Onondaga County’s top doc: Most seniors with Covid should take Paxlovid, but majority aren’t

Syracuse, NY — A Covid treatment drug that has proven highly effective at keeping sick patients out of the hospital should be used more as virus cases spike across the region, Onondaga County’s health commissioner said.

Paxlovid is a safe and effective prescription drug for nearly any Covid-positive adult, said Dr. Katie Anderson, a trained epidemiologist. That’s especially true for seniors, who are the most likely to suffer hospitalization and death from Covid.

But, nationally, two-thirds of older people eligible for Paxlovid are not getting it, despite the drug being widely available at pharmacies, Anderson said.

The reason for the hesitancy in taking Paxlovid isn’t precisely known, she said. Sometimes, Covid-positive patients appear to reject taking the pill treatment. In other cases, she said, primary care providers seem reluctant to prescribe it to patients who are suffering non-life-threatening Covid symptoms at home.

One big stumbling block could also be price: Paxlovid’s maker, Pfizer, is selling the treatment for $1,390 after its government contract expired last year. That means that people with private insurance might have to pay large amounts out-of-pocket for it, depending on plan. (Older people on Medicare or those on Medicaid can still get the treatment for free, as can the uninsured. Also, some pharmacies still have free Paxlovid left over from the government contract; check your pharmacist for details.)

Health-related concerns about Paxlovid stem from reports that it may negatively interact with other medications, or that the drug may cause a Covid “rebound” for those suffering from the disease. Those concerns are causing too many people to be cautious, Anderson said.

“The vast majority would benefit” from Paxlovid if Covid-positive, Anderson said. (Paxlovid does not prevent someone from getting Covid in the first place.)

The health commissioner made her comments as local hospitals are seeing the biggest spike in Covid-positive patients in more than a year.

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“What we’re struggling against is a significant amount of apathy or antipathy when thinking about Covid and protecting yourself,” Anderson said. “The challenge is, how do we break through the thought that we have moved on from Covid, when we can’t.”

The latest surge comes as the number of people getting Covid vaccinations has gone down each year they have been available, with a 20 to 25% vaccination rate last year and only 18% this year, she said. The initial vaccine was administered to more than 50% of the nation’s population.

So far, Central New York has avoided the calamity of a year ago, when the combination of Covid, RSV and flu brought the children’s hospital to its knees, Anderson said. This year, RSV struck first, with Covid and flu coming later — though Covid and flu cases are still rising.

But there’s a good chance in future years that all three diseases could strike again at the same time, Anderson said. Coupled with a hospital labor shortage and overburdened emergency rooms, there may not be enough capacity to handle future surges, she said.

That’s why vaccines, Paxlovid and targeted masking are important tools, Anderson said.

As for masking, the county and state are still following federal guidance for Covid-positive people: five days of isolation, followed by five days of masking, Anderson said. (Ten days of isolation is advised for people with high risk of complications.)

The latest vaccine has proven to be effective at preventing serious illness for all known Covid variants, she added. However, the latest strain is proving more contagious, if not more serious, than previous ones.

“We have a lot of tools at our disposal,” Anderson concluded. “The main concern is that people are not taking advantage of the tools.”

Staff writer Douglass Dowty can be reached at [email protected] or (315) 470-6070.