Paxlovid is one of at least six COVID-19 treatments approved for emergency use in the United States. “With COVID-19 the realm of healing is the next horizon for us,” Dr. Marin Willis, Marin County Public Health Officer, told county supervisors last month during one of his periodic updates. “COVID-19 is an increasingly treatable disease with medication.” “We have about 25 new cases of COVID-19 a day in the Marin,” Willis said, “and one to three people are prescribed Paxlovid every day.” No evidence of a new increase in Marin cases has emerged despite the predominance of the more contagious BA.2 sub-variant of the omicron variant, Willis said this week. “I’m increasingly confident that we’re not going to see a significant increase in BA.2 cases,” Willis said. Four people were treated for COVID-19 in Marin on Thursday and no one was in the intensive care unit. Willis said the secondary variant proves to be less threatening in communities like Marin with high rates of vaccination and souvenirs and, ironically, in communities with high rates of infection because they resisted precautions. Both types of sites have high levels of community immunity. “In some places,” Willis said, “this immunity has been difficult to obtain through illness and death. “Another way to gain this level of immunity is through vaccinations.” Willis said Paxlovid was in short supply during the most recent case increase in January and February, but there is now plenty of stock. The drug, which Marin’s public health department receives from the state and distributes to local hospitals, is an antiviral drug that inhibits the reproduction of the SARS-CoV-2 protein. However, the drug is not a panacea for people who prefer to wait until they become infected with the coronavirus before seeking treatment. It must be prescribed by a doctor and in order to be eligible patients must be at high risk of hospitalization or death from COVID-19. Patients must also be 12 years of age or older and weigh at least 88 kg. Paxlovid is not recommended for people with severe kidney or liver disease. Lipitor and other lipid-lowering drugs may interact with Paxlovid, so they can not be taken at the same time. Probably the most frightening obstacle to using Paxlovid is the requirement to take it within five days of the first symptoms of COVID-19. This means that patients must be examined and seen by their doctor within a few days. “It’s definitely a challenge,” Willis said. “That’s where my work with the healthcare system is now in trying to streamline the whole process.” To that end, Willis said, Marin Hospitals and federal health centers have agreed to accept an antigen test at home as confirmation of infection instead of requiring the most definitive PCR test, which can take much longer to schedule and to be processed. Willis said the state also provides the county with a monthly distribution of 20 doses of Evusheld, a monoclonal antibody treatment that helps protect immunocompromised individuals from becoming infected with the virus. Willis said the treatment, which requires two simultaneous injections, “is to help protect people at the highest risk of bad results.” This includes people receiving treatment for cancer or dialysis due to kidney failure. Other approved treatments for COVID-19 are all less attractive for one reason or another. Molnupiravir, an alternative antiviral pill, is not recommended for women who are pregnant or breastfeeding. A study has shown that the drug can cause mutations in human DNA. France and India have decided not to approve its use. Willis said alternative therapies for monoclonal antibodies are difficult to administer because they involve injections or injections and are stored because they must be refrigerated. In addition, monoclonal antibody therapies must be well-matched to a particular variant in order to be effective. As a result, they are more vulnerable to mutations in the virus. Remdesivir, an antiviral therapy, and dexamethasone, a corticosteroid, remain the drugs of choice for the treatment of critically ill patients with COVID-19 after hospitalization. The results of studies at the National Institutes of Health on several more potential therapeutic agents are expected in the first half of this year and there are hundreds of similar studies in progress worldwide. Willis said the number of treatments already available and their effectiveness “is basically a sign that this virus is treatable.” “There are likely to be more treatments and more effective treatments,” he said. “This could change the game for us to move forward, especially if a more aggressive executive hits.” On Wednesday, a team of vaccine consultants at the Food and Drug Administration spent hours discussing key questions about renewing the COVID-19 vaccine and conducting future support campaigns. “Our goal here is to stay ahead of future variations and cases and ensure that we do our best to reduce the number of diseases and deaths due to COVID-19,” said Dr. Peter Marks, FDA Head of Vaccines. . Marks said frequent reinforcement could not be continued as an approach for future variants. More vaccine group meetings are expected in the coming months. The Associated Press contributed to this report.
