Patient wonders why Paxlovid wasn’t prescribed for COVID

DEAR DR. ROACH >> In June 2022, I had a fever of 101 degrees Fahrenheit, severe sore throat and headache, and

I tested positive for COVID-19 on a home test. I was 67. I called my doctor’s office the next morning and was advised to take Tylenol as needed for pain as well as tea with honey. I did ask about medication, but no antiviral medication was prescribed. But it turned out that I was ill for about two weeks and then fully recovered.

I am really baffled about why I was not prescribed Paxlovid or any other medication, as my understanding is that age 67 would be considered in the highrisk category for COVID. My question is, why did my doctor make that decision? I am in good health and take no regular medications.

DEAR READER >> Of course, I can’t answer what went through your physician’s mind, but it is true that a person with symptomatic new onset COVID and risk factors for severe diseases should be recommended for treatment. And the best treatment is nirmatrelvir/ ritonavir (Paxlovid). The specific indications are any of these:

Some medicines need to be held, or the dose needs to be adjusted for Paxlovid (but that’s not the case for you).

Some physicians worry about the fact that some people will get symptoms when they stop Paxlovid, called the “rebound” effect; however, the benefit (almost 90% reduction in severe disease) outweighs the risk of recurrent symptoms, which can happen even without the use of Paxlovid.

Paxlovid should not be given to people with severe kidney or liver disease. People who already have a severe disease at the time they come in to receive medical attention belong in the hospital, where different treatments are given.

Paxlovid should be started as soon as possible, definitely within five days of the onset of symptoms. I strongly believe that Paxlovid should be recommended to everyone who meets the indication above. Physicians need to know the indications for its use and how to find the potential drug interactions, and they should advocate for the use of this potentially life-saving medicine.