Paxlovid cuts death risk, but those who need it are not taking it

As COVID- 19 rises again, killing about 1,500 Americans each week, medical researchers are trying to understand why so few people are taking Paxlovid, amedicine that is stunningly effective in preventing severe illness and death from the disease.

A study of 1 million high-risk people with COVID-19 found that only about 15% who were eligible for the drug took it. If half of the eligible patients had gotten Paxlovid, 48,000 deaths could have been prevented, authors of the study, conducted by the National Institutes of Health, concluded.

It’s not because people don’t know about the drug — most do— but the reluctance seems to come from doctors worried about interactions with other drugs and people wary of a possible rebound case or the metallic aftertaste.

Regional differences offer a clue, with uptake highest in the Democratic strongholds of the Northeast and Pacific Northwest of the United States and lowest in deep-red areas including Florida and Indiana.

Yet no careful study has clarified why so few people used the medication, which cut the risk of death by 73% for high-risk patients in the NIH study.

“I don’t know why there is such variability and why uptake isn’t higher across the board,” said Dr. Josh Fessel, a senior clinical adviser on the NIH team that studied the drug’s use. “If you can take Paxlovid and you do take Paxlovid within the recommended time frame, the likelihood of death or hospitalization are significantly reduced. That’s a big deal.”

COVID-19 deaths have been elevated since September at 1,200 to 1,300 deaths per week, inching up to about 1,500 per week in December.

Researchers say they most likely will continue to rise unless more people get the updated COVID-19 vaccines and antiviral treatments.

Paxlovid, made by Pfizer, is a two-medication treatment meant to be taken within five days of the onset of COVID-19 symptoms to quash viral spread within the body. It was approved for adults who are at high risk for severe COVID-19, which tends to include those age 65 and older and people with diabetes, obesity, asthma and other conditions.