Questions over antiviral Covid drugs

Faced with the prospect of a Covid-19 wave peaking at Christmas, questions around antiviral drug treatments are rising. The Ministry of Health on Tuesday reported 7487 cases of Covid-19, almost double the previous day’s infections, which experts believe could reach 10,000 by Christmas. It is the largest percentage increase between a Monday and Tuesday since the start of the Omicron outbreak earlier this year.

Auckland University computer science senior lecturer Dr David Welch says the rise in cases is driven by new variants that have a transmission advantage due to mutations on the virus’ spike protein. These variants had superseded older strains as people developed immunity from past infections or vaccinations. Fortunately, data shows the active ingredients in antiviral treatments available in NZ are effective against these variants.

Covid-19 antivirals have the potential to greatly reduce the number who get severely sick or die from the virus, but Dr Jin Russell says they are “ridiculously difficult” to access.

Anti-viral medications Paxlovid, Lagevrio and Veklury, which must be taken within the first five days of getting Covid-19 symptoms, were made free to about one million Kiwis in October but Russell said there appeared to be multiple barriers to access.

To be eligible for free Covid-19 antivirals, Pharmac requires that a person must either have symptoms and have tested positive, or have symptoms and be a household contact of a person with Covid.

One of the following must also apply: Being aged 65-plus; Ma¯ori or Pacific aged 50-plus; aged 50-plus and having had fewer than two Covid-19 vaccinations; having a severely weakened immune system; Down Syndrome; sickle cell disease; having been in critical care or high-dependency hospital care from Covid-19; or having three or more high-risk medical conditions. These are listed on the Ministry of Health website.

The narrow bands of eligibility were expanded on September 14 and Pharmac has published “maps” to help Kiwis chart if they might be eligible. A prescriber still needs to confirm eligibility.

Naturally, masking in confined spaces with people present and being up to date with vaccine boosters should be obvious.

Those who have, or suspect they have, Covid-19 and are at high risk of severe illness from it, should test early and get in touch with their healthcare provider. These providers are best placed to decide on the treatment options. Remember, treatments must be started within short timeframes.