14 January 2022
2 min read
It was late in 2021 when two companies announced that they had developed pills that treat COVID-19: Mulnupiravir, developed by Merck, and Paxlovid, developed by Pfizer. Both pill regimens continue to undergo rigorous research and testing, though it does initially seem as though the pill regimens reduce the risk of severe disease in unvaccinated people who contract COVID-19.
As per usual, more studies may determine if these pills are as effective in treating breakthrough infections among those who have been vaccinated for the coronavirus. Other pills, such as Avifavir, have been approved for use in different countries. Avifavir, in particular, is the first drug approved for the Coronavirus treatment in Russia and was released on the market in June of 2020. It was determined that by day 10 of treatment with this particular pill, the number of negative patients that initially tested positive, had reached 90 percent.
These pills could be a game-changer for the most vulnerable because they can be taken at home twice a day for five days to prevent hospitalization and death. The problem? Not many people are aware of the existence of these pills. Let’s change that.
As defined by the Cleveland Clinic, antivirals are medications that help your body fight off certain viruses that can cause disease as well as protect you from getting viral infections or spreading a virus to others. These antivirals do two things: boost the immune system to help it fight off a viral infection and lower the amount of viral load in our body.
More than that, they can ease symptoms, shorten the length, and rid the body of viral infections like flu and Ebola. Side effects from antivirals may vary depending on the specific drug type and strength, though one could naturally expect any of the following: cough, dry mouth, diarrhea, dizziness, fatigue, headaches, insomnia, joint or muscle pain, nausea, and skin rash.
It would be important to note that antiviral drugs don’t actually kill a virus but instead limit the production of new viruses in host cells. Effective antiviral treatments can shorten the duration of the illness and lessen complications in some people - with it making the virus latent or inactive such that you experience fewer symptoms.
The greatest success against virus infections has been by increasing immunity through vaccination with live virus cells weakened or killed in the process. This is especially true in the cases of influenza, polio, measles, mumps, and smallpox.
In all these cases, vaccines are the most effective primary strategy available for preventing and lowering the impact of an influenza outbreak. That is not to say, however, that antivirals have no place in individual immunization. Treatment for COVID-19 using antivirals should be used in addition to vaccines, not in place of them - this is particularly true for people who can’t be vaccinated or don’t mount a good response to vaccines, such as the immune-compromised and the elderly, the Guardian writes.
Yale adds that if and when antiviral pills are authorized, vaccination will continue to remain an essential process for preventing COVID-19 infection and for slowing its spread. “Some people might say, ‘I'm not getting vaccinated because I'll have access to these medications’—to this pill or other treatments. But you can’t trade one for the other. If you haven’t done so already, the most important thing is still to get the vaccine.", Yale highlights in their statement.
From the initial research and results from field use, it’s quite clear that all currently available COVID-19 antiviral pills are effective in reducing the severity of the virus. The Pfizer pill, in particular, reduced COVID-19 hospitalization or death by 89% if taken within 3 days of symptom onset and 88% if taken within 5 days. In vitro studies have also indicated that the pill could work against the Omicron variant, as reported by CIDRAP University of Minnesota.
The efficacy of these pills resides in their capability to block the ability of the COVID-19 virus to replicate. With coronavirus being able to use RNA as its genetic material, Molnupiravir, in particular, resembles the nucleosides used to make the virus’ RNA, incorporating themselves into the body's cells as the virus continues to synthesize itself. More information could be found in Yale Medicine’s article on Molnupiravir.
Unfortunately, it’s been highlighted that shortages in viral pills are expected to persist in the short term. Antivirals are notoriously difficult to create and it will often take at least six to eight months from approval to mass production.
Unfortunately, the antiviral pills aren’t for everyone who gets a positive test. The pills are intended for those with mild or moderate COVID-19 who are more likely to become seriously ill. That includes older people and those with other health conditions like heart disease, cancer, or diabetes that make them more vulnerable.
It’s a good reminder that certain medications – some heart medications and blood thinners, for example, as well as herbal supplements like St John’s wort – could be affected by the treatment. Those who receive the medication will need to work closely with their doctors to monitor these medication interactions.