Health Advisory: Tools and resources for increasing access, prescribing, and uptake of COVID-19 treatment
February 16, 2023
- Talk with symptomatic or COVID-positive patients about COVID-19 treatment options.
- Encourage early treatment for patients at high risk of severe illness.
- Strongly consider regardless of vaccination status:
- Adults ≥ 65 years old
- Pregnant women, especially those with comorbidities
- Age 50-65 years old with chronic health conditions, especially if not up to date on vaccination or not boosted
- Moderately-to-severely immunosuppressed: congenital or acquired immunodeficiency, SOT, BMT, active malignancy receiving chemo, or immunosuppressive therapy
- Consider in individuals with one or more chronic conditions:
- Chronic respiratory disease or cardiovascular disease or HTN
- Chronic kidney disease (eGFR ≥ 30 mL/min), diabetes mellitus, or obesity (BMI ≥35 kg/m2)
- Complex genetic or metabolic syndromes
- Severe congenital anomalies, neurodevelopmental disorders, or sickle cell disease
- Medical-related technological dependence (e.g. tracheostomy)
- Consider in individuals with limited access to care or members of communities disproportionately impacted by COVID-19
- Antivirals must be taken within five days of symptom onset or positive test if asymptomatic.
- Use of these antivirals should be prioritized as follows: ritonavir-boosted nirmatrelvir (Paxlovid™) followed by remdesivir (Velkury®); alternative therapy: Molnupiravir (Lagevrio™)
- Healthcare partners should consult the COVID-19 therapeutic distribution locator on current availability of outpatient COVID-19 treatments and Test to Treat locations.
- Emphasize for patients the importance of testing early if they are symptomatic for COVID, and of contacting a healthcare provider promptly if they are at increased risk of severe illness.
- This includes patients who are 50 years of age or older and/or have certain medical conditions such as chronic heart or lung disease, obesity, diabetes or a weakened immune response.
- Review other medications patients are taking and other health issues to help determine if antivirals or another intervention is a good fit for them.
- For information on contraindications, fact sheets, and guidance, see the Washington State Department of Health’s (DOH) page on therapeutics.
- For many patients the benefit of treatment will outweigh the risk of drug side effects, or any risks associated with short-term holding of chronic medications that might interact with COVID-19 therapies.
- Know how to access and direct people to DOH’s free telehealth resource for COVID-positive patients ages 18 and older, and promote the resource among socially vulnerable communities such as those in rural or underserved urban areas.
- There are two options for patients to set up a telehealth appointment:
Treatment for COVID-19 is under-utilized in higher risk patients with acute COVID-19 infection despite having been shown to reduce hospitalization and death in these high-risk populations when started within 5 days of symptom onset. COVID-19 continues to cause 2,000 to 3,000 deaths per week in the U.S. High risk patients include those who are moderately to severely immune compromised or pregnant regardless of age, those 65 years or older, and those 50 years or older who have chronic health conditions.
DOH relaunched its popular telehealth program on February 6. This expands on the federal government’s Test to Treat initiative. More than 6,000 patients were served under the State program’s previous run (July-December 2022), and 70% of patients who connected with the program received some type of treatment, according to DOH. This service is currently provided by DOH in collaboration with partner Color Health.