Most Alaskans are eligible for COVID-19 treatments once infected. Here’s what you need to know.

Medications that can significantly reduce the risk of hospitalization from COVID-19 are widely available for the majority of Alaskans who are infected or reinfected with the virus, health officials say.

Since most people rely on home testing, which is not reported to the state health department, it is difficult to get true estimates of how much virus is currently circulating in each community.

But the proliferation of the highly contagious omicron BA.4 and BA.5 variants means that many Alaskans who have had the virus before are more likely to be reinfected. Dr. Lisa Rabinowitz, a physician with the Alaska Department of Health, said that in recent months the state has seen an increase in COVID-19 hospitalizations among Alaskans 70 and older who could likely be prevented by early medical intervention after a positive test.

Many Alaskans may not know they are eligible for these treatments — or how and where to access the drugs, which have been generally underutilized since becoming available, Rabinowitz said.

In a recent social media posting, the state health department has encouraged Alaskans to come up with a plan for what to do if they are one of many to contract COVID-19 at this point in the pandemic — which includes find out if they may be eligible for prescription drugs that can significantly reduce the risk of hospitalization and death.

Here’s what you need to know about the treatments and therapies currently available for the virus.

What treatments are currently available for those who test positive for COVID-19? What are the differences between these treatments?

The state health department has created a webpage, covidrx.alaska.gov, which features all of the treatments currently available in clinics, doctors’ offices, and pharmacies across the state. These include:

Paxlovid, an oral antiviral for patients at least 12 years old and weighing at least 88 pounds. The treatment works by stopping viral replication and has been linked to an 88% reduction in hospitalizations and deaths. It must be taken within five days of the onset of symptoms and is intended to treat mild to moderate cases of the virus.

In rare cases, some patients have undergone COVID rebound after completing their Paxlovid treatment. Rabinowitz noted that in these rare cases, the symptoms are usually quite mild or milder than the initial symptoms, and said health officials are encouraging people not to be deterred from seeking treatment.

Molnupiravir, another oral antiviral medication, this one for patients 18 years or older. It works in the same way as Paxlovid and should also be started within five days of the onset of symptoms. Paxlovid is prescribed more often than molnupiravir because it has higher efficacy, but molnupiravir is a great option for people who can’t take Paxlovid due to medical issues or underlying medications, Rabinowitz said.

Remdesivir, an antiviral drug for patients of all ages weighing at least 7.7 pounds, is given by IV infusion. It is commercially available, not through the federal government, which means there may be a cost associated with accessing it. It also requires an individual to return three days in a row for an infusion. It is the only treatment option for people under the age of 12.

Bebtelovimab, a monoclonal antibody treatment for patients who are at least 12 years old and weigh at least 88 pounds. It is the only monoclonal antibody that remains effective against omicron. In an opinion piece published earlier this month, Dr. Anne Zink, Alaska’s Chief Medical Officer, noted that the supply of bebtelovimab is running out in Alaska and the state does not anticipate that the supply will last well past August. It’s part of a broader move away from monoclonal antibodies, which Zink says are generally more expensive, harder to distribute, less effective and less convenient than the oral antivirals Paxlovid and molnupiravir.

Who is eligible for these drugs?

Although each drug has its own eligibility criteria, generally Alaskans 50 and older or who have a pre-existing medical condition that puts them at higher risk for serious illness per this CDC list are eligible for the above drugs.

The vast majority — about 75% — of Alaskans fit the general qualifications for these drugs, and Rabinowitz said she would recommend Alaskans see a primary care physician if they don’t see their condition but think they may be eligible.

The list of medical conditions includes, but is not limited to: cancer, chronic kidney disease, chronic liver disease, chronic lung disease, cystic fibrosis, dementia, diabetes (type 1 or type 2), disabilities, heart problems, HIV, immunocompromised or weakened people. immune system, mental health problems, overweight and obesity, physical inactivity, pregnancy, sickle cell disease, current or former smoking, solid organ or blood stem cell transplant, stroke or cerebrovascular disease, substance use disorders and tuberculosis.

The treatments work for both vaccinated and unvaccinated, require a prescription, and work best if taken within five days of the onset of symptoms or a positive COVID test.

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How sick do you have to be to consider these treatments?

Most of the prescriptions above are for the treatment of mild to moderate cases of COVID-19, i.e. all symptoms. Rabinowitz said it was important for people to seek treatment quickly, rather than waiting for their symptoms to worsen.

“They should be started within five days of the onset of symptoms,” she said. “It’s a very short time frame for once you have symptoms, get tested and get your prescription from your provider. This is why we encourage people to have a plan ahead, simply because we are seeing an increase in COVID transmission right now.

Having a plan can mean knowing if you qualify for these drugs before you test positive.

Are they free and where can you access them?

Most of these drugs are free because they’re purchased by the federal government, though some prescription-issuing providers may charge an appointment or administrative fee, Rabinowitz said.

The best option for getting a prescription is through a primary care physician, “because they really know your medical history and can do the best evaluation to figure out which one is right for you,” Rabinowitz said.

Due to recent regulatory changes, Alaskans can also contact pharmacists directly for an assessment and prescription. There are also community health centers, public health centers, and telehealth options.

Alaskans can visit covidrx.alaska.gov for more information on treatment options and access. Questions can be answered by calling the Alaska COVID Helpline at 907-646-3322. Hours are 9 a.m. to 6:30 p.m. weekdays.

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About Terry Gongora

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