Antiviral pills are soon available to treat COVID-19. But is America ready?

COVID-19 antiviral pills will soon be approved, but it only gives sick Americans a 72-hour care clock when symptoms appear.

It’s been 21 months since COVID-19 hit the U.S. in full force, and we seem to be right back to where we started: wondering whether we have enough tests. The urgency today stems from new COVID-19 antiviral pills from Pfizer and Merck that will soon be fully approved by the Food and Drug Administration (FDA). Pfizer announced Tuesday that it has prepared the first shipments of its COVID-19 antiviral pill PAXLOVID. Promising news was also announced this week for Merck’s Molnupiravir at-home treatment.  

A new survey shows that the vast majority of Americans would be willing to take a COVID-19 antiviral pill once approved. But will our traditional healthcare system be able to deliver pills in time to all who need them? Will testing be able to show who’s infected and who needs the antiviral pills? Will we be able to deliver drugs to patients quickly enough for them to be effective, including to the 60 million of us Americans who live in rural areas? The successful deployment of antiviral medication hinges almost entirely on effective COVID-19 testing protocols. We must get testing right and companies like ours at Nomi Health can show the way. Testing must happen early, often and fast.

At Nomi Health, our 2,500 team members nationwide have spent the past 21 months refining the delivery of COVID-19 care in more than 10 states including Utah, Iowa, Nebraska, Texas and Florida. To date, we’ve implemented effective testing, vaccinations and even monoclonal antibody treatment for more than 10 million Americans, and we conduct more testing on a daily basis than all the big box pharmacies combined. We built a vertically integrated healthcare delivery system for effective, scalable COVID-19 testing deployment in both big cities and rural counties. We saw firsthand why our traditional healthcare system was unprepared for these new realities of care delivery. Now, the country must deliver more testing at scale so that hospital beds free up for the sickest patients and antiviral pills can be delivered quickly to those in need.

Here’s how we believe it should work:

1. Test early -- Americans must get tested at the earliest onset of possible symptoms. Access to testing cannot be restricted by cost, location or the confirmation of symptoms. Americans need easy access to a COVID-19 test where they live, work or play. Mobile care units must serve communities alongside physical sites. Delivery teams must keep open hours so that it’s effortless to receive testing before or after work and school.
2. Test often -- People must have easy access to testing with zero out-of-pocket costs. This helps guarantee frequent testing in their communities. The Biden Administration has been adamant about this since the beginning when they planned for up to 25 million tests per month--but we’re still far short of reaching even a fraction of that goal.
3. Expedite results -- Americans must receive a PCR result within 24 hours. This is key. If PCR results take any longer, people testing positive lose critical time for effective treatment with the antiviral. The Merck presentation to the FDA this week makes clear how the antiviral medications work, including noting treatment should begin within just five days of the onset of symptoms.
4. Treat immediately -- Once symptoms emerge and a positive test result is delivered, people must be directed to the right care protocol as quickly as possible. Imagine this: Upon receiving your positive test result, you get an electronic prescription from licensed telemedicine staff, and a follow-up text or email directing you to the nearest pharmacy for pickup of the antiviral medications. Ideally, you will be offered the option of at-home delivery.

If COVID-19 antivirals are to work, we must have a sound deployment plan. The clinical community has done tremendous work in research and development on truncated timelines. Now, the country must meet the operational challenge to deploy the drug effectively, at scale and across communities large and small. We must get testing right--and speed is of the essence. Traditional healthcare hasn’t been able to deliver to date. Nomi Health, as a newer market entrant, is changing that. As a country, we now have another shot to get testing right, and this time, the stakes are even higher.