NYC Wants to Remind Us Antiviral Pills Work Real Well Against Severe COVID, Too

NYS breakthrough case rates have increased over the last few weeks, but it's not clear what is responsible for that. Most importantly, breakthrough hospitalization rates haven't changed in a statistically significant way

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New York City COVID infections have been on the rise once again in recent weeks, and while there's no corresponding increase in severity, the health commissioner is reminding the public and providers that antiviral pills are effective treatments, too.

Paxlovid, specifically, can reduce the risk of hospitalization and death by up to 88% when taken within five days of symptoms starting, Dr. Ashwin Vasan said in an advisory issued to healthcare providers citywide on Tuesday.

That pill is the preferred treatment option for most high-risk patients with mild to moderate COVID, based on federal treatment guidelines. Molnupiravir is another pill available and also should be used within five days of symptom onset, Vasan says.

Oral antivirals are available by prescription at a number of New York City pharmacies, including Test to Treat centers, which were launched as a part of a Biden administration national initiative to test and prescribe treatment in one location.

Another option, Vasan reminds providers, is monoclonal antibody treatment, which can be provided intravenously within a week of symptom onset. See locations here

The advisory also informs providers of the availability of Evusheld as a preventative treatment for patients who are immunocompromised and may not sufficiently respond to the vaccines and for patients allergic to the vaccines. Evusheld is not a substitute for vaccination in people who can be vaccinated, Vasan's note says.

The city has partnered with Alto Pharmacy to enable same-day or next-day delivery of Evusheld to patients at no cost. Alto will also deliver it to providers' offices.

Whatever the treatment course, Vasan says it's critical, especially at this juncture in the city's COVID recovery, that providers offer multiple options and that they help patients understand the pros and cons of each for their unique situations.

"The tools we have available to prevent the worst outcomes of COVID-19 are better than they have been at any other point in the pandemic, but they’re only effective if providers know to use them, and how to access them for their patients," Vasan said. "We are raising awareness in the medical community that treatments save lives, and there are ready options for you and your patients who test positive for COVID-19."

If you have symptoms or test positive for COVID-19, talk to your health care provider or call 212-COVID19 (212-268-4319). Read the commissioner's full advisory here.

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