Anyone with even one risk factor for severe COVID-19 should ask their doctor about treatment the moment they test positive, even if the result is through an at-home test.
That’s the message from Berkshire Health Systems, as treatment availability has expanded in recent weeks.
The hospital system says vaccines are the best way to avoid severe illness and death from COVID. But, the hospital also has two key tools for people early in the course of infection — and those are becoming more widely available as case counts decline.
The two drugs are sotrovimab, a monoclonal antibody, and Paxlovid, a new antiviral pill.
Both treatments have been shown to reduce hospitalization and death by 80 to 90 percent.
“We want to get the word out now because so many people are using home tests,” said James Lederer, chief medical officer at Berkshire Health Systems. “If you have a significant medical condition, and you test positive, you need to know that you may have a treatment option available.”
Anyone with at least one risk factor is eligible for treatment. That includes everyone older than 65, and anyone older than 12 with at least one of numerous conditions that put them at higher risk for severe disease. Those include: high body mass index (BMI), pregnancy, diabetes, chronic kidney disease, immunosuppressive disease, hypertension, cardiovascular disease, chronic lung diseases such as asthma, and other conditions. See a full list of conditions at cdc.gov/covid.
The new drug, Paxlovid, might not work for some patients, Lederer said. Paxlovid has more interactions with other drugs than monoclonal antibody therapy does, and it must be used during the first five days after symptoms begin.
Sotrovimab can be used up to 10 days after symptoms begin, though it is most effective when used early.
Both drugs are provided by the state, at no cost to patients.
The hospital also has a supply of molnupiravir, another oral antiviral, but it plans to prioritize Paxlovid, which has been shown to work better.
At present, the hospital expects that it has enough supply to treat everyone who meets the criteria with either Paxlovid or sotrovimab.
“[The antivirals] came out of the gate touted as being in very, very short supply,” Lederer said. “All of a sudden, the state has started wanting us to give more and more. We’ve ben able to get more supply. It’s in our Berkshire Medical Center pharmacy, in our North Adams pharmacy, and even in to-go packs in our emergency departments.”
The hospital also has started to administer the first prophylactic anti-COVID drug — a medication you can take before you get infected. The drug, Evusheld, is a monoclonal antibody treatment intended for patients at high risk, particularly those who are immunocompromised.
“It’s defined for very, very high-risk patients,” Lederer said. “Transplant patients, people receiving active chemotherapy ... people who don’t mount an antibody response to the vaccine for whatever reason.”
The drug provides the antibodies that someone who is immunocompromised might not produce after three or more shots of the vaccine. It also can help people who had a reaction to the first shot and never finished their vaccine series, Lederer said.
The hospital system has worked to identify patients who could benefit from them and distribute the two-shot treatment.