Why COVID Pills Aren’t Enough to Help Fight Omicron


This week the Biden administration placed another order for Pfizer’s new anti-COVID pills. President Biden announced in a White House press briefing on Tuesday that the U.S. government is effectively doubling the size of its original December order for 10 million treatment courses of Paxlovid to 20 million courses total. But it will take time to meet that demand, Biden cautioned—meaning the drug is not going to be available to enough Americans in time to make a meaningful dent in the country’s current COVID-19 surge.

The first shipment of Paxlovid, which went out on Christmas Eve, days after receiving approval from the U.S. Food and Drug Administration, is “already saving lives,” Biden said. “These pills are going to dramatically…decrease hospitalizations and deaths from COVID-19,” he said. “They’re a game changer and have the potential to dramatically alter the impact of COVID-19.” One clinical trial found the treatment course—which includes 30 pills over five days, a mix of Paxlovid and an antiviral—to be as much as 89% effective at reducing the risk of hospitalization and death compared to a placebo, as SELF reported. While real-world data are still coming in, early lab testing indicates Paxlovid will still be effective against the omicron variant.

However, while production is ramping up to full capacity and more doses are being shipped this week, the complex manufacturing process means it will take months to complete the full order—and the current production rate will do little to offset the omicron wave. Pfizer will deliver just 35,000 of the newly ordered treatment courses this month, and an additional 50,000 treatment courses in February, a senior administration official told The New York Times. That’s in addition to the 350,000 treatment courses from the original order that are expect to come through this month and next, according to the Times. The current projection is that there will be just 435,000 treatment courses available in January and February. Monthly deliveries won’t reach the millions until April, the Times reports, and the full 20 million order won’t be met until September.

There are also remaining questions about accessibility and distribution. It’s not yet clear how the pills will be allocated to various states. Plus, with COVID-19 testing capacity extremely limited in many parts of the country, identifying who is actually in need of the pill will be difficult. On top of that, the current order still may not be sufficient. “We may need even more,” Biden said.

Rather than being a magical game changer in the fight against omicron, for now, Pfizer’s limited supply of anti-COVID pills will be more of a last-resort stopgap measure against hospitalization and death for a select few who are vulnerable to severe illness, are able to get testing, and are prescribed the pill. (The medication was studied in both unvaccinated adults at average risk of severe illness from COVID-19 and vaccinated adults at elevated risk of severe illness.) And there is good reason to think the pill will remain effective against omicron and potentially new variants, regardless of variations in the spike protein (which the omicron strain, for example, has so many mutations on). Paxlovid works by impeding the ability of the virus to break itself into smaller pieces and replicate itself, as SELF has explained (in concert with ritonavir, an antiviral drug that helps keep Paxlovid stay active in the body for a longer period of time).

As supplies of Paxlovid grow, the drug can play an increasingly important role in protecting the highly vulnerable against hospitalization and death. In the meantime, our first line of defense is the same key public health measures at our disposal. That means getting fully vaccinated and getting boosted, as well as wearing a well-fitting respirator or surgical face mask, quarantining, and testing where available. These are still the most effective and reliable tools we have for protecting ourselves against omicron and mitigating the impact of this current wave.


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