January 13, 2023 • 19 mins
While Covid-19 vaccines remain the best protection against the novel virus, if you do catch Covid there are also several treatments to help manage symptoms, like Covid cough, and prevent hospitalization. Onisis Stefas, PharmD, executive director of VIVO Health, breaks down what treatments are available over the counter, by prescription (paxlovid and molnupiravir) and if you do end up in the hospital (remdesivir). He explains the difference between the types of medications (anti-viral vs monoclonal antibodies) and which remain effective today against the new Covid variants.
Chapters:
- 00:07 - Intro 02:08 - A personal experience with paxlovid 05:26 - Covid treatments for mild-to-moderate Covid-19 08:13 - Categories of Covid treatments 10:05 - Paxlovid effectiveness 10:24 - Molnupiravir vs paxlovid 11:22 - When should you take paxlovid 12:05 - Remdesivir infusion 12:57 - Covid anti-viral medication vs monoclonal antibodies 14:11 - Paxlovid, molnupiravir, remdesivir work against new Covid variants 14:47 - Why paxlovid usage is low 16:39 - Outro
Listen to more from Dr. Stefas on 20-Minute Health Talk:
- When hospitals close: How to address "care deserts" - March 15, 2022
- Breaking down the Johnson & Johnson Covid-19 vaccine - March 5, 2021
- What's in the Covid-19 vaccine? - Jan. 13, 2021
Watch episodes of 20-Minute Health Talk on YouTube.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:06):
Welcome to 20 minutes health talk.
I'm Rob Hoell.
And I am Sandra Lindsay.
Hey, Sandra.
You know, we're talking about treatments for COVID-19, and obviously
you know a lot about COVID-19.
You are the first person in the United States, outside of clinical
trial, to receive a vaccine.
And we've talked a lot about the vaccines, but there are a lot of
treatments out there now in case you do get it.
(00:26):
Yeah, Rob, this is really a very good topic because we've spent a lot
of time, as you said, talking about vaccines, and we do know that even
among vaccinated people, we can still get the virus.
So what are the treatment options out there for those mild to moderate
(00:49):
cases that people can take before it progresses to severe?
I feel like we really need to address that topic, especially now with
the variance, the subvariance, the XBB 1.5, who knows what else is
coming.
So we really need to arm people with information and vaccines.
(01:13):
I just have to say this remain the best protection against severe
illness and hospitalizations and death.
But I feel like we do need to address what treatments are out there.
Yeah.
And I think in the beginning of this whole pandemic, there wasn't
really a lot of treatments.
There wasn't really any really.
(01:34):
I mean, there was some that were being experimented and tested and
whatnot.
But now we have some proven treatments.
So even if we do get vaccinated and we do get COVID, we can start
treating it right away with some prescription medicine, which is
great.
And right away, you mentioned right away, because these treatments are
time sensitive for some, it's from the day of you start experiencing
(02:01):
symptoms, you need to contact your physician to find out what is the
best treatment for you.
Yeah, we learned a lot from the flu also, right.
Like, if you get the flu shot, and hopefully when you get the flu
shot, you don't get the flu, but if you do, you get a milder version.
But most people, when they do get the flu, they start tamiflu right
away.
And that has really been proven to reduce the pain and suffering from
(02:24):
the flu.
And there's actually a COVID treatment that does basically the same
thing.
It's called Paxlovid.
Now, this drug does require a prescription, and we'll talk a little
bit more about that later in the show.
But just from a personal experience, my wife wasn't feeling so well,
so she works in healthcare.
So she went down to a Go Health by us to get tested.
And when they called her back and said she was indeed positive right
(02:45):
away over the phone, they called in a prescription for paxlovid, and
she asked me to go to the pharmacy to pick it up for her, which I did.
And when I went, I was pleasantly surprised because when I went to go
pay, they said it was $0, free of charge.
So I was like, wow, great.
Oh, wow.
I read that, and I wasn't sure.
Wow.
I'm like, is it free?
(03:05):
Yeah, I was surprised.
I had the card right there, ready to go, and they were like, no
charge.
I was like, oh, this is great.
So there you have it.
By the way, I wish your wife well.
So are you isolated?
I am isolating.
That's why I'm in the basement right now.
And, um, well, she's up in her room, but I'm in the basement.
(03:27):
That's why I'm doing this recording.
But she is taking the paxlovid, and I think I don't know if you would
call them pills or tablets, but she's supposed to take three twice a
day, so it's it's six doses for five straight days.
So, Rob, it sounds like she's done the right thing.
So far.
They recommended paxlovid, which is frequently what you hear about.
(03:47):
But I think there's another one.
This one is called I've never heard of it.
molnupiravir.
When do you use that drug versus paxlovid?
We're going to sort this all out with our expert.
And, Sandra, you just mentioned our guest today.
We're speaking with Dr.
Onisa Stefus, who is the chief executive officer of Vivo Health
(04:09):
Northwell's outpatient pharmacy network consisting of retail, mail
order, specialty, and clinical pharmacy services.
Vivo provides comprehensive care and outpatient pharmacy services to
more than 80,000 patients.
And Dr.
Stefus has really grown this pharmacy network from the ground up.
And he's just really a brilliant person.
He's been methods from the beginning, helping us wade through what we
(04:30):
need to know about the vaccines.
And he's actually, Sandra, the person that mixed the COVID vaccine
that went to you, that wound up being the first COVID shot that was
basically heard around the world.
Yes.
I remember him walking in with the vial, and it was like liquid gold.
So I know he's an expert, and he will help us sort all of this
(04:55):
treatment out.
But it's important for people to know that the treatments, these
COVID-19 treatments, work by lowering the amount of virus in your
body, reducing symptoms, and helping one to avoid hospitalization.
And I think now is the time to get to that interview.
So here is our conversation with Dr.
(05:16):
O nisa Stefas.
Good afternoon, Dr.
Stefas.
It's so nice of you to join us today.
Hello.
So we've come a long way in our fight against COVID-19.
I remember you were instrumental in my vaccination process, so thank
(05:41):
you for that.
But today we want to talk a little bit about the treatments that are
out there for mild to moderate cases of the virus.
When someone has COVID, what can or should they do for symptoms?
Symptoms in terms of COVID The good thing is that the majority of
(06:06):
patients today are receiving COVID with mild symptoms.
These mild symptoms consist of fever, chills, cough, fatigue, sore
throat, congestion, typical things that you may see with either the
flu or that you may see with a common old.
(06:26):
And the goal is that if you're experiencing mild COVID, you should
really stay home to minimize the exposure and get tested.
But with that, there's also over the counter products that you can use
to help you during this period of time.
Now, the thing to keep in mind is the over the counter products that
(06:48):
we're going to discuss today doesn't actually fight against the virus
or treat the virus.
What it does is it makes you and your body more comfortable as you
fight off the COVID-19 virus.
So that that's really important to note, and a good majority of the
people can go ahead and do that without any other further
(07:10):
intervention.
What are the ones that you can go to the store and buy over the
counter?
So it's very similar to what you would get if you had a cold or a flu.
You can pick up acetaminophen or ibuprofen, which is also known as
like Town, all, motorin and Advil.
Those products could be used for body aches.
They can also be used for fever, as that's one of the symptoms that
(07:34):
you would want to focus on, particularly fever for myelcode, to make
sure that you keep that in check.
You can also take lozengers for your sore throat or use a vapor rub
for your congestion so you would understand what your symptoms are.
And then from there you would pick up a remedy within the local
pharmacy to resolve those symptoms as your body is fighting off the
(07:56):
virus.
I wouldn't load up Proactively on a lot of different over the counter
medications, because, as you know, COVID can exhibit differently
within different people, that you would just get a good understanding
of what that is and try to meet them, particularly if they're mild
symptoms.
Dr.
Stefas it sounds like there are a lot of treatments on the market to
(08:17):
treat COVID-19, both for nonhospitalized patients and for hospitalized
patients.
I wonder if you could talk us through some of these treatments.
When I think of COVID I break it down into a couple of different
categories.
I look at it as mild COVID for fairly healthy people that will resolve
(08:38):
on its own, and then from there, you would typically pick up over the
counter items just to make yourself comfortable as you go ahead and
you start fighting off the infection.
You then have prescription items like Paxovid and Mong and pure beer,
which are oral, ant, viral medications.
And what they do is they stop the replication of the virus.
(09:00):
Typically, if you talk to a provider and you're over 65 or you have
Virus.
other comorbidities like diabetes, COPD, cardiovascular disease,
immunocompromised providers will typically write for these agents to
reduce the chance of it progressing to severe COVID and requiring
hospitalization.
(09:21):
It is free of no charge today, and a lot of times the pharmacies will
even deliver it to the home.
But with that, you do need a prescription.
So you do need to talk to a prescriber most of the time in order to
get that product, which would then be prescribed to the pharmacy and
then sent to your home.
(09:44):
Paxilvid, or Paxlivid, has been actually really good because even
during all the various different mutations, variance and iterations of
COVID it still remains highly effective.
And the goal is to get on treatment within five days of symptoms.
How effective is it?
So it's up around 85% to 90% effective.
(10:06):
If you take it as soon as you test positive or you start to exhibit
symptoms, you take it over the course of about five days.
And and what?
We mean effective, we mean reduces the potential for hospitalization.
Most consumers have heard about Paxilovid, but I wasn't aware of this
(10:29):
antiviral, but I read about it.
Malnutrivir.
When would you use that versus a Paxovid?
Okay.
Great question, Sandra.
So, Malnutriavir is another antiviral medication has a little bit of a
different mechanism of action, but it's not as effective as PAXEL.
(10:50):
Bid so, Paxovid is usually the first line of treatment, treatment.
Now, with monoconavir, however, it has much less drug interactions.
So there are a certain number of drugs that if you're on, then you
can't take taxovit, but you can take monoprivier.
So if Paxovid is not right, based on the other medications and other
(11:11):
things that you have going on, there is an alternative monoprivir.
But unfortunately, it's not as effective, but it's better than not
taking anything at all.
When should I take Paxylavid?
So basically, PAXEL bed needs to be taken the moment that you test
positive.
There's been studies show that the earlier you take the Paxilvid, the
(11:31):
better that it works, because what it's doing is it's reducing the
replication of the virus.
So the less virus in your body, the more you can attack those and the
less replication you get and the quicker your body can fight off
whatever is remaining.
That's good to know because I get this question all the time from my
friends who test positive, and they're like, what?
(11:54):
I'm feeling fine right now and I don't know if I should take this
Paxovid.
But thanks for that information.
I'll tell them to get right on it.
Right.
And if you're really bad, if you wind up in the hospital, what can be
done inside the hospital from there?
There's another antiviral on the market called Remdenzavir, and
(12:16):
Remdenzevir is typically used for hospitalized patients similar to
Paxovitaminoprivir, but it's in the IV form and you can get it in an
outpatient setting, but you would need to get it as an infusion three
days in a row in an outpatient setting or in more severe cases,
hospitalized.
There are multiple options out there for patients in order for them to
(12:40):
get treated and get better.
It's really important to understand and appreciate the different
variants that are out there and the new variants that are coming,
because a lot of that really does go into consideration in terms of
what treatment options you're going to use.
So, for example, the monoclonal antibiotics are no longer authorized
(13:01):
to be used.
And that's basically based on the new variants that are out there
today, that those monoclonal antibodies are having a hard time
detecting the COVID-19 virus within your body because when those
mutations of those variants occur, they occur on the spike protein,
which is the sticky part that comes out of the virus.
(13:22):
And that's what these monoclonal antibodies are using to identify
COVID and then ultimately kill the virus.
When you're talking about these antivirals like Paxlivid, Mama
Pierrevira or Remdenzvir, those actually reduce the replication of the
virus, mostly by attacking an enzyme, and that doesn't change.
(13:46):
Right.
So even as COVID is mutating that virus, that results in the
replication I'm sorry, that part of the virus that results in the
replication of the virus is unchanged and continue to be targeted.
And that's why you're still seeing good numbers of efficacy as it
pertains to Paxabenopiravir and Remandsvir.
(14:06):
And that's why those continue to be the drugs of choice.
We have all these variants, they just seem to pop up, it seems like
weekly, and I think you mentioned this before, but I just want to be
clear.
Does Paxlevid work against Omecron and all its subvariants?
Yes, Sandra, it does.
(14:27):
It would be the same with the monopriver and the ring denzivir.
Once again, because they're antivirals and not the monoclonal
antibodies, they continue to remain their effectiveness based on their
mechanism of action, of focusing on the replication of the virus, not
actually killing the COVID-19 that's circulating in your body.
We know PAX lovat is effective, but physicians are only prescribing
(14:50):
the drug in 13% of new COVID cases in the United States.
What can be done to get more people on PAX LoVid to help fight off
COVID?
I just think it's continued awareness and greater education.
It's interesting because when Paxovid first came out, it was very
little supply, right?
So it was a tremendous demand and a little supply.
(15:12):
So it was embedded within the prescribers and other folks that should
really only use this and the patients that have the potential to be
the most sickest that are out there.
Now that we do have a very good supply where there's more supply than
demand, it's important for us to understand that any patient where the
(15:33):
benefit outweighs the risk should really be considered for Paxelin.
And I think as people get more comfortable with the product and people
really understand the nuances between those things, I'm hopeful that
there'll be more and more uptake of the product resulting in less
hospitalization and overall less depth.
(15:54):
Awesome.
Well, you mentioned awareness, and on 20 Minutes Health Talk, that is
our goal, to raise awareness and to educate our audience.
So thank you very much for joining us today.
Great.
Well, Sandra, it was an honor to participate in your vaccination, and
I want to thank you very much for being that person to receive the
(16:16):
vaccination and really being a tremendous advocate and support for
COVID vaccinations and treatments and everything that you do.
So it's an honor and pleasure to join you today and just wanted to
thank you for that.
My pleasure.
(16:38):
So, Sandra, that was a great conversation.
And it's great that we learned so much today about there's such a
supply of this PAX, flow of it.
So if we did get COVID, we know there's something that we can do to
lessen the disease and hopefully be feeling better quicker.
Yeah.
Rob, that was a fascinating conversation with Dr.
Stefas.
And something else that he said that was encouraging is that Paxovid
(17:04):
in particular is effective against the many variants and subvariants
that we seem to see weekly these days of the Feinstein Institutes for
(17:24):
And he talked about how important it was to get treatments like just
Medical Research.
like tamiflu for the flu.
And the Feinstein, also working with Cold Spring Harbor National
Laboratory, have really been out in the forefront of trying to do
research to find new treatments to take care of COVID If you do get
COVID, right, because hospitalization cannot be the go to, as we've
(17:49):
learned today, for mild and moderate symptoms, these can be treated at
home, which is great.
And also, too, that you could just have it delivered.
Delivered from your pharmacy.
And for the PAX lovin, it's free.
What's important, and what I want our listeners to know, is that the
(18:10):
sooner you start the drug, the better you will feel.
Yeah, like we talked about, because there's so much research, it gives
even more hope.
And we're going to zero in on one research project in particular on
next week's episode, which looked at the common over the counter
heartburn drug called femotidine, better known as Pepsid, as a
potential treatment for COVID-19.
(18:32):
We spoke with the head investigator, Dr.
Tobias Janowitz, who is an assistant professor at the Cold Spring
Harbor National Laboratory and an adjunct professor at the Feinstein
Institutes for Medical Research.
We sat down with Dr.
Janowitz back in December at Cold Spring Harbor.
We found that fermotidine may help patients recover sooner as they
have sustained inflammation because of COVID-19.
(18:54):
To essentially alleviate this inflammation early and make patients
feel better sooner.
Make sure to check back with us next week for the full interview.
As we wrap up here, I want to thank Dr.
Onisa Stefus, who has really been along with us the whole way here at
20 Minutes Health Talk, helping us break down the COVID vaccines.
He was a frequent guest on the show and now helping us break down the
(19:15):
information we need to know about these treatments.
So big.
Thanks to Dr.
Stefas.
Such a great conversation.
Thank you to the listener for tuning in to 20 Minutes Health Talk.
I'm Rob Hoyle.
And I'm Sandra Lindsay.
Thank you for listening.
Get more expert insight from the lead in Voices in Healthcare today.
(19:38):
You can subscribe to a 20 Minutes House Talk wherever podcasts are
available.
Welcome to 20 minutes health talk.
I'm Rob Hoell.
And I am Sandra Lindsay.
Hey, Sandra.
You know, we're talking about treatments for COVID-19, and obviously
you know a lot about COVID-19.
You are the first person in the United States, outside of clinical
trial, to receive a vaccine.
And we've talked a lot about the vaccines, but there are a lot of
treatments out there now in case you do get it.
(00:26):
Yeah, Rob, this is really a very good topic because we've spent a lot
of time, as you said, talking about vaccines, and we do know that even
among vaccinated people, we can still get the virus.
So what are the treatment options out there for those mild to moderate
(00:49):
cases that people can take before it progresses to severe?
I feel like we really need to address that topic, especially now with
the variance, the subvariance, the XBB 1.5, who knows what else is
coming.
So we really need to arm people with information and vaccines.
(01:13):
I just have to say this remain the best protection against severe
illness and hospitalizations and death.
But I feel like we do need to address what treatments are out there.
Yeah.
And I think in the beginning of this whole pandemic, there wasn't
really a lot of treatments.
There wasn't really any really.
(01:34):
I mean, there was some that were being experimented and tested and
whatnot.
But now we have some proven treatments.
So even if we do get vaccinated and we do get COVID, we can start
treating it right away with some prescription medicine, which is
great.
And right away, you mentioned right away, because these treatments are
time sensitive for some, it's from the day of you start experiencing
(02:01):
symptoms, you need to contact your physician to find out what is the
best treatment for you.
Yeah, we learned a lot from the flu also, right.
Like, if you get the flu shot, and hopefully when you get the flu
shot, you don't get the flu, but if you do, you get a milder version.
But most people, when they do get the flu, they start tamiflu right
away.
And that has really been proven to reduce the pain and suffering from
(02:24):
the flu.
And there's actually a COVID treatment that does basically the same
thing.
It's called Paxlovid.
Now, this drug does require a prescription, and we'll talk a little
bit more about that later in the show.
But just from a personal experience, my wife wasn't feeling so well,
so she works in healthcare.
So she went down to a Go Health by us to get tested.
And when they called her back and said she was indeed positive right
(02:45):
away over the phone, they called in a prescription for paxlovid, and
she asked me to go to the pharmacy to pick it up for her, which I did.
And when I went, I was pleasantly surprised because when I went to go
pay, they said it was $0, free of charge.
So I was like, wow, great.
Oh, wow.
I read that, and I wasn't sure.
Wow.
I'm like, is it free?
(03:05):
Yeah, I was surprised.
I had the card right there, ready to go, and they were like, no
charge.
I was like, oh, this is great.
So there you have it.
By the way, I wish your wife well.
So are you isolated?
I am isolating.
That's why I'm in the basement right now.
And, um, well, she's up in her room, but I'm in the basement.
(03:27):
That's why I'm doing this recording.
But she is taking the paxlovid, and I think I don't know if you would
call them pills or tablets, but she's supposed to take three twice a
day, so it's it's six doses for five straight days.
So, Rob, it sounds like she's done the right thing.
So far.
They recommended paxlovid, which is frequently what you hear about.
(03:47):
But I think there's another one.
This one is called I've never heard of it.
molnupiravir.
When do you use that drug versus paxlovid?
We're going to sort this all out with our expert.
And, Sandra, you just mentioned our guest today.
We're speaking with Dr.
Onisa Stefus, who is the chief executive officer of Vivo Health
(04:09):
Northwell's outpatient pharmacy network consisting of retail, mail
order, specialty, and clinical pharmacy services.
Vivo provides comprehensive care and outpatient pharmacy services to
more than 80,000 patients.
And Dr.
Stefus has really grown this pharmacy network from the ground up.
And he's just really a brilliant person.
He's been methods from the beginning, helping us wade through what we
(04:30):
need to know about the vaccines.
And he's actually, Sandra, the person that mixed the COVID vaccine
that went to you, that wound up being the first COVID shot that was
basically heard around the world.
Yes.
I remember him walking in with the vial, and it was like liquid gold.
So I know he's an expert, and he will help us sort all of this
(04:55):
treatment out.
But it's important for people to know that the treatments, these
COVID-19 treatments, work by lowering the amount of virus in your
body, reducing symptoms, and helping one to avoid hospitalization.
And I think now is the time to get to that interview.
So here is our conversation with Dr.
(05:16):
O nisa Stefas.
Good afternoon, Dr.
Stefas.
It's so nice of you to join us today.
Hello.
So we've come a long way in our fight against COVID-19.
I remember you were instrumental in my vaccination process, so thank
(05:41):
you for that.
But today we want to talk a little bit about the treatments that are
out there for mild to moderate cases of the virus.
When someone has COVID, what can or should they do for symptoms?
Symptoms in terms of COVID The good thing is that the majority of
(06:06):
patients today are receiving COVID with mild symptoms.
These mild symptoms consist of fever, chills, cough, fatigue, sore
throat, congestion, typical things that you may see with either the
flu or that you may see with a common old.
(06:26):
And the goal is that if you're experiencing mild COVID, you should
really stay home to minimize the exposure and get tested.
But with that, there's also over the counter products that you can use
to help you during this period of time.
Now, the thing to keep in mind is the over the counter products that
(06:48):
we're going to discuss today doesn't actually fight against the virus
or treat the virus.
What it does is it makes you and your body more comfortable as you
fight off the COVID-19 virus.
So that that's really important to note, and a good majority of the
people can go ahead and do that without any other further
(07:10):
intervention.
What are the ones that you can go to the store and buy over the
counter?
So it's very similar to what you would get if you had a cold or a flu.
You can pick up acetaminophen or ibuprofen, which is also known as
like Town, all, motorin and Advil.
Those products could be used for body aches.
They can also be used for fever, as that's one of the symptoms that
(07:34):
you would want to focus on, particularly fever for myelcode, to make
sure that you keep that in check.
You can also take lozengers for your sore throat or use a vapor rub
for your congestion so you would understand what your symptoms are.
And then from there you would pick up a remedy within the local
pharmacy to resolve those symptoms as your body is fighting off the
(07:56):
virus.
I wouldn't load up Proactively on a lot of different over the counter
medications, because, as you know, COVID can exhibit differently
within different people, that you would just get a good understanding
of what that is and try to meet them, particularly if they're mild
symptoms.
Dr.
Stefas it sounds like there are a lot of treatments on the market to
(08:17):
treat COVID-19, both for nonhospitalized patients and for hospitalized
patients.
I wonder if you could talk us through some of these treatments.
When I think of COVID I break it down into a couple of different
categories.
I look at it as mild COVID for fairly healthy people that will resolve
(08:38):
on its own, and then from there, you would typically pick up over the
counter items just to make yourself comfortable as you go ahead and
you start fighting off the infection.
You then have prescription items like Paxovid and Mong and pure beer,
which are oral, ant, viral medications.
And what they do is they stop the replication of the virus.
(09:00):
Typically, if you talk to a provider and you're over 65 or you have
Virus.
other comorbidities like diabetes, COPD, cardiovascular disease,
immunocompromised providers will typically write for these agents to
reduce the chance of it progressing to severe COVID and requiring
hospitalization.
(09:21):
It is free of no charge today, and a lot of times the pharmacies will
even deliver it to the home.
But with that, you do need a prescription.
So you do need to talk to a prescriber most of the time in order to
get that product, which would then be prescribed to the pharmacy and
then sent to your home.
(09:44):
Paxilvid, or Paxlivid, has been actually really good because even
during all the various different mutations, variance and iterations of
COVID it still remains highly effective.
And the goal is to get on treatment within five days of symptoms.
How effective is it?
So it's up around 85% to 90% effective.
(10:06):
If you take it as soon as you test positive or you start to exhibit
symptoms, you take it over the course of about five days.
And and what?
We mean effective, we mean reduces the potential for hospitalization.
Most consumers have heard about Paxilovid, but I wasn't aware of this
(10:29):
antiviral, but I read about it.
Malnutrivir.
When would you use that versus a Paxovid?
Okay.
Great question, Sandra.
So, Malnutriavir is another antiviral medication has a little bit of a
different mechanism of action, but it's not as effective as PAXEL.
(10:50):
Bid so, Paxovid is usually the first line of treatment, treatment.
Now, with monoconavir, however, it has much less drug interactions.
So there are a certain number of drugs that if you're on, then you
can't take taxovit, but you can take monoprivier.
So if Paxovid is not right, based on the other medications and other
(11:11):
things that you have going on, there is an alternative monoprivir.
But unfortunately, it's not as effective, but it's better than not
taking anything at all.
When should I take Paxylavid?
So basically, PAXEL bed needs to be taken the moment that you test
positive.
There's been studies show that the earlier you take the Paxilvid, the
(11:31):
better that it works, because what it's doing is it's reducing the
replication of the virus.
So the less virus in your body, the more you can attack those and the
less replication you get and the quicker your body can fight off
whatever is remaining.
That's good to know because I get this question all the time from my
friends who test positive, and they're like, what?
(11:54):
I'm feeling fine right now and I don't know if I should take this
Paxovid.
But thanks for that information.
I'll tell them to get right on it.
Right.
And if you're really bad, if you wind up in the hospital, what can be
done inside the hospital from there?
There's another antiviral on the market called Remdenzavir, and
(12:16):
Remdenzevir is typically used for hospitalized patients similar to
Paxovitaminoprivir, but it's in the IV form and you can get it in an
outpatient setting, but you would need to get it as an infusion three
days in a row in an outpatient setting or in more severe cases,
hospitalized.
There are multiple options out there for patients in order for them to
(12:40):
get treated and get better.
It's really important to understand and appreciate the different
variants that are out there and the new variants that are coming,
because a lot of that really does go into consideration in terms of
what treatment options you're going to use.
So, for example, the monoclonal antibiotics are no longer authorized
(13:01):
to be used.
And that's basically based on the new variants that are out there
today, that those monoclonal antibodies are having a hard time
detecting the COVID-19 virus within your body because when those
mutations of those variants occur, they occur on the spike protein,
which is the sticky part that comes out of the virus.
(13:22):
And that's what these monoclonal antibodies are using to identify
COVID and then ultimately kill the virus.
When you're talking about these antivirals like Paxlivid, Mama
Pierrevira or Remdenzvir, those actually reduce the replication of the
virus, mostly by attacking an enzyme, and that doesn't change.
(13:46):
Right.
So even as COVID is mutating that virus, that results in the
replication I'm sorry, that part of the virus that results in the
replication of the virus is unchanged and continue to be targeted.
And that's why you're still seeing good numbers of efficacy as it
pertains to Paxabenopiravir and Remandsvir.
(14:06):
And that's why those continue to be the drugs of choice.
We have all these variants, they just seem to pop up, it seems like
weekly, and I think you mentioned this before, but I just want to be
clear.
Does Paxlevid work against Omecron and all its subvariants?
Yes, Sandra, it does.
(14:27):
It would be the same with the monopriver and the ring denzivir.
Once again, because they're antivirals and not the monoclonal
antibodies, they continue to remain their effectiveness based on their
mechanism of action, of focusing on the replication of the virus, not
actually killing the COVID-19 that's circulating in your body.
We know PAX lovat is effective, but physicians are only prescribing
(14:50):
the drug in 13% of new COVID cases in the United States.
What can be done to get more people on PAX LoVid to help fight off
COVID?
I just think it's continued awareness and greater education.
It's interesting because when Paxovid first came out, it was very
little supply, right?
So it was a tremendous demand and a little supply.
(15:12):
So it was embedded within the prescribers and other folks that should
really only use this and the patients that have the potential to be
the most sickest that are out there.
Now that we do have a very good supply where there's more supply than
demand, it's important for us to understand that any patient where the
(15:33):
benefit outweighs the risk should really be considered for Paxelin.
And I think as people get more comfortable with the product and people
really understand the nuances between those things, I'm hopeful that
there'll be more and more uptake of the product resulting in less
hospitalization and overall less depth.
(15:54):
Awesome.
Well, you mentioned awareness, and on 20 Minutes Health Talk, that is
our goal, to raise awareness and to educate our audience.
So thank you very much for joining us today.
Great.
Well, Sandra, it was an honor to participate in your vaccination, and
I want to thank you very much for being that person to receive the
(16:16):
vaccination and really being a tremendous advocate and support for
COVID vaccinations and treatments and everything that you do.
So it's an honor and pleasure to join you today and just wanted to
thank you for that.
My pleasure.
(16:38):
So, Sandra, that was a great conversation.
And it's great that we learned so much today about there's such a
supply of this PAX, flow of it.
So if we did get COVID, we know there's something that we can do to
lessen the disease and hopefully be feeling better quicker.
Yeah.
Rob, that was a fascinating conversation with Dr.
Stefas.
And something else that he said that was encouraging is that Paxovid
(17:04):
in particular is effective against the many variants and subvariants
that we seem to see weekly these days of the Feinstein Institutes for
(17:24):
And he talked about how important it was to get treatments like just
Medical Research.
like tamiflu for the flu.
And the Feinstein, also working with Cold Spring Harbor National
Laboratory, have really been out in the forefront of trying to do
research to find new treatments to take care of COVID If you do get
COVID, right, because hospitalization cannot be the go to, as we've
(17:49):
learned today, for mild and moderate symptoms, these can be treated at
home, which is great.
And also, too, that you could just have it delivered.
Delivered from your pharmacy.
And for the PAX lovin, it's free.
What's important, and what I want our listeners to know, is that the
(18:10):
sooner you start the drug, the better you will feel.
Yeah, like we talked about, because there's so much research, it gives
even more hope.
And we're going to zero in on one research project in particular on
next week's episode, which looked at the common over the counter
heartburn drug called femotidine, better known as Pepsid, as a
potential treatment for COVID-19.
(18:32):
We spoke with the head investigator, Dr.
Tobias Janowitz, who is an assistant professor at the Cold Spring
Harbor National Laboratory and an adjunct professor at the Feinstein
Institutes for Medical Research.
We sat down with Dr.
Janowitz back in December at Cold Spring Harbor.
We found that fermotidine may help patients recover sooner as they
have sustained inflammation because of COVID-19.
(18:54):
To essentially alleviate this inflammation early and make patients
feel better sooner.
Make sure to check back with us next week for the full interview.
As we wrap up here, I want to thank Dr.
Onisa Stefus, who has really been along with us the whole way here at
20 Minutes Health Talk, helping us break down the COVID vaccines.
He was a frequent guest on the show and now helping us break down the
(19:15):
information we need to know about these treatments.
So big.
Thanks to Dr.
Stefas.
Such a great conversation.
Thank you to the listener for tuning in to 20 Minutes Health Talk.
I'm Rob Hoyle.
And I'm Sandra Lindsay.
Thank you for listening.
Get more expert insight from the lead in Voices in Healthcare today.
(19:38):
You can subscribe to a 20 Minutes House Talk wherever podcasts are
available.
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