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Everything you need to know about “COVID pills”

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Everything you need to know about “COVID pills”

| News Today | abc News

The United States is buying millions of courses of two antiviral drugs that treat COVID-19 – known as “COVID pills” – which they intend to make readily available for free. It’s a clear sign of confidence that the new drugs could change the trajectory of the pandemic, and possibly even help end it.

But what is that probability, really? And how do the pills work? Here’s what you need to know.

There are currently two different pills in development – one by Pfizer and one by Merck.

Although the Biden administration is rushing to get doses of both drugs, neither has actually been approved.

Merck, which is working with Ridgeback Biotherapeutics on the development of its pill, asked the Food and Drug Administration last month for emergency use authorization for its antiviral pill molnupiravir. And Pfizer this week applied for authorization for emergency use of its pill, Paxlovid. Both pills are intended for people at high risk of serious illness from COVID, due to factors such as age, underlying health issues or vaccination status. But eligibility will ultimately depend on the FDA, if and when it approves their use.

An FDA panel is scheduled to discuss Merck’s request on November 30. If the panel recommends clearance and the FDA agrees, the drug could be available within a few weeks – possibly in December, when some fear we are headed for another COVID surge. The FDA has yet to say whether it plans to convene a similar panel to review the Pfizer pill.

The purpose of both pills is to prevent serious illness and death

COVID pills cannot prevent people from getting infected, but they can help people who have caught the virus become seriously ill or die.

According to data released by the companies, Merck’s COVID pill halves the risk of hospitalization or death, while Pfizer’s pill cuts it by 89%.

Both would be prescription drugs that would be filled in a pharmacy and taken at home, unlike infusion drugs like remdesivir that are given in the hospital to people who are already very ill.

“Both drugs, when given to people with early-onset COVID infections – so before the virus has had a chance to spread widely – appear to reduce hospitalizations,” said Erica Johnson, chair of the Infectious Disease Board of the American Board of Internal Medicine. COVID pills.

In studies, people were given the pills within five days of the onset of their symptoms, Johnson noted. And the people who got them within three days seemed to have the best results.

Antiviral drugs are not new. They are used to fight many types of viruses, from influenza to HIV. How they work depends on their particular formulation, but they usually block receptors so viruses cannot attack healthy cells, and they lower a person’s overall viral load.

COVID pills really depend on early and reliable testing

Because COVID pills need to be administered early in a person’s illness cycle, their effectiveness really depends on quick and accurate testing. This means that a person who develops symptoms should have a PCR test with quick results and then start treatment as soon as possible.

The reality, however, is that rapid testing continues to be a problem.

“We are still missing a large number of cases nationwide and missing cases in people potentially at higher risk compared to other countries where tests are more readily available,” said James Lawler, medical specialist. infectious diseases in Nebraska Medicine.

Lawler pointed out that in Nebraska, for example, residents of many counties have to drive for a few hours to get a PCR test, which is the gold standard COVID test, and then have to wait for the results.

“We just aren’t able to diagnose cases quickly and efficiently, which is obviously a critical part of the chain of effective use of these drugs. You have to be able to diagnose cases. You have to be able to provide the drugs to the patients at the onset of the disease, ”Lawler said.

This may cause more people to rely on rapid antigen tests to get a COVID pill prescription, as these results are delivered within hours. However, rapid antigenic tests are not as reliable or sensitive as PCR tests. A Cochrane review found that they correctly identified COVID-19 in 72% of people with symptoms, but only 58% of people without symptoms. The CDC and the FDA have also warned that rapid antigen testing can lead to false positives in low prevalence settings.

Medicines are NOT a substitute for vaccines

The two COVID pills could provide another line of defense against the severe consequences of the virus. But the most important thing is to get vaccinated (and boost).

Vaccines not only prevent people from getting really sick with the virus, but they also help reduce the risk of transmission – despite a lot of public confusion on this point.

“This is an additional strategy that we need to help manage the infection for those infected, but does not replace the value of vaccination,” Johnson said of the pills.

Additionally, the pills are not a substitute for other proven public health strategies, such as masking in high transmission areas, Johnson added.

In part, that’s because it’s not yet clear whether COVID pills could reduce the likelihood that a person will pass the virus on to others. This is something that future research will need to explore.

Experts hope COVID pills can help the pandemic as a whole, but it’s too early to tell

There are reasons to hope that COVID pills could help bring the pandemic under control, but only time will tell. First of all, they have to go through the authorization process. And if allowed, doctors and researchers will closely monitor their performance in real time.

“All of this should be taken with a grain of salt, as none of this data has actually been published in the peer-reviewed literature, so we rely, so far, on press releases from pharmaceutical companies. themselves, ”Lawler said. . Of course, federal regulators will take a very close look at this data before approving drugs.

Lawler added that he believes there has been an “overly optimistic exuberance” in some people’s expectations of how these pills could change the pandemic. Still, the drugs could help keep people from getting really, really sick, and can be particularly helpful in preventing hospitals in COVID hotspots from becoming overwhelmed.

“These are drugs that we can give to people who haven’t gotten so sick yet,” Johnson said. “And that’s why I think there is a lot of enthusiasm for these drugs. “

Experts are still learning more about COVID-19. The information in this story is what was known or available at the time of publication, but directions may change as scientists find out more about the virus. Please consult the Centers for Disease Control and Prevention for the most recent recommendations.

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