Members-Only Article
I’ve mentioned a few times recently both Merck and Pfizer have new COVID-targeted anti-viral medications which dramatically reduce the chances of severe disease and death if taken early in the course of illness. Merck’s pill (molnupiravir) reduced the risk of hospitalization by 50% if taken within 5 days of symptom onset; Pfizer’s pill (paxlovid) reduced the risk of hospitalization by 85% if taken with 5 days onset and 89% if taken within three days.
Both treatments showed 100% efficacy against death.
Obviously that doesn’t mean that patients can’t ever die from COVID if they take these medications. But the Merck study had eight deaths in its placebo group and Pfizer had 10. None of the test subjects who took the actual medications, regardless of when they took it, died.
That’s a big, big deal.
One very significant point is that these trials were with unvaccinated people with comorbidities that put them at heightened risk for complications. Presumably these treatments would push the chances of hospitalization and death even lower for the vaccinated and those in better health. But the trials didn’t include vaccinated patients. So we don’t actually know the answer to that. There’s also a separate question about whether it makes sense to take these treatments if people only have mild infections. (Pfizer is currently running a trial with vaccinated patients.)
Pfizer announced this morning that it is selling 10 million courses of its treatment to the US government for $5.3 billion. (The Pfizer treatment is actually two separate drugs taken in combination.) It’s not clear to me whether the US plans to provide this treatment free of charge, as it has with COVID vaccines. If that’s the case it seems like we’ll need quite a few more than 10 million treatments courses. And if we’re going to be buying at that volume, we should be pressing for a pretty big volume discount. (Here’s a helpful article from Statnews which goes into the details about these two drugs.)
For the moment let’s set aside the cost issues. These antivirals are a game changer in the history of the pandemic. These aren’t a thing where you take one pill at the doctor’s office and you’re good to go. They are multi-pill regimens over several days. Both treatments are two doses a day for five days. But these are treatments are easily self-administered.
If you and your family are vaccinated you’ve likely shifted from seeing COVID as a potential life and death issue to a major annoyance. No one wants to get it. And there’s still the threat of long covid. But if you’re fairly healthy and not very old you’re not going to die from it. Yet roughly a thousand Americans are currently dying from COVID every day. And that number is certain to rise at least somewhat as we head into the winter. When these drugs are widely available, which should be very soon, those numbers should fall dramatically, even with the same prevalence of the disease in the population. They should also drastically reduce the number of people in hospitals and ICU wards, clearing beds for people suffering from other ailments and reducing the load on overtaxed health care personnel.
They are a genuine game changer, not only in the scales of human suffering but also in the country’s ability to emerge into a post-COVID future.
