Most Alaskans with COVID are eligible for medications that can dramatically decrease risk of hospitalization

Medications that can dramatically decrease hospitalization risk from COVID-19 are widely available to a majority of Alaskans who are getting infected or reinfected with the virus, health officials say.

Because most people are relying on at-home tests, which aren’t reported to the state health department, true estimates for how much virus is currently circulating in each community is difficult to come by.

But the proliferation of highly contagious omicron variants BA.4 and BA.5 means many Alaskans who’ve previously had the virus are more likely to become reinfected. Dr. Lisa Rabinowitz, a physician with the Alaska Department of Health, said that in recent months, the state has seen a rise in COVID-19 hospitalizations among Alaskans 70 and older that could likely be prevented by early medical intervention after a positive test.

Many Alaskans may not know that they’re eligible for those treatments — or how and where to access the drugs, which have been generally underutilized since they became available, Rabinowitz said.

In a recent social media post, the state health department encouraged Alaskans to make a plan for what to do if they are one of many to get COVID-19 at this point in the pandemic — which includes knowing whether they may be eligible for prescription medications that can dramatically reduce the risk of hospitalization and death.

Here’s what to know about currently available treatments and therapeutics for the virus.

What treatments are currently available for those who test positive for COVID-19? What are the differences between these treatments?

The state health department has put together a webpage, covidrx.alaska.gov, which lays out all the treatments currently available at clinics, doctors’ offices and pharmacies around the state. These include:

• Paxlovid, an oral antiviral for patients who are at least 12 years old and weigh at least 88 pounds. The treatment works by halting viral replication and has been linked to an 88% reduction in hospitalization and deaths. It needs to be taken within five days of symptom onset, and is meant to treat mild to moderate cases of the virus.

In rare cases, some patients have experienced a COVID rebound after completing their Paxlovid treatment. Rabinowitz noted that in those rare cases, symptoms are usually pretty mild or milder than initial symptoms, and said health officials are encouraging people to not let that deter them from seeking treatment.

• Molnupiravir, another oral antiviral drug, this one for patients 18 or older. It works similarly to Paxlovid and also needs to be started within five days of symptom onset. Paxlovid is prescribed more often than molnupiravir because it has higher efficacy, but molnupiravir is a great option for individuals who are unable to take Paxlovid due to underlying medical issues or medications, Rabinowitz said.

• Remdesivir, an antiviral drug for patients of all ages who weigh at least 7.7 pounds, is administered by IV infusion. It is available commercially, not through the federal government, which means there may be a cost associated with accessing it. It also requires an individual to come back three days in a row for an infusion. It is the only therapeutic option for individuals under 12 years old.

• Bebtelovimab, a monoclonal antibody treatment for patients who are at least 12 years old and weigh at least 88 pounds. It is the only monoclonal antibody that remains effective against omicron. In an opinion piece published earlier this month, Dr. Anne Zink, Alaska’s chief medical officer, noted that supplies of bebtelovimab are becoming depleted in Alaska, and that the state does not anticipate the supply will last us much past August. This is part of a broader switch away from monoclonal antibodies, which Zink said are typically more expensive, harder to distribute, less effective and less convenient than the oral antivirals Paxlovid and molnupiravir.

Who is eligible for these medications?

While each medication has its own eligibility requirements, typically Alaskans who are 50 and older or who have a preexisting health condition that puts them at higher risk for severe illness per this list from the CDC are eligible for the above medications.

The vast majority — around 75% — of Alaskans fit the broad qualifications for these medications, and Rabinowitz said she’d recommend that Alaskans check with a primary care physician if they don’t see their condition but think they may qualify.

The list of medical conditions includes but is not limited to: cancer, chronic kidney disease, chronic liver disease, chronic lung diseases, cystic fibrosis, dementia, diabetes (type 1 or type 2), disabilities, heart conditions, HIV, immunocompromised or weakened immune system, mental health conditions, overweight and obesity, physical inactivity, pregnancy, sickle cell disease, current or former smoker, solid organ or blood stem cell transplant, stroke or cerebrovascular disease, substance use disorders and tuberculosis.

The treatments work for both the vaccinated and unvaccinated, require a prescription, and work best if taken within five days of symptom onset or a positive COVID test.

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How sick do you need to be to consider these treatments?

Most of the above prescriptions are for treating mild to moderate cases of COVID-19 — meaning, any symptoms at all. Rabinowitz said it’s important for people to seek treatment quickly, instead of waiting until their symptoms become more serious.

“They do need to be started within five days of symptom onset,” she said. “It’s a really short timeframe to once you get symptoms, get tested and get your prescription from your provider. So that’s why we’re encouraging people to have a plan ahead of time, just because we are seeing increased transmission of COVID right now.”

Having a plan can mean knowing whether you qualify for these medications before you test positive.

Are they free, and where you can you access them?

Most of these medications are free because they are purchased by the federal government, though some providers issuing prescriptions may charge an appointment or administrative fee, Rabinowitz said.

The best option for getting a prescription is via a primary doctor, “because they really know your medical history and can do the best assessment on which one is the best for you,” Rabinowitz said.

Due to recent regulatory changes, Alaskans can also reach out directly to pharmacists for an assessment and prescription. There are also community health centers, public health centers and telehealth options available.

Alaskans can visit covidrx.alaska.gov for more information about treatment options and access. Questions can be answered by calling the Alaska COVID Helpline at 907-646-3322. Hours are 9 a.m.-6:30 p.m. on weekdays.