Paxlovid is a tablet that prevents the virus that causes Covid-19 from multiplying in your body. Since levels of the virus (called viral load) remain low, its immune formula can fight the germ. This means that your health may not be so poor that you could die or have to go to the hospital. Trials show that the risk of death decreases by nearly 90% when a user takes the drug within five days of an illness.
New studies show that it’s also helping to lessen the threat of a prolonged outbreak of Covid-19, a condition in which a user continues to feel ill health long after the initial infection (called the acute phase) has cleared, and which can persist for months, eventually. This is because the virus stays in the frame and bypasses immune cells.
Symptoms can include chest pain, nausea and abdominal discomfort, incessant ringing in the ears, shortness of breath, disturbances in sleep patterns, and abnormal heartbeat, which is why the condition is so difficult to diagnose.
Jooste had taken a roughly nine-hour flight from Dubai to Durban, sitting across from a maskless guy who coughed incessantly. Two days after landing, he began to feel like he was catching the flu; it was a bit like when I had Covid in April last year. At the time, the disease made her so tired that she couldn’t exercise and found it hard to concentrate and not forget things – “brain fog” is not unusual in other people with Covid.
I didn’t need to go through that again.
At the time, Jooste’s symptoms persisted long after she got over the worst of the immediate infection, which usually clears up within 14 days, and while she can’t be sure, she wouldn’t be surprised if she had Covid for long.
Research suggests that the threat of contracting the long-term edition of Covid-19 is similar to the number of symptoms a user reports when sick, with more than five in the first week, headaches, body aches, shortness of breath and fatigue. , expanding the possibilities.
Jooste ticked the boxes of the units. She is also a woman and is over 50 years old, two points more risk for the emergence of the disease.
But the challenge is that it is difficult to pin down the duration of Covid because there is no precise diagnosis, nor do we know for sure how it develops, says Resia Pretorius, head of the Department of Physiological Sciences at Stellenbosch University.
According to studies conducted by Pretorius and his team, it appears that the disease affects almost any and all organ systems, as the virus damages the lining of blood vessels (throughout the body) and affects the way things like immune cells, oxygen, and nutrients are used. enter and exit the frame. blood.
Because few symptoms of long Covid are clear enough to verify a diagnosis, and because there is no definitive control or agreed definition, the disease is believed to be only in the head.
“It’s a diagnosis of exclusion, where doctors want to know precisely what they’re looking for,” Pretorius says, “and unfortunately, those doctors are very few. “
Chasing a unicorn
With a dubious diagnosis, getting drugs that can help save you is rarely a priority for most doctors, or even if they’re worth investing in.
For Paxlovid to work, you will need to take the pills within five days of the onset of the disease.
Jooste learned that he needed to receive it before the end of the week if he was looking for any chance of reducing the threat of him having severe symptoms or a prolonged Covid.
But, as a global fitness media advisor for Internews, an independent foreign media organization, part of her search was driven by journalistic curiosity.
Would pills be similarly and seamlessly available to everyone?Or is access to the remedy symptomatic of a divided and unequal fitness formula in South Africa?
It turns out that getting the pills is as complicated as getting a diagnosis.
“I was surprised at how complicated it is to prescribe [Paxlovid],” Jooste says.
While searching for a script, he also tried to figure out where the drugs were stored.
He called retail pharmacies in Durban and then also hospital pharmacies, but none had it. A retail store at an Umhlanga hospital, which is part of a giant chain, checked all its branches and found the drug in a single hospital in Johannesburg.
How much does it cost
The pill parcel was sent to Durban and collected on the last day of the period in which the start of treatment would be effective.
But is the difficulty of medicine just a matter of unequal access?
Although South Africa’s Health Products Regulatory Authority registered Paxlovid in January, the drug is “not widely found in South Africa,” says Andy Gray, a senior lecturer in pharmacology at the University of KwaZulu-Natal and a member of the National List. the Committee for Essential Medicines, which advises the government on medicines to be purchased for public institutions.
For a price of just over R14,000 for the five-day course, “the value is insufficient for most,” Gray says. “It is not included in the National List of Essential Medicines,” which means that the Ministry of Health will not buy it. .
But value is rarely the only deciding factor; There are many other things that must also be taken into account when the government has to decide what medicines it buys for the country; It also comes into play to determine whether this is practical and how many other people will gain advantages.
“Starting treatment after a diagnosis a few days after symptoms appear is challenging,” Gray says. A patient should undergo a Covid-19 test and the doctor should check if Paxlovid could be an option for him as it can interact with many other medicines, all before the tablets can be dispensed at a pharmacy.
“Not everyone would be able to get tested or treated early enough for the remedy to work,” he says.
But, he says, an even bigger challenge is that it’s unclear to what extent the availability of drugs like Paxlovid would benefit the country, even if South Africa got a less expensive edition of the pills.
The drug has been approved for generic production through the Medicines Patent Pool, but no pharmaceutical company has implemented it for registration, Gray says. In addition, a generic form of the drug would only be sold to the state.
“There is theoretical merit that Paxlovid would possibly do anything to prolong the duration of Covid, but we don’t know who is at risk [of developing the disease]. And we don’t know if there’s strong evidence that an early viral load replacement effects on another [outcome].
Tired of being tired
The risk of long Covid is higher in women, people over 50 and those with other physical conditions, such as high blood pressure or diabetes, issues that mean that it is not unlikely that more than 10-20% of people who have had Covid-19, according to estimates, may move on to extend the long version.
Of those who contract Covid long, one in 10 has to stop running. In a global survey, about a fraction of other people with persistent symptoms may simply not function a full day six months after their first illness and about a quarter were not running on time. All at that time because they were exhausted after doing undeniable things, like washing dishes or walking to department stores and having a cloudy head.
The non-descriptive set of symptoms of prolonged Covid resembles myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS for short), a condition in which a user becomes incredibly tired after taking on undeniable physical or thinking responsibilities and may simply expand after becoming inflamed with a non-unusual type of herpes virus, the Epstein-Barr virus.
Although the symptoms have been described in medical texts for about 90 years, doctors did not begin to accept them as a true disease until the mid-1990s, leading to stigma and reduction of the disease, similar to that of long Covid.
“People with ME/CFS just didn’t do it [in the past] and were told that all their symptoms were in their minds,” Pretorius says. But just because there is rarely a biomarker or diagnosis for a disease doesn’t mean it doesn’t exist. it doesn’t exist – it just means we still want to locate it – just as it was for ME/CFS in the past.
“We don’t perceive all the adjustments [in our bodies] because of Covid, which leads to a lot of other symptoms being present for a long time,” Gray says. “And without that, we don’t know how to treat it. “
Research should focus first on understanding the disease and diagnosing it, rather than using interventions like Paxlovid, he says.
Did Jooste find the answer he was looking for in his search for Paxlovid?
She is not sure: “With or without medication, with a prolonged Covid, there will be inequalities in terms of paid leave, hospitalization and information. “
This article was produced by the Bhekisisa Center for Health Journalism. Subscribe to receive the newsletter.
In the last five years, none of the goals pursued by political leaders after the last round of high-level discussions on TB at the UN General Assembly have been achieved.
Gray is the board’s first female president and CEO and has chaired the Covid-19 Research Committee.
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