat with Paxlovid, we prevent one New Yorker from getting so sick that they have to be admitted to the hospital,” Dr. Long said.
In New York City, Coronavirus cases have risen 6 percent over the past two weeks, according to The New York Times’ tracker, driven largely by the highly contagious Omicron subvariant BA.2. Hospitalizations have crept up to 23 percent over the same time period.
Across the country, hundreds of thousands of Paxlovid pills have gone unused, and the White House announced plans to expand this week.
The city’s health department didn’t say how many pills were distributed in New York, though Dr. Ashwin Vasan, the health commissioner, said the uptake had been “significant.” This city has worked to get word out through newspaper ads and public service announcements.
“We’re in a new phase of the pandemic response, where we’ve got a range of tools at our disposal,” said Dr. Vasan.
But some experts believe far too few people know about the treatments.
“I’m not really sure the average person who needs Paxlovid – that I mean older people, people with comorbidities or otherwise medically vulnerable, unvaccinated people – knows this is critical information,” said Dr. Denis Nash, a professor of epidemiology at the University of New York.
Paxlovid, a Pfizer drug that was authorized in late December, is one of several available treatments that have been proven effective against Covid-19. It is preferred by the federal government and New York City officials because of how effectively it reduces the risk of death and hospitalization from Covid-19 in high-risk, unvaccinated adults during trials.
Here’s an overview of the various Covid-19 treatments and how to get them in New York City.
Which Covid-19 treatments are available?
Both oral antiviral treatments and monoclonal antibodies are available. Antiviral pills work by interrupting the virus of infecting cells and then taking over those cells to replicate in the body, said Dr. Vasan. Monoclonal antibodies work by sweeping up the proteins that produce viruses, which in turn helps promote a person’s immune system.
Two oral antiviral pills are available for Covid-19 in New York City: Paxlovid and molnupiravir.
Paxlovid is prescribed as three pills taken once a day for five days, while molnupiravir – authorized for use in December – is prescribed as four pills taken twice a day for five days.
Both pills are available through an online pharmacy, Alto, and a select number of pharmacies across the city. You can find a list of those nearby on a federal website.
Most New Yorkers seeking antiviral treatment should expect to receive Paxlovid, given its efficacy. Vasan.
There are also two antibody treatments that appear to be effective against laboratory studies: Bebtelovimab, authorized for use in February and taken intravenously, and Evusheld, authorized for use in December, for people who are allergic to vaccines or are immunosuppressed.
Who is eligible for the treatments?
For most of the treatments, city officials give priority to people who are not only tested positive for the coronavirus, but who also have mild to moderate symptoms and are at increased risk of developing serious illness. (Evusheld is given to people before they test positive.)
You are considered at high risk of developing serious illness from Covid-19 if you are age 65 or older, or if you have health risks such as diabetes, hypertension or heart disease. Immunosuppressed people are also considered to be at high risk.
The federal government has urged providers to prioritize treatments for people who are unvaccinated, or aren’t yet fully vaccinated.
You have to be older than 12 and weigh more than 40 kilograms, or about 88 pounds, to receive Paxlovid, bebtelovimab, and Evusheld. But you have to be at least 18 to take molnupiravir.
People with severe kidney or liver disease may not be eligible for Paxlovid, and molnupiravir cannot be used during pregnancy. Pregnant or breastfeeding women should talk to their health care providers before taking Paxlovid, according to the FDA fact sheet for the treatment.
It is important for patients to talk to their providers about the medications they are taking, as they can negatively interact with the treatments, said Dr. Andrew Wallach, the ambulatory care chief medical officer at New York City Health and Hospitals.
How do I get them?
After you test positive, you should inform your doctor or call the city’s Covid hotline, 212-COVID19 (212-268-4319) and press 9 to become one of the city’s doctors determining your eligibility. You can also visit Virtual Express Care to schedule a phone or video visit or fill out the city’s screening tool too.
After a doctor decides which treatment is right for you, it will be sent to a nearby pharmacy or to your home. The city’s partnership with Alto Pharmacy makes same-day home delivery possible.
The Biden administration also recently unveiled a “test to treat” initiative, which makes it possible to get tested for coronavirus at certain pharmacies, and if you test positive, receive free antiviral pills on the spot. You can find locations on the federal website.
Do I have to pay?
They are currently free for all New Yorkers, Dr. Vasan said.
Are the treatments effective?
The oral treatments have been proven to reduce hospitalization and death from Covid-19 if taken soon after the onset of symptoms.
Paxlovid reduces the risk of hospitalization and death in high-risk, 88 percent by people taken 88 percent of the onset symptoms within five days after a Pfizer trial was published in December, before the Omicron wave.
Molnupiravir reduced the risk of hospitalization and death in high-risk, unvaccinated people by 30 percent when taken within five days of the onset of symptoms, according to an analysis from Merck that was published in November.
Bebtelovimab, which must be administered within seven days of symptoms, has not been tested in a study that shows it can stave off severe disease, and the Food and Drug Administration said it should not be a preferred treatment.
Evusheld, which can be administered as often as every six months, was found to be effectively effective at preventing Covid in a clinical trial.
Are there any side effects?
Paxlovid is “well-tolerated,” said Dr. Wallach. Side effects that have been seen in small numbers in clinical trials include diarrhea, hypertension and soreness.
Because bebtelovimab is given intravenously, some people may experience a rash at the injection site.
How Many New Yorkers Have Received These Treatments?
It ‘s hard to say. The health department was unable to provide data, in part because it did not have “visibility in the entire universe of pharmacies” that distribute many of its treatments, said Patrick Gallahue, a spokesman.
There is an immunization registry that tracks vaccinations, but there is no registry for prescription medication, said Dr. Nash.
“It’s a problem that they don’t have on their finger, because it’s the main thing that is going to help us get these surges, hospitalizations and deaths,” he said. “That plus vaccines and boosters.”
Dr. Nash worried that the inequities seen during each phase of the pandemic, including the rollout of testing and vaccines, would play out again with these treatments.
“If you do not anticipate access to the underlying inequities, health care is going to be magnified, if you do not plan for it, then you have done a poor job at taking care of your job most vulnerable people. in the city, “said Dr. Nash.
How has the rollout gone so far?
The treatments are now available through Alto Pharmacy and community health centers. The health department is working on expanding access to brick-and-mortar pharmacies throughout the city, too. Ultimately, state officials decide how to allocate treatments to pharmacies.
Colombo’s Pharmacy in Queens is one of the places that now offers Paxlovid and molnupiravir.
It received its first batch, 20 doses of each medication, earlier this month. Dr. David Kandov, the pharmacist, said only about five people had asked for the treatments so far.
Dr. Kandov expressed frustration about how long it took to get the first batch, saying to the network that he had been trying unsuccessfully to get access to the medications since December, when they were first authorized.
He blamed the health department. “They effectively cut us out of it, and cut out the access to the communities,” Dr. Kandov said. “Because at the end of the day, as much as things are available virtually, mail order and those types of things, that is not anywhere near the same patients as it is right there in their community.”
“The city is offering a delivery model that ensures rapid access to any New York address, which began at a time when supplies were insufficient to stock brick and mortar pharmacies across the city,” said Mr. Gallahue. “As supplies have improved, more pharmacies have been onboarded.”