Doctors are finding barriers to the use of pills to treat COVID-19On March 21, 2022 by editor
High-risk COVID-19 patients now have new treatments that they can take home to stay out of the hospital – if doctors get them pills fast enough.
Healthcare systems across the country are releasing prescription deliveries on the same day. Some clinics have begun testing and treating patients in one visit, an initiative President Joe Biden’s administration recently announced.
The goal is for patients to start having symptoms within five days of Pfizer’s Paxlovid tablets or Mark’s Malnupiravi capsules. This can prevent people with major health risks from getting sick and being hospitalized if another wave is created.
But tough deadlines pose a number of challenges. Some patients are delaying the test, thinking they have a cold. Others have been reluctant or unable to try new drugs.
With vaccines and treatments available, “if people are willing to take care of themselves, we can handle this much more in the future,” said Dr. Brian Zarbeck, who led the COVID-19 treatment and vaccination effort for the Minnesota health care system. M Health Fairview.
The Food and Drug Administration approved the drug last year. Physicians have hailed these pills as a huge breakthrough in the fight against COVID-19 because in part because of their benefits compared to other treatments that require infusion or injection.
But patients may miss the small window of the pill if they eliminate symptoms such as headaches or runny nose and wait to see if they go away before asking for help.
Dr Thomas Liu of Stanford said he had seen high-risk and unvaccinated people who had waited more than a week. Some patients admitted to the hospital with oxygen told him that they did not think of any of their first symptoms.
“They say everyone in the family has decided it’s a cold or allergy season, but it’s always been cowardly,” he said.
People are reluctant to seek help for many health problems, not just Kovid-19, Liu noted. But when it comes to the virus, doctors believe that patients may not be aware of strict deadlines.
Even those who are tested quickly sometimes refuse the pills, doctors say.
Zarabek estimates that half of the 30% of patients who qualified for the antiviral pill refused treatment at his healthcare system earlier this year.
He said some people do not consider themselves at high risk or feel that they are sick enough to need free medicine for patients. They are also concerned about side effects or how the drugs interact with other drugs.
Jeff Carlson could not try Paxlovid when COVID-19 hit him in January because it could interfere with his heart medicine. The 61-year-old suburb of St. Paul, Minnesota, has type 1 diabetes and heart disease.
A doctor told her to try Malnupiravi about three days after she started experiencing symptoms. By then Carlson could not get off his sofa. Her fever was high and she was having trouble breathing.
His wife picked up the prescription and a few days later, Carlson felt good enough to snow.
“About 18 hours after I took the first dose, it basically turned me on to one thing,” he said.
Some healthcare providers have started free delivery services for Paxlovid or Malnupiravir.
New York City has set up a hotline where patients can call if they test positive for coronavirus. They can talk to a care provider if they do not have a doctor and if they are a good candidate they are sent a pill.
Boston-based Mass. General Brigham Health Systems has launched a similar program that sends pills to some patients via FedEx.
About three hours after a doctor cleared him for a prescription last month, Raymond Kelly received a package of paxlovid. The 75-year-old Needham, Massachusetts resident said he contracted the virus despite being vaccinated and receiving booster shots.
Her doctor was on the phone with her a few minutes after the health system informed her that she had tested positive.
“It was all kind of vague because it’s moving so fast,” Kelly said.
Mass General Brigham’s goal is to quickly treat patients and solve transportation problems through its program. Dr. Scott Dryden-Peterson noted that some COVID-19 patients may not be able to pick up the pill, especially since their bus and ride-sharing services should be discontinued.
“Transportation is not evenly distributed in our society,” he said.
For transportation patients, the drugstore chain CVS Health MinuteClinic has launched the “Test for Treatment” program in about 1,200 of its stores, including the location. Pharmacists cannot test and treat, so this program will not happen in all stores.
Other retailers, such as Grocery Kroger, also plan to test and treat in some places. The Biden administration has called on federally qualified community health centers to do the same, but Health Secretary Xavier Besser recently told the Associated Press that the “medical examination” initiative could be hampered by funding stagnation with Congress.
Cook County Health in Chicago has been conducting drive-through COVID-19 testing since the beginning of the epidemic. It plans to pilot a program that adds therapy. Patients can drive in a tent, get tested, wait about 15 minutes for results and then talk to a doctor via telemedicine, Dr. Greg Hoon said.
With the rapid increase in care options, doctors and public health officials say it is time to examine people indoors and outdoors.
University of Maryland health policy expert Neil J. Sehgal said the supply of tests that were low during the Omicron wave has increased again. However, he noted that future supplies would also depend on federal funding.
Doctors say people at high risk of developing health problems with COVID-19 should be alert to the symptoms and seek immediate help, especially if another increase occurs.
“It simply came to our notice then.
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