DOCTOR IS IN by Dr. Adil Manzoor OP/ED
I spent the better part of last year campaigning for the coronavirus vaccines. This is because the vaccines are our only viable way of eventually beating the coronavirus if there’s something like that. Yes, it’s looking increasingly likely the coronavirus is here to stay. So, as it stands, we will have to “renew” our immunization status periodically, but that’s a story for another day.
Over the last few months, we have seen new variants of the coronavirus emerge. There have been quite a few, but Delta and Omicron are the clear standouts. Not only are they more transmissible or dangerous than the parent strain, but they also figured out how to evade the protective efforts vaccines offer.
As you would expect, it raised many eyebrows, particularly among people reluctant to take the vaccine in the first place. The whole scenario was screaming the question, “if the vaccines don’t prevent people from getting the virus, then why take it at all?” I can’t even be upset with that line of reasoning because they kinda have a point.
However, studies have shown that the chances of having severe illnesses are ridiculously low with the vaccine. The chances of death are virtually zero. So there’s that. Also, studies have shown that transmissibility is not as high with the vaccine.
But there’s still the problem that vaccinated people can still get the virus. And the longer the virus persists among us, the higher the chances of it mutating further, and, trust me, we don’t want that at all. This is why the antivirals have been greatly hyped. Some have even gone as far as calling it our “cavalry.”
Late last year, the FDA granted the antiviral pills emergency use in high-risk people, mostly people over the age of 65, with existing health issues, obese people – you know the drill.
That’s brilliant news, as it means people can treat coronavirus cases without leaving their homes at all. You may not see much value in it here in the United States, but imagine how helpful it will be in curbing the spread of the virus in countries with lesser developed health systems.
There are two leading pills – Molnupiravir and Paxlovid. Both pills work differently, but they share the same aim. I remember raving about them late last year. There is no real fear of the pills being ineffective against current or even newer variants if recent studies are anything to go by. Molnupiravir, in particular, has been dubbed to be resistant to resistance, if that makes sense to you.
Right now, the pills only have an emergency authorization, but we expect that will change soon when it has satisfied the requirements set by the FDA.
Because of the limited amount available, the antivirals will only be available to high-risk people and people with mild to moderate illnesses. The antivirals will not be available for people with severe illness, which I must reiterate is unlikely anyway. People with severe illnesses will need antiviral therapy, which is more complex than the pills and is typically administered intravenously.
Also, both drugs have several contraindications, meaning they cannot just be given to anyone. For example, Molnupiravir cannot be given to children below 12 or pregnant women. In addition, Paxlovid cannot also be used for people with liver or kidney issues.
Then there’s also the issue of compliance. People have to take at least three pills twice a day for five days. That’s 30 pills in five days – at least. There’s a strong possibility people just stop taking the pills when they feel better after three days. We absolutely cannot afford that here. The risk of the virus becoming resistant is one we simply cannot afford to take. I feel like I’ve said that once already, and I’m saying it again because of just how essential it is.
All of this antivirals talk don’t excuse you or anyone from taking the vaccine. We still need to take the vaccine and its booster doses to prevent the virus from even infecting the body in the first place. Stay safe, folks.
This article was written by Dr. Adil Manzoor DO, a Board Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice Mobile Medicine NJ.
References
· https://www.webmd.com/lung/news/20211229/the-new-covid-antiviral-pills-what-you-need-to-know
· https://www.express.co.uk/news/uk/1539970/omicron-news-covid19-NHS-antivirals-sajid-javid/amp
· https://www.gov.uk/government/news/oral-covid-19-antiviral-paxlovid-approved-by-uk-regulator
· https://www.npr.org/sections/health-shots/2021/12/31/1069323181/covid-antivirals-paxlovid-molnupiravir?t=1641919328668
