‘Game-changer’: Local doctors weigh in on new FDA approved COVID pills

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ROCHESTER, N.Y. (WROC) — A second pill to fight COVID-19 is here. 

One day after authorizing Pfizer’s Paxlovid pill, the Food and Drug Administration has cleared Merck’s pill, Molnupiravir. 

“Having the FDA approve these two pills is a big game changer for us in combating this global pandemic,” Dave Dobrzynski, an Assistant Professor of Medicine in the Division of Infectious Diseases with URMC said. 

The pills are expected to keep high-risk individuals from getting severely ill and hospitalized from the virus, or even from dying. Pfizer’s pill is shown to reduce the risk of hospitalization and death by 89%, while Merck’s pill reduces it by roughly 30%. 

“Vaccines still remain the number one prevention strategy, but I think as we’re seeing with Omicron, and potentially other variants in the future, that we’re still going to have some breakthrough infections,” Dobrzynski said. “Being able to treat people at home before they come in the hospital during these potential surges is really gonna be critical to kind of ease the burden off our healthcare system.”

The two pills are intended to be taken within days of COVID symptoms. 

“You need to take it within the first five days of symptom onset and so a lot of people may have some symptoms at home for a couple days. But if it gets to that point, maybe these medicines may not be as effective at that point,”Dobrzynski said. 

Dr. Ed Walsh, an Infectious disease Consultant at Rochester General Hospital, said in order for people to get a pill they have to test positive. 

“The use of an oral anti-viral drug for COVID is going to depend upon your ability to get tested right away and have a result right away. The at-home kits are terrific because you can do them very simply in your house, they only take 15 minutes, however, they also are not 100% sensitive, meaning they will miss a significant number of infections,” Walsh said. 

Walsh recommends people getting a PCR test if possible, or taking two at-home antigen rapid tests. 

“It’s going to be a combination of somebody who develops COVID-like symptoms, which frankly early on are very similar common colds, and then to be rapidly tested, and if positive then seek treatment with these antiviral drugs,” Walsh said. 

The two pills are also designed specifically for individuals who are likely to get severely ill from COVID-19. Pfizer’s pill is for those over the age of 12 and weighs 88 lbs. Merck’s is for those over the age of 18. 

“It’s unlikely that your 30-year-old, very healthy, athletic individual who’s been vaccinated is likely to to be able to get access to these medications early on,” Walsh said. But he added the pills could become more widely available overtime. 

While the pills are good news for fighting severe illness, patients will likely still feel mild symptoms. Doctors say the number one way to protect against COVID-19 is through vaccination. 

“A lot of people have wondered, well, will this replace a vaccine? And the answer is absolutely not. I mean, this is a medication for treating someone who’s infected. The vaccine obviously is developed for either prevention of infection completely, or if infection were to occur, for it to be mild,” Walsh said. 

“We hope obviously that as time passes, those that are not vaccinated will kind of continue to see the data, the vaccines really are really effective in preventing serious illness,” Dobrzynski said. “We hope that people rely on these on these pills necessarily, but I think the nice thing for providers is that if we’re going to have patients that are not going to want to get the vaccine, now we have an option to treat them at home before they get severely ill.”

Pfizer’s pill comes in three tablets, taken twice a day for five days. Merck’s pill consists of four capsules that are taken every 12 hours for five days. 

It will likely not be until next year until these pills starting rolling out. Dobrzynski said he hopes URMC will get supplies in in the next couple weeks, with most pills going to outpatient pharmacies. 

For a while, supplies are expected to be extremely limited. The U.S. has agreed to buy enough Paxlovid to treat 10 million people, along with 3.1 million courses of Merck’s pill.

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