Editorial: Third wave of Covid raises questions over antiviral drugs

Pfizer's Covid-19 antiviral treatment Paxlovid. Photo / Getty Images

EDITORIAL

Faced with the very real prospect of a Covid-19 wave peaking at Christmas in New Zealand, questions around antiviral drug treatments are inevitably also 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 New Zealand’s Omicron outbreak at the beginning of the year.

Auckland University computer science senior lecturer Dr David Welch says the rise in cases is being driven by a number of 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 These variants had superseded older strains as people developed immunity from past infections or vaccinations.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 New Zealand 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 Auckland community and developmental paediatrician 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 accessing them.

And that’s true to a point. 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. But that’s not all.

One of the following must also apply: Being aged 65-plus; being Māori or Pacific ethnicity aged 50-plus; being aged 50-plus and having had fewer than two Covid-19 vaccinations; having a severely weakened immune system; having Down syndrome; having sickle cell disease; having previously been in critical care or high-dependency hospital care from Covid-19; or having three or more high-risk medical conditions. The high-risk conditions 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 New Zealanders chart whether they might be eligible. Once a person believes they are eligible, they still need a prescriber to confirm this.

Naturally, the best course of action remains precautionary, such as masking in confined spaces with numbers of people present and being up to date with vaccine boosters.

Those who have, or suspect they have, Covid-19 and are at high risk of developing 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 that treatments must be started within short timeframes from the onset of symptoms and should not be put off.

This wave is still rising. Being informed now may save crucial time should infection occur.