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Dear Editor
On the 21st December 2021 a press release issued by the Department of Health and Social care carried the following headline"UK secures millions more antivirals to help fight omicron". The press release went on to declare "Since the beginning of the pandemic, the UK has proven itself to be a world leader in identifying and rolling out effective treatments for COVID-19, including the world's first treatment, dexamethasone, which has saved over a million loves worldwide" [1].
We must revitalise that enthusiastic mindset by reinstating our test and trace system, and by facilitating access to antiviral treatment. A patient who has tested positive with his or her home kit should have prompt and timely confirmation of COVID from a state run facility for performing the reverse transcriptase PCR test. Thereafter the patient should receive the benefit of timely referral to a doctor for the purpose of receiving a prescription for antivirals, within the 5 days therapeutic time window , provided the risk of adverse drug-to-drug interactions has been ruled out.
The efficacy of antiviral treatment in mitigating the risk of COVID-related hospitalisation is now beyond all doubt[2-5] There is also some evidence that antiviral agents mitigate the risk of subsequent development of long Covid[6].
In view of those observations it makes no sense to restrict the use of antiviral agents to the narrow subgroups defined by the Department of Health and Social Care[7[
References
[1]Department of Health and Social care
Press release: UK secures millions more antivirals to help fight Omicron https://www.gov.uk/government/news/uk-secures-millions-more-antivirals-t...
[2]Lui DT., Chung MSH., Lau EHY et al
Analysis of all-cause hospitalization and death among nonhospitalized patients with Type 2 diabetes and SARS-CoV-2 infection treated with molupiravir or nirmatrelvir-ritonavir during omicron wave in Hong Kong
JAMA Network Open 2023;6:e2314393
[3]LinD-Y., Fadel FA., Huang S al
Nirmatrelvir of molnupiravir use and severe outcomes from Omicron infections
JAMA Network Open 2023;6:e2335077
[4]Arbel R., Sagy YW., Hoshen M et al
Nirmatrelvir use and severe covid-19 outcomes during Omicron surge
NEJM 2022;387:790-798
[5]Najjar-Debbiny R., Gronich N., Weber G et al
Effectiveness of Paxlovid in reducing severe coronavirus disease 2019 and mortality in high risk patients
Clinical Infectious Diseases 2022 doi.org/10.1093/cid/ciac443
[6]Fung KW., Baye F., Baik SY., McDonald CJ
Nirmatrelvir and molnupiravir and post-covid-19 condition in older patients
JAMA Internal Medicine 2023;183:1404-1406
[7]Department of Health and Social Care
Highest risk patients eligible for new COVID-19 treatments: a guide for patients
GOV.UK Published 13 June 2022
Re: The vacuum of information about covid’s prevalence puts me at risk—bring back better data collection, and make paxlovid more readily available.
Dear Editor
On the 21st December 2021 a press release issued by the Department of Health and Social care carried the following headline"UK secures millions more antivirals to help fight omicron". The press release went on to declare "Since the beginning of the pandemic, the UK has proven itself to be a world leader in identifying and rolling out effective treatments for COVID-19, including the world's first treatment, dexamethasone, which has saved over a million loves worldwide" [1].
We must revitalise that enthusiastic mindset by reinstating our test and trace system, and by facilitating access to antiviral treatment. A patient who has tested positive with his or her home kit should have prompt and timely confirmation of COVID from a state run facility for performing the reverse transcriptase PCR test. Thereafter the patient should receive the benefit of timely referral to a doctor for the purpose of receiving a prescription for antivirals, within the 5 days therapeutic time window , provided the risk of adverse drug-to-drug interactions has been ruled out.
The efficacy of antiviral treatment in mitigating the risk of COVID-related hospitalisation is now beyond all doubt[2-5] There is also some evidence that antiviral agents mitigate the risk of subsequent development of long Covid[6].
In view of those observations it makes no sense to restrict the use of antiviral agents to the narrow subgroups defined by the Department of Health and Social Care[7[
References
[1]Department of Health and Social care
Press release: UK secures millions more antivirals to help fight Omicron
https://www.gov.uk/government/news/uk-secures-millions-more-antivirals-t...
[2]Lui DT., Chung MSH., Lau EHY et al
Analysis of all-cause hospitalization and death among nonhospitalized patients with Type 2 diabetes and SARS-CoV-2 infection treated with molupiravir or nirmatrelvir-ritonavir during omicron wave in Hong Kong
JAMA Network Open 2023;6:e2314393
[3]LinD-Y., Fadel FA., Huang S al
Nirmatrelvir of molnupiravir use and severe outcomes from Omicron infections
JAMA Network Open 2023;6:e2335077
[4]Arbel R., Sagy YW., Hoshen M et al
Nirmatrelvir use and severe covid-19 outcomes during Omicron surge
NEJM 2022;387:790-798
[5]Najjar-Debbiny R., Gronich N., Weber G et al
Effectiveness of Paxlovid in reducing severe coronavirus disease 2019 and mortality in high risk patients
Clinical Infectious Diseases 2022 doi.org/10.1093/cid/ciac443
[6]Fung KW., Baye F., Baik SY., McDonald CJ
Nirmatrelvir and molnupiravir and post-covid-19 condition in older patients
JAMA Internal Medicine 2023;183:1404-1406
[7]Department of Health and Social Care
Highest risk patients eligible for new COVID-19 treatments: a guide for patients
GOV.UK Published 13 June 2022
Competing interests: No competing interests