What you need to know about accessing COVID treatments in Alaska

A glass vial with a clear liquid sitting on top of a cardboard box that says etesevimab injection
A vial of monoclonal antibody treatment at the Alaska Native Tribal Health Consortium warehouse on Oct. 5, 2021 (Lex Treinen/Alaska Public Media)

State health officials are reminding eligible Alaskans to seek COVID treatments if they test positive.

There are a wide range of factors that could qualify you for a COVID treatment, including being older than 50, being pregnant, being unvaccinated or not up to date on your COVID vaccines, and being immunocompromised. Certain medical conditions, like asthma; cancer; dementia; and kidney, liver or lung disease can also make you eligible.

In a public health presentation last week, state physician Dr. Lisa Rabinowitz said it’s especially important for older Alaskans to know how to access treatment right now, as the BA.5 omicron variant spreads widely. 

“We’ve definitely seen an increase over the last few months of hospitalizations in this older age group,” she said.

State pharmacist Dr. Coleman Cutchins said eligible Alaskans should seek treatment right away if they test positive for COVID. Treatments must be started five to seven days after the onset of symptoms in order to be effective.

“Once someone gets severely ill, it’s really too late for these,” he said. “Don’t watch and wait. Don’t say, ‘Hey, my symptoms started, I want to see if I get worse.’ Because by the time you get worse, it’s probably too late for these drugs to do any good.”

There are four treatment options currently available. One is a monoclonal antibody treatment and the others are antivirals.

Remdesivir is the only treatment option for kids under 12. It’s given by IV, mostly at hospitals.

Paxlovid is available for people 12 and older. It reduces the risk of hospitalization by 88%, and it’s now widely available around the state. As of this month, pharmacists can prescribe Paxlovid, not just primary care providers. Patients take the pills at home over five days.

Recent studies have shown that some people have had rebound cases after taking Paxlovid. That means they tested positive, took Paxlovid, and then tested positive again a week later. Cutchins emphasized that rebound cases have been as common in people who took Paxlovid as they’ve been in those who didn’t. And in both groups, rebound cases are very rare.

“It’s not a reason to not take this drug,” he said. “We’re not hearing about more severe rebound cases. And in the clinical trials, even in retrospective data, it’s less than 1% of people.”

Molnupiravir is available for people over 18, and reduces hospitalization by 30%. It can be a good option for people with kidney and liver disease, who might take medication that disqualifies them from taking Remdesivir or Paxlovid.

Bebtelomivab is the only monoclonal antibody treatment still available. Cutchins said it will likely only be available through August.

The COVID treatments currently available include one monoclonal antibody treatment and three antivirals. (Screenshot from DHSS’ ECHO presentation on July 13, 2022.)

People who are moderately to severely immunocompromised may be eligible for a monoclonal antibody called Evusheld. It’s given every six months to prevent, rather than treat, COVID-19. You could be eligible if you’re older than 12 years old and are immunocompromised, or have a history of allergic reactions to COVID vaccines. For example, Rabinowitz said people who’ve had chemotherapy or an organ transplant might benefit from Evusheld.

If you qualify for one of these treatments, there are a few ways to get them.

All four of them require a prescription, so your primary care doctor is a good place to start. They’re typically low cost or free, Cutchins said.

If your doctor is hesitant to prescribe you a treatment, Rabinowitz said be sure to explain why you think you qualify. 

“Advocating is the key,” she said. “There’s been a lot of changes to treatment, and even clinicians are trying to keep up and make sure they’re up to speed on everything.”

If you don’t have a primary care provider, officials suggest contacting a local public health clinic, urgent care clinic or pharmacy. Cutchins said now is a good time to find a primary care provider if you can.

“Even aside from pandemics and COVID, there’s a lot of really good reasons to have a personal relationship with a healthcare provider you can trust,” he said.

A federal website lists pharmacies and clinics that “test to treat,” meaning they can test patients for COVID and prescribe treatments at the same location. In Alaska, there are locations in Sitka, Kodiak, Kenai, Homer and Naknek. Cutchins said he expects more pharmacies to test to treat now that pharmacists can prescribe Paxlovid, but he acknowledged that staff shortages at pharmacies could limit the practice.

The state health department also operates a COVID helpline, which Alaskans can call for help finding treatment options. The number is 907-646-3322.

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