Personal care treatments

Covid treatments are not known to populations at risk

Health Sciences

Years of sometimes confusing Covid messages have left half of those eligible for antiviral treatment unaware

A potentially life-saving antiviral treatment that can reduce the severity of Covid in an infected person has gone unnoticed by many people it would help the most.

It’s a sign of a new phase of the pandemic, where the statistically milder Omicron variant has been linked to more deaths in New Zealand than the original variant ever was.

Despite the free availability of the Pharmac-approved antiviral treatment PAXLOVID, which can slow or stop the virus, more than half of those at risk such as the immunocompromised and the elderly were unaware of its availability.

And because treatment must start within the first five days of infection, it does not adequately reach vulnerable groups who are also sometimes more likely to have low health literacy or problems accessing health care. health.

Research by PAXLOVID manufacturers Pfizer and Talbot Mills found that 54% of people identified as Maori and Pasifika and over the age of 50 had low treatment knowledge.

Pfizer New Zealand medical director Dr Krishan Thiru said most troubling was that while there is a general lack of treatment awareness among New Zealanders, those most at risk are not were more aware.

“Most New Zealanders are unaware, but particularly those at risk also have a low level of knowledge,” he said. “You might expect them to know more because they see more doctors, but their level of awareness is about the same as the general public.”

Thiru said unawareness of these treatments prevented quick action by those recently infected.

“It is extremely important that everyone is aware that these treatments exist because time is running out,” he said. “If these antiviral treatments are to be used – and effectively – they must be started within five days of Covid.”

But with the Omicron variant, at least in its original form, there has been widespread reportage a milder onset of symptoms, often resembling the common cold.

Thiru argues that if people are unaware of antiviral treatment – ​​a potentially life-saving weapon in their arsenal – they will be less likely to visit a doctor with free time.

“For people at risk – and we believe there are around a million – for those people, if they know about antiviral treatment and contact their doctor early enough, that provides a strong second-line defence.”

Dr Krishan Thuri said it was extremely important for people to know that these treatments exist as they must be given within five days of infection. Photo: Supplied

Daniel Hirst, Te Whatu Ora Health NZ group leader for care in the community, said at least 42,708 Covid antiviral drug courses have been delivered since April 4 this year, including 28,091 PAXLOVID and 14,617 molnupiravir .

“Since April 2022, Te Whatu Ora has been working with Pharmac to make it easier for more people to access these medicines when needed,” he said. “Pharmac has extended the access criteria three times since the drugs became available in April – on May 5, July 18 and September 14.”

He noted that the distribution of antiviral drugs increased by 44.3% during the week of October 10-16 compared to the previous week.

however, Pfizer’s findings don’t tell us enough about how the study was conducted to ensure researchers are reaching those most in need of antivirals.

“However, Te Whatu Ora and Manatū Hauora were delighted to see that the Pfizer material indicates that 80% – or more – of survey respondents were aware that Covid-19 antiviral treatments are currently available in New Zealand free of charge for some people,” he said. said. “The fact that it’s not 100% yet helps to show why we need to continue the campaign work mentioned here.”

This campaign work involves Te Whatu Ora and Manatū Hauora working to raise awareness among at-risk groups that these drugs are available to eligible individuals and can improve health outcomes and the Prime Minister and Cabinet Department and Te Puni Kōkiri launch campaigns public information on antiviral medication this week.

The PAXLOVID trials found that the five-day treatment, the pill in the morning and the pill in the evening, reduced the risk of hospitalization or death from Covid by up to 86% compared to placebo in non-hospitalized, adult patients at high-risk and unvaccinated treated within five days of onset of symptoms.

The two treatment pills work together to block a key enzyme the virus needs to grow further.

“Once the virus enters your body, it relies on a certain enzyme to replicate,” Thiru said. “For most people, their immune system is likely to be able to beat the virus, but for some people it may not be able to, and it’s basically like an antibiotic.”

The New Zealand government announced it had secured another 40,000 PAXLOVID treatments in September last year, bringing the total to 100,000 by the time Medsafe gave interim consent for the supply and use of the drug in March.

At the time, Health Minister Andrew Little said the pill was an important measure to ease the pressures the pandemic has placed on the healthcare system.

“The first shipment of Paxlovid has arrived in New Zealand ahead of schedule and will start being offered to those most at risk from next week, protecting people from becoming seriously ill and the healthcare system from being overwhelmed. “, did he declare.

But although the drug is now freely available to almost a million New Zealanders, including unvaccinated people over 50, Maori and Pasifika over 50 or anyone over 65 , if people don’t know, they may not present themselves to a healthcare professional in time. .

Thiru said that while Pfizer has worked with the New Zealand government to support its educational efforts, it believes there is a greater sense of personal responsibility at play in this phase of the pandemic.

“My personal opinion is that during the pandemic we are moving into this phase of what I assume is personal responsibility where members of the public and community are asked to take control of their own health and know the treatments available. ”

Thiru said people who think they might be eligible should speak to their pharmacist or healthcare professional and act quickly at the first signs of symptoms.

“The view is that Omicron is a mild infection or will be asymptomatic,” he said. “For the vast majority, that’s true – but it’s not true for those at risk.”

Te Whatu Ora Health NZ stressed that people should speak to medical professionals before trying to obtain antivirals.

“Covid-19 antiviral drugs can have side effects and cannot be taken with other drugs and treatments,” Hirst said. “Even if someone is eligible, the medications may not be right for them. People who think they are eligible should speak to their doctor, nurse practitioner or pharmacy to see if Covid-19 antiviral medications might be right for them. “