Latest / 20-Minute Health Talk / Covid treatments: Over-the-counter, prescription and in-hospital

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Covid treatments: Over-the-counter, prescription and in-hospital · 20-Minute Health Talk

• 0:06
  Welcome to 20 minutes health talk.
• 0:07
  I'm Rob Hoell.
• 0:09
  And I am Sandra Lindsay.
• 0:10
  Hey, Sandra.
• 0:11
  You know, we're talking about treatments for COVID-19, and obviously
• 0:14
  you know a lot about COVID-19.
• 0:15
  You are the first person in the United States, outside of clinical
• 0:18
  trial, to receive a vaccine.
• 0:20
  And we've talked a lot about the vaccines, but there are a lot of
• 0:23
  treatments out there now in case you do get it.
• 0:26
  Yeah, Rob, this is really a very good topic because we've spent a lot
• 0:32
  of time, as you said, talking about vaccines, and we do know that even
• 0:38
  among vaccinated people, we can still get the virus.
• 0:43
  So what are the treatment options out there for those mild to moderate
• 0:49
  cases that people can take before it progresses to severe?
• 0:55
  I feel like we really need to address that topic, especially now with
• 1:01
  the variance, the subvariance, the XBB 1.5, who knows what else is
• 1:08
  coming.
• 1:08
  So we really need to arm people with information and vaccines.
• 1:13
  I just have to say this remain the best protection against severe
• 1:20
  illness and hospitalizations and death.
• 1:23
  But I feel like we do need to address what treatments are out there.
• 1:29
  Yeah.
• 1:29
  And I think in the beginning of this whole pandemic, there wasn't
• 1:32
  really a lot of treatments.
• 1:33
  There wasn't really any really.
• 1:34
  I mean, there was some that were being experimented and tested and
• 1:37
  whatnot.
• 1:38
  But now we have some proven treatments.
• 1:40
  So even if we do get vaccinated and we do get COVID, we can start
• 1:45
  treating it right away with some prescription medicine, which is
• 1:49
  great.
• 1:50
  And right away, you mentioned right away, because these treatments are
• 1:54
  time sensitive for some, it's from the day of you start experiencing
• 2:01
  symptoms, you need to contact your physician to find out what is the
• 2:05
  best treatment for you.
• 2:07
  Yeah, we learned a lot from the flu also, right.
• 2:10
  Like, if you get the flu shot, and hopefully when you get the flu
• 2:13
  shot, you don't get the flu, but if you do, you get a milder version.
• 2:16
  But most people, when they do get the flu, they start tamiflu right
• 2:20
  away.
• 2:20
  And that has really been proven to reduce the pain and suffering from
• 2:24
  the flu.
• 2:25
  And there's actually a COVID treatment that does basically the same
• 2:28
  thing.
• 2:28
  It's called Paxlovid.
• 2:30
  Now, this drug does require a prescription, and we'll talk a little
• 2:32
  bit more about that later in the show.
• 2:34
  But just from a personal experience, my wife wasn't feeling so well,
• 2:37
  so she works in healthcare.
• 2:39
  So she went down to a Go Health by us to get tested.
• 2:41
  And when they called her back and said she was indeed positive right
• 2:45
  away over the phone, they called in a prescription for paxlovid, and
• 2:49
  she asked me to go to the pharmacy to pick it up for her, which I did.
• 2:51
  And when I went, I was pleasantly surprised because when I went to go
• 2:54
  pay, they said it was $0, free of charge.
• 2:57
  So I was like, wow, great.
• 2:59
  Oh, wow.
• 3:00
  I read that, and I wasn't sure.
• 3:00
  Wow.
• 3:03
  I'm like, is it free?
• 3:05
  Yeah, I was surprised.
• 3:06
  I had the card right there, ready to go, and they were like, no
• 3:09
  charge.
• 3:10
  I was like, oh, this is great.
• 3:12
  So there you have it.
• 3:14
  By the way, I wish your wife well.
• 3:18
  So are you isolated?
• 3:21
  I am isolating.
• 3:22
  That's why I'm in the basement right now.
• 3:24
  And, um, well, she's up in her room, but I'm in the basement.
• 3:27
  That's why I'm doing this recording.
• 3:28
  But she is taking the paxlovid, and I think I don't know if you would
• 3:31
  call them pills or tablets, but she's supposed to take three twice a
• 3:35
  day, so it's it's six doses for five straight days.
• 3:39
  So, Rob, it sounds like she's done the right thing.
• 3:42
  So far.
• 3:43
  They recommended paxlovid, which is frequently what you hear about.
• 3:47
  But I think there's another one.
• 3:50
  This one is called I've never heard of it.
• 3:53
  molnupiravir.
• 3:55
  When do you use that drug versus paxlovid?
• 3:59
  We're going to sort this all out with our expert.
• 4:02
  And, Sandra, you just mentioned our guest today.
• 4:04
  We're speaking with Dr.
• 4:05
  Onisa Stefus, who is the chief executive officer of Vivo Health
• 4:09
  Northwell's outpatient pharmacy network consisting of retail, mail
• 4:12
  order, specialty, and clinical pharmacy services.
• 4:15
  Vivo provides comprehensive care and outpatient pharmacy services to
• 4:19
  more than 80,000 patients.
• 4:21
  And Dr.
• 4:22
  Stefus has really grown this pharmacy network from the ground up.
• 4:25
  And he's just really a brilliant person.
• 4:27
  He's been methods from the beginning, helping us wade through what we
• 4:30
  need to know about the vaccines.
• 4:32
  And he's actually, Sandra, the person that mixed the COVID vaccine
• 4:35
  that went to you, that wound up being the first COVID shot that was
• 4:40
  basically heard around the world.
• 4:41
  Yes.
• 4:42
  I remember him walking in with the vial, and it was like liquid gold.
• 4:50
  So I know he's an expert, and he will help us sort all of this
• 4:55
  treatment out.
• 4:56
  But it's important for people to know that the treatments, these
• 5:00
  COVID-19 treatments, work by lowering the amount of virus in your
• 5:05
  body, reducing symptoms, and helping one to avoid hospitalization.
• 5:12
  And I think now is the time to get to that interview.
• 5:14
  So here is our conversation with Dr.
• 5:16
  O nisa Stefas.
• 5:24
  Good afternoon, Dr.
• 5:26
  Stefas.
• 5:26
  It's so nice of you to join us today.
• 5:29
  Hello.
• 5:31
  So we've come a long way in our fight against COVID-19.
• 5:34
  I remember you were instrumental in my vaccination process, so thank
• 5:41
  you for that.
• 5:43
  But today we want to talk a little bit about the treatments that are
• 5:48
  out there for mild to moderate cases of the virus.
• 5:54
  When someone has COVID, what can or should they do for symptoms?
• 6:00
  Symptoms in terms of COVID The good thing is that the majority of
• 6:06
  patients today are receiving COVID with mild symptoms.
• 6:12
  These mild symptoms consist of fever, chills, cough, fatigue, sore
• 6:18
  throat, congestion, typical things that you may see with either the
• 6:22
  flu or that you may see with a common old.
• 6:26
  And the goal is that if you're experiencing mild COVID, you should
• 6:30
  really stay home to minimize the exposure and get tested.
• 6:36
  But with that, there's also over the counter products that you can use
• 6:42
  to help you during this period of time.
• 6:45
  Now, the thing to keep in mind is the over the counter products that
• 6:48
  we're going to discuss today doesn't actually fight against the virus
• 6:53
  or treat the virus.
• 6:54
  What it does is it makes you and your body more comfortable as you
• 6:59
  fight off the COVID-19 virus.
• 7:02
  So that that's really important to note, and a good majority of the
• 7:07
  people can go ahead and do that without any other further
• 7:10
  intervention.
• 7:12
  What are the ones that you can go to the store and buy over the
• 7:15
  counter?
• 7:16
  So it's very similar to what you would get if you had a cold or a flu.
• 7:20
  You can pick up acetaminophen or ibuprofen, which is also known as
• 7:24
  like Town, all, motorin and Advil.
• 7:26
  Those products could be used for body aches.
• 7:29
  They can also be used for fever, as that's one of the symptoms that
• 7:34
  you would want to focus on, particularly fever for myelcode, to make
• 7:37
  sure that you keep that in check.
• 7:39
  You can also take lozengers for your sore throat or use a vapor rub
• 7:44
  for your congestion so you would understand what your symptoms are.
• 7:48
  And then from there you would pick up a remedy within the local
• 7:52
  pharmacy to resolve those symptoms as your body is fighting off the
• 7:56
  virus.
• 7:57
  I wouldn't load up Proactively on a lot of different over the counter
• 8:00
  medications, because, as you know, COVID can exhibit differently
• 8:04
  within different people, that you would just get a good understanding
• 8:07
  of what that is and try to meet them, particularly if they're mild
• 8:11
  symptoms.
• 8:12
  Dr.
• 8:13
  Stefas it sounds like there are a lot of treatments on the market to
• 8:17
  treat COVID-19, both for nonhospitalized patients and for hospitalized
• 8:23
  patients.
• 8:24
  I wonder if you could talk us through some of these treatments.
• 8:29
  When I think of COVID I break it down into a couple of different
• 8:32
  categories.
• 8:33
  I look at it as mild COVID for fairly healthy people that will resolve
• 8:38
  on its own, and then from there, you would typically pick up over the
• 8:42
  counter items just to make yourself comfortable as you go ahead and
• 8:45
  you start fighting off the infection.
• 8:48
  You then have prescription items like Paxovid and Mong and pure beer,
• 8:54
  which are oral, ant, viral medications.
• 8:56
  And what they do is they stop the replication of the virus.
• 9:00
  Typically, if you talk to a provider and you're over 65 or you have
• 9:00
  Virus.
• 9:05
  other comorbidities like diabetes, COPD, cardiovascular disease,
• 9:10
  immunocompromised providers will typically write for these agents to
• 9:15
  reduce the chance of it progressing to severe COVID and requiring
• 9:20
  hospitalization.
• 9:21
  It is free of no charge today, and a lot of times the pharmacies will
• 9:26
  even deliver it to the home.
• 9:29
  But with that, you do need a prescription.
• 9:31
  So you do need to talk to a prescriber most of the time in order to
• 9:35
  get that product, which would then be prescribed to the pharmacy and
• 9:40
  then sent to your home.
• 9:44
  Paxilvid, or Paxlivid, has been actually really good because even
• 9:48
  during all the various different mutations, variance and iterations of
• 9:51
  COVID it still remains highly effective.
• 9:54
  And the goal is to get on treatment within five days of symptoms.
• 9:59
  How effective is it?
• 10:01
  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
• 10:12
  symptoms, you take it over the course of about five days.
• 10:16
  And and what?
• 10:18
  We mean effective, we mean reduces the potential for hospitalization.
• 10:24
  Most consumers have heard about Paxilovid, but I wasn't aware of this
• 10:29
  antiviral, but I read about it.
• 10:32
  Malnutrivir.
• 10:34
  When would you use that versus a Paxovid?
• 10:38
  Okay.
• 10:39
  Great question, Sandra.
• 10:40
  So, Malnutriavir is another antiviral medication has a little bit of a
• 10:45
  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.
• 10:53
  Now, with monoconavir, however, it has much less drug interactions.
• 10:59
  So there are a certain number of drugs that if you're on, then you
• 11:02
  can't take taxovit, but you can take monoprivier.
• 11:06
  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.
• 11:15
  But unfortunately, it's not as effective, but it's better than not
• 11:19
  taking anything at all.
• 11:21
  When should I take Paxylavid?
• 11:23
  So basically, PAXEL bed needs to be taken the moment that you test
• 11:26
  positive.
• 11:27
  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
• 11:34
  replication of the virus.
• 11:35
  So the less virus in your body, the more you can attack those and the
• 11:39
  less replication you get and the quicker your body can fight off
• 11:43
  whatever is remaining.
• 11:46
  That's good to know because I get this question all the time from my
• 11:50
  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
• 11:58
  Paxovid.
• 12:00
  But thanks for that information.
• 12:02
  I'll tell them to get right on it.
• 12:04
  Right.
• 12:04
  And if you're really bad, if you wind up in the hospital, what can be
• 12:07
  done inside the hospital from there?
• 12:11
  There's another antiviral on the market called Remdenzavir, and
• 12:16
  Remdenzevir is typically used for hospitalized patients similar to
• 12:21
  Paxovitaminoprivir, but it's in the IV form and you can get it in an
• 12:26
  outpatient setting, but you would need to get it as an infusion three
• 12:30
  days in a row in an outpatient setting or in more severe cases,
• 12:34
  hospitalized.
• 12:36
  There are multiple options out there for patients in order for them to
• 12:40
  get treated and get better.
• 12:41
  It's really important to understand and appreciate the different
• 12:45
  variants that are out there and the new variants that are coming,
• 12:49
  because a lot of that really does go into consideration in terms of
• 12:53
  what treatment options you're going to use.
• 12:56
  So, for example, the monoclonal antibiotics are no longer authorized
• 13:01
  to be used.
• 13:02
  And that's basically based on the new variants that are out there
• 13:06
  today, that those monoclonal antibodies are having a hard time
• 13:10
  detecting the COVID-19 virus within your body because when those
• 13:15
  mutations of those variants occur, they occur on the spike protein,
• 13:19
  which is the sticky part that comes out of the virus.
• 13:22
  And that's what these monoclonal antibodies are using to identify
• 13:26
  COVID and then ultimately kill the virus.
• 13:31
  When you're talking about these antivirals like Paxlivid, Mama
• 13:36
  Pierrevira or Remdenzvir, those actually reduce the replication of the
• 13:41
  virus, mostly by attacking an enzyme, and that doesn't change.
• 13:46
  Right.
• 13:46
  So even as COVID is mutating that virus, that results in the
• 13:52
  replication I'm sorry, that part of the virus that results in the
• 13:55
  replication of the virus is unchanged and continue to be targeted.
• 13:58
  And that's why you're still seeing good numbers of efficacy as it
• 14:03
  pertains to Paxabenopiravir and Remandsvir.
• 14:06
  And that's why those continue to be the drugs of choice.
• 14:10
  We have all these variants, they just seem to pop up, it seems like
• 14:14
  weekly, and I think you mentioned this before, but I just want to be
• 14:19
  clear.
• 14:20
  Does Paxlevid work against Omecron and all its subvariants?
• 14:25
  Yes, Sandra, it does.
• 14:27
  It would be the same with the monopriver and the ring denzivir.
• 14:31
  Once again, because they're antivirals and not the monoclonal
• 14:34
  antibodies, they continue to remain their effectiveness based on their
• 14:38
  mechanism of action, of focusing on the replication of the virus, not
• 14:42
  actually killing the COVID-19 that's circulating in your body.
• 14:46
  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.
• 14:55
  What can be done to get more people on PAX LoVid to help fight off
• 14:58
  COVID?
• 15:00
  I just think it's continued awareness and greater education.
• 15:04
  It's interesting because when Paxovid first came out, it was very
• 15:09
  little supply, right?
• 15:09
  So it was a tremendous demand and a little supply.
• 15:12
  So it was embedded within the prescribers and other folks that should
• 15:17
  really only use this and the patients that have the potential to be
• 15:21
  the most sickest that are out there.
• 15:23
  Now that we do have a very good supply where there's more supply than
• 15:27
  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.
• 15:38
  And I think as people get more comfortable with the product and people
• 15:42
  really understand the nuances between those things, I'm hopeful that
• 15:46
  there'll be more and more uptake of the product resulting in less
• 15:51
  hospitalization and overall less depth.
• 15:54
  Awesome.
• 15:55
  Well, you mentioned awareness, and on 20 Minutes Health Talk, that is
• 16:00
  our goal, to raise awareness and to educate our audience.
• 16:04
  So thank you very much for joining us today.
• 16:06
  Great.
• 16:07
  Well, Sandra, it was an honor to participate in your vaccination, and
• 16:10
  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
• 16:20
  COVID vaccinations and treatments and everything that you do.
• 16:23
  So it's an honor and pleasure to join you today and just wanted to
• 16:28
  thank you for that.
• 16:29
  My pleasure.
• 16:38
  So, Sandra, that was a great conversation.
• 16:40
  And it's great that we learned so much today about there's such a
• 16:44
  supply of this PAX, flow of it.
• 16:46
  So if we did get COVID, we know there's something that we can do to
• 16:49
  lessen the disease and hopefully be feeling better quicker.
• 16:53
  Yeah.
• 16:54
  Rob, that was a fascinating conversation with Dr.
• 16:58
  Stefas.
• 16:58
  And something else that he said that was encouraging is that Paxovid
• 17:04
  in particular is effective against the many variants and subvariants
• 17:11
  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
• 17:24
  Medical Research.
• 17:28
  like tamiflu for the flu.
• 17:29
  And the Feinstein, also working with Cold Spring Harbor National
• 17:33
  Laboratory, have really been out in the forefront of trying to do
• 17:36
  research to find new treatments to take care of COVID If you do get
• 17:40
  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
• 17:55
  home, which is great.
• 17:57
  And also, too, that you could just have it delivered.
• 18:00
  Delivered from your pharmacy.
• 18:01
  And for the PAX lovin, it's free.
• 18:04
  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.
• 18:15
  Yeah, like we talked about, because there's so much research, it gives
• 18:18
  even more hope.
• 18:19
  And we're going to zero in on one research project in particular on
• 18:23
  next week's episode, which looked at the common over the counter
• 18:26
  heartburn drug called femotidine, better known as Pepsid, as a
• 18:30
  potential treatment for COVID-19.
• 18:32
  We spoke with the head investigator, Dr.
• 18:34
  Tobias Janowitz, who is an assistant professor at the Cold Spring
• 18:37
  Harbor National Laboratory and an adjunct professor at the Feinstein
• 18:40
  Institutes for Medical Research.
• 18:41
  We sat down with Dr.
• 18:43
  Janowitz back in December at Cold Spring Harbor.
• 18:46
  We found that fermotidine may help patients recover sooner as they
• 18:51
  have sustained inflammation because of COVID-19.
• 18:54
  To essentially alleviate this inflammation early and make patients
• 18:59
  feel better sooner.
• 19:01
  Make sure to check back with us next week for the full interview.
• 19:04
  As we wrap up here, I want to thank Dr.
• 19:06
  Onisa Stefus, who has really been along with us the whole way here at
• 19:10
  20 Minutes Health Talk, helping us break down the COVID vaccines.
• 19:12
  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.
• 19:17
  So big.
• 19:18
  Thanks to Dr.
• 19:19
  Stefas.
• 19:20
  Such a great conversation.
• 19:22
  Thank you to the listener for tuning in to 20 Minutes Health Talk.
• 19:25
  I'm Rob Hoyle.
• 19:26
  And I'm Sandra Lindsay.
• 19:28
  Thank you for listening.
• 19:32
  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
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