How effective COVID-19 treatments are making the pandemic more manageable

While doctors agree vaccinations remain the best weapon in the fight against COVID-19, they also say an array of therapeutics and treatments are helping prevent the serious complications from the disease seen in the early stages of the pandemic.

“There are many things at play,” said Dr. Tom Oryszczak, chief medical officer and executive vice president at Northwest Community Healthcare in Arlington Heights. “Vaccinations remain key, and we are also benefiting from the availability of various therapeutics. And then we're also doing better for our hospitalized patients because our knowledge of how to treat COVID and nursing care is much better after two years of the pandemic.”

IDPH officials on Friday reported that while COVID-19 hospitalizations had increased by nearly 120 patients over the course of the week, the number of COVID-19 patients needing an ICU bed had actually decreased during that time.

Though cases are steadily rising again and hospitalizations are inching up, too, public health officials aren't as alarmed as they were in previous upticks, largely because of the availability of therapeutic or preventive treatments.

“The treatments are widely available at more than 2,000 locations in Illinois, and they are much more effective at preventing hospitalizations and deaths when they are taken early in the course of the illness,” said Amaal Tokars, acting director of the Illinois Department of Public Health. “IDPH has been closely monitoring the usage and distribution of these therapeutics to ensure there are sufficient courses spread across our treatment providers in Illinois.”

Paxlovid, an oral antiviral medication made by Pfizer, has quickly become the predominant treatment for those infected with COVID-19 and at high risk for severe complications from the respiratory disease.

“Because this can be taken orally instead of infused intravenously, patients can have much quicker access to it,” said Dr. Jonathan Pinsky, medical director of infection control and prevention at Edward Hospital in Naperville. “We're hearing from primary care physicians they're primarily using the orals now.”

Paxlovid is recommended for anyone over the age of 12 who is symptomatic after testing positive for COVID-19 and at risk of severe complications. It should be administered within the first five days of becoming symptomatic, according to research.

A Yale University study published last week showed unvaccinated individuals who were given Paxlovid were 89% less likely to develop extreme illness or die of COVID-19 than other unvaccinated individuals who were not treated with Paxlovid.

Oryszczak said the antiviral drug is widely available at pharmacy chains throughout the state, but does require a prescription.

Merck also makes a similar antiviral called Lagevrio, or generically molnupiravir, though it's not as effective, Pinsky said. It's recommended for those 18 and older who can't take Paxlovid.

In addition to the oral antiviral, many hospitals throughout the state are stocked with doses of monoclonal antibodies, an intravenous antiviral medication.

Because the previous version of monoclonal antibodies wasn't as effective against the omicron variant and the BA. 2 subvariant that followed, it was re-engineered recently and new doses were distributed by the federal government.

Like Paxlovid, monoclonal antibodies are for those 12 and older who are symptomatic but not sick enough to warrant hospitalization.

For those hospitalized with COVID-19, the treatment plan is almost always a course of Remdesivir.

“When we are talking about effectiveness, it's keeping people from severe outcomes and death,” Oryszczak said. “And there have been no issues with supplies of Remdesivir because it was in production before the pandemic.”

The U.S. Food and Drug Administration recently approved the use of Remdesivir for hospitalized children under the age of 12.

Doctors also tout the availability of Evusheld, a preventive drug made by AstraZeneca, that research has shown reduced the risk of symptomatic COVID-19 by 77%.

“I think we could be doing better with Evusheld. It is not being used as widely as we want it to be used,” Pinsky lamented. “We have an initiative to get the word out on Evusheld, especially among specialists like rheumatologists and others who see high-risk patients.”

Evusheld is an injection taken every six months and currently available to those 12 and older with preexisting conditions that make them vulnerable to severe outcomes from a COVID-19 infection.

“It is not considered a treatment for COVID-19,” Tokars said, “but is more of an agent to bolster antibodies in those who cannot mount a good response to the vaccine.”