How to Get Covid Treatments in New York City

Covid-19 treatments are widely available to high-risk New Yorkers, but many who could benefit from them may not even know they exist.

One of those treatments, an antiviral drug called Paxlovid, is very effective, said Dr. Ted Long, the chief of New York City’s Test and Trace Corps, a city program that provides free testing and support to New Yorkers with Covid-19.

“For every 20 New Yorkers we treat with Paxlovid, we prevent one New Yorker from getting so sick that they would have to be hospitalized,” said Dr. lung.

The number of coronavirus cases in New York City has increased by 6 percent in the past two weeks, according to The New York Times tracker, driven largely by the highly contagious Omicron subvariant BA.2. Hospital admissions have increased by 23 percent over the same period.

Hundreds of thousands of Paxlovid pills have gone unused across the country, and the White House announced plans this week to expand access.

The city’s health department didn’t say how many pills had been distributed in New York, though Dr. Ashwin Vasan, the health commissioner, said the uptake was “significant”. This city has worked to gain exposure through newspaper advertisements and public service announcements.

“We are in a new phase of the pandemic response, where we have a range of tools at our disposal,” said Dr. vasan.

But some experts believe that far too few people know about the treatments.

“I’m not really sure that the average person who needs Paxlovid — by that I mean older people, those with co-morbidities, or otherwise medically vulnerable, unvaccinated people — knows this crucial information,” said Dr. Denis Nash, a professor of epidemiology at the City University of New York.

Paxlovid, a Pfizer drug that was approved in late December, is one of several available treatments that have been proven to be effective against Covid-19. It is preferred by the federal government and New York City officials for its effective reduction in the risk of death and hospitalization from Covid-19 in high-risk unvaccinated adults during studies.

Here’s an overview of the different Covid-19 treatments and how to get them in New York City.

Both oral antiviral treatments and monoclonal antibodies are available. Antiviral pills work by interrupting the cycle of viruses that infect cells and then take over those cells to multiply in the body, said Dr. vasan. Monoclonal antibodies work by sweeping up the proteins viruses produce, which in turn helps strengthen a person’s immune system.

For Covid-19, two oral antiviral pills are available in New York City: Paxlovid and molnupiravir.

Paxlovid is prescribed as three pills taken twice a day for five days, while molnupiravir — approved 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 at select pharmacies in the city. You can find a list of those nearby on a federal website.

Most New Yorkers seeking antiviral treatments should expect Paxlovid, given its efficacy, said Dr. vasan.

There are also two antibody treatments that appeared to be effective against BA.2 in lab studies: Bebtelovimab, approved for use in February and taken intravenously, and Evusheld, approved for use in December, for people who are allergic to vaccines or are immunosuppressed.

For most treatments, city officials are prioritizing people who have not only tested positive for the coronavirus but 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 to be at high risk of developing serious illness from Covid-19 if you are 65 years of age or older, or if you have health risks such as diabetes, hypertension or heart disease. Immunosuppressed people are also considered high risk.

The federal government has urged providers to prioritize treatments for people who have not been vaccinated or have not yet been fully vaccinated.

You must be over 12 and weigh more than 40 kilograms, or about 88 pounds, to receive Paxlovid, bebtelovimab, and Evusheld. But you must be at least 18 years old to take molnupiravir.

People with severe kidney or liver disease may not be suitable for Paxlovid and molnupiravir should not be used during pregnancy. Pregnant or breastfeeding women should talk to their health care providers before taking Paxlovid, according to the FDA’s treatment fact sheet.

It’s important for patients to talk to their providers about the drugs they’re taking because they can negatively impact the treatments, said Dr. Andrew Wallach, the chief physician of outpatient care at New York City Health and Hospitals.

After testing positive, you should inform your doctor or call the city’s Covid hotline, 212-COVID19 (212-268-4319) and press 9 to be put through to one of the city’s doctors to determine whether you qualify. You can also visit Virtual Express Care to schedule a phone or video visit, or complete the city’s screening tool.

After a doctor has decided 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 enables same-day home delivery.

The Biden administration also recently unveiled a “test-to-treat” initiative, which will allow you to be tested for the coronavirus at select pharmacies and, if you test positive, receive free antiviral pills on the spot. Locations can be found on the federal website.

They are currently free to all New Yorkers, said Dr. vasan.

Oral treatments have been proven to reduce hospitalization and death from Covid-19 when taken shortly after the onset of symptoms.

Paxlovid reduced the risk of hospitalization and death in high-risk unvaccinated people by 88 percent when taken within five days of the onset of symptoms in a Pfizer study published in December, before the Omicron wave.

According to a Merck analysis published in November, 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.

Bebtelovimab, which must be given within seven days of the onset of symptoms, has not been tested in a study showing whether it can prevent serious illness, 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, has been shown to be highly effective in preventing Covid in a clinical trial.

Paxlovid is “well tolerated,” said Dr. Wallach. Side effects observed in small numbers in clinical trials include diarrhea, hypertension, and pain.

Because bebtelovimab is given intravenously, some people may develop a rash at the injection site.

It’s hard to say. The health department was unable to provide data, in part because it had “no visibility into the entire universe of pharmacies” that distribute many of the treatments, said Patrick Gallahue, a spokesman.

There is an immunization registry that keeps track of vaccinations, but there is no registry for prescription drugs, said Dr. nash.

“It’s a problem that they don’t have their finger on the pulse of this because it’s the most important thing that will help us contain these spikes, hospitalizations and deaths,” he said. “That plus vaccines and boosters.”

dr. Nash was concerned that the disparities seen at each stage of the pandemic, including in the rollout of tests and vaccines, would recur with these treatments.

“If you don’t expect the underlying inequalities in access to health care to grow, if you don’t plan for it, you’ve done a bad job of taking care of the most vulnerable people. in the city,” said Dr. nash.

The treatments are now available through Alto Pharmacy and health centers. The health department is working to expand access to brick-and-mortar pharmacies across the city. 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 drug, earlier this month. dr. David Kandov, the pharmacist, said only about five people had requested the treatments so far.

dr. Kandov expressed frustration at how long it took to receive the first batch, saying the network he belongs to had tried unsuccessfully to access the drugs since December when they were first authorized.

He blamed the health service. “They’ve effectively locked us out of it and closed off access in the communities,” said Dr. kandov. “Because ultimately, so many things are available virtually, mail order and things like that, that’s not nearly the same as patients having it out there in their community.”

“The city is offering a delivery model that guarantees quick access to any address in New York that began at a time when supplies were insufficient to supply brick-and-mortar pharmacies across the city,” said Mr. Gallahue. “As supplies have improved, more pharmacies have come on board.”

This post How to Get Covid Treatments in New York City

was original published at “https://www.nytimes.com/2022/04/28/nyregion/covid-treatments-nyc.html”