If You Get Sick with COVID-19, Antiviral Treatments Can Protect You Against Severe Illness

With COVID-19 hospitalizations on the rise, it is important that people who get sick and are at higher risk for severe illness get on treatment in the first days of illness because symptoms can change and worsen quickly. While these antivirals are effective at preventing severe disease, not enough people are taking them. If more people at higher risk for severe illness get treatment in a timely manner, we will save lives.

This blog helps clarify the most frequently asked questions about COVID-19 treatments.

1. COVID-19 antiviral treatments might be for you if you are at higher risk of getting very sick from COVID-19.

Some people are more likely to get very sick from COVID-19 or need hospital care. Antivirals can provide additional protection, even if you are vaccinated, if:

• You are at least 50 years of age, especially 65 and older, OR
• You have certain underlying medical conditions, such as a weakened immune system, heart disease, obesity, diabetes, or chronic lung disease, regardless of your age

You should talk to a medical provider about getting treatment for COVID-19 if you fall into one of the two categories above.

2. There are treatment options available for people with COVID-19.

There are treatment options for people at higher risk of severe disease. The antiviral your doctor prescribes depends on whether you’re at home or in the hospital, and on which medications you are currently taking. Children under 12 years of age can only take one antiviral.

3. Taking antivirals can help decrease your risk of being hospitalized for COVID-19.

• COVID-19 antivirals can reduce the risks of hospitalization and death if you’re at increased risk of getting very sick, regardless of your vaccination status. You should consider treatment for COVID-19 if it is recommended for you.
• Antivirals are not a replacement for COVID-19 vaccines. Vaccines help reduce the risk of getting very sick before you have COVID-19; treatments can help you feel better if you have COVID-19. Both are helpful tools that can prevent serious illness.
• Vaccination is the best way to protect yourself against the most serious effects of COVID-19. It is important to stay up to date on your COVID-19 vaccinations.

4. If you think you have COVID-19, get tested. And if you are at risk for severe disease, talk to your doctor about whether you should take treatment.

• Because symptoms can change and might get worse quickly, take every step you can to avoid getting very sick and potentially going to the hospital.
• You can prepare ahead of time by ordering four free at-home test kits for your household by going to COVIDtests.gov.
• Testing can be important to determine whether you have COVID-19 or flu (or even a different infection). If you have symptoms or have been exposed to someone with COVID-19, you can get a COVID-19 test by:
  • Buying at-home test kits online or in pharmacies and retail stores.
  • Getting tested at pharmacies, urgent cares, doctor offices, and other local testing sites.
  • Visiting the testing locator to find a free COVID-19 test, if you are uninsured.
  • Talking to a healthcare provider about other testing options.
• Testing is not required to begin COVID-19 antivirals. For example, if you have a known exposure and are at higher risk for severe disease, talk to your healthcare provider about treatment as soon as possible, even before test results come back.
• If you are at risk for severe illness, you can take COVID-19 antivirals if your symptoms are mild to moderate. If you have severe symptoms, your provider will decide if you should be admitted to the hospital for inpatient care.
• Treatments are most effective when taken within 5-7 days after symptoms begin. It’s best to start as soon as you can.

5. Among people who are at risk for severe illness, the benefits of antiviral treatments outweigh the potential risks of rebound.

• COVID-19 antivirals, such as Paxlovid (nirmatrelvir/ritonavir), are effective at preventing severe disease.
• Taking antivirals is an important intervention to prevent hospitalization and death due to severe COVID-19 illness.
• Rebound, a return of symptoms or a new positive test after having tested negative, has been reported in people with and without the use of the COVID-19 antivirals. Current evidence suggests rebound presents as mild symptoms 3-7 days after initial illness resolves.
• If you are at high risk for severe COVID-19, treatment benefits outweigh the potential risks of rebound.

6. You can take antivirals safely even if you’re taking other medications.

• Antivirals can be taken safely with other medications.
• It is important that your healthcare provider review your medications to determine how you can take antivirals safely.
• Paxlovid is more likely to interact with medications than other COVID-19 antivirals, but most people can still take it. Your healthcare provider might adjust or stop your medications while you take Paxlovid.
• If you can’t take Paxlovid, there are effective treatments that have fewer interactions with other medications. These other treatments, Veklury (remdesivir) and Lagevrio (molnupiravir), may be right for you.

 7. You can get treatment even if you don’t see a doctor regularly.

• You can get evaluated for COVID-19 treatment even if you do not have a primary care physician or cannot quickly be seen by your doctor.
• You can get a COVID-19 antiviral prescription at a doctor’s office or an urgent care. Other options include telehealth, such as the free Home Test to Treat program, which provides COVID-19 and influenza testing and antivirals; test-to-treat sites; Health Resources and Services Administration (HRSA)-supported health centers; and pharmacies with clinics.
• Check to see if your community has test-to-treat sites for rapid testing and treatment resources.

8. You can get COVID-19 antivirals for free or at a reduced cost even if you don’t have insurance.

• On Nov. 1, 2023, Paxlovid and Lagevrio became commercially available. Patient assistance programs that help pay for these drugs are available to people who are underinsured, uninsured, or publicly insured through Medicaid, Medicare or other programs.
• You may be eligible for reduced or no-cost antivirals, once you have a prescription, through:
  • Manufacturer access programs such as PAXCESS (Paxlovid), including the U.S. Government Patient Assistance Program (USG PAP) operated by Pfizer, and Merck Helps (Lagevrio).
  • Home Test to Treat program: free tests, a telehealth appointment with a healthcare provider, and treatment if eligible, shipped directly to you.
• Patients that use certain federal entities, including Health Resources and Services Administration (HRSA)-supported health centers such as Federally Qualified Health Centers (FQHCs), Indian Health Service provider sites, and others, will have continued access to free, U.S. Government procured Paxlovid and Lagevrio.

9. You can take antiviral drugs to treat flu, too!

• Testing can help determine whether you have COVID-19 or flu (or even a different infection).
  • Testing is not required to begin taking flu antivirals, and treatment should not be delayed for test results.
• Flu antivirals are recommended for people at higher risk of flu complications, including young children, adults 65 years and older, pregnant people, and people with certain medical conditions such as asthma, diabetes, and heart disease.
• Flu antiviral drugs can lessen fever and flu symptoms and shorten the time you are sick by about one day. They also may reduce the risk of complications such as ear infections in children, respiratory complications requiring antibiotics, and hospitalization in adults.
• Antivirals approved and recommended for flu treatment this season:
  • Oseltamivir (available as a generic version or under the trade name Tamiflu)
  • Zanamivir (trade name Relenza)
  • Peramivir (trade name Rapivab)
  • Baloxavir marboxil (trade name Xofluza)
• Starting flu antivirals later can still be beneficial, especially if the sick person is at higher risk of developing serious flu complications or is in the hospital with severe flu illness.
• If many people in your community have flu, your healthcare provider may give you an antiviral for flu without a test.