Correction: Due to inaccurate information previously published on the federal Department of Health and Human Services website, an earlier version of this story wrongly indicated that there was a test-to-treat location in Richford. As of April 19, Health and Human Services has corrected its website to reflect there are no test-to-treat locations in Vermont.
In his State of the Union address in January, President Joe Biden promised a new strategy for defeating Covid-19. One key element was a new “test-to-treat” program, where Americans could take an antigen test and immediately receive antiviral therapy if they qualified for it.
But Vermont pharmacies soon learned that none of them had the infrastructure needed to participate in the program, which required in-pharmacy clinics. One month later, doctor’s offices, too, have mostly failed to join the program.
There are no test-to-treat locations in Vermont, according to the U.S. Department of Health and Human Services.
However, getting antiviral treatment in Vermont is still an option for high-risk individuals. Research shows that antiviral therapy can lower the risk of hospitalization and death, particularly if taken early in the course of the disease.
Here are more details about getting antiviral treatment.
What antiviral medications are out there?
Antiviral therapies work by targeting viral activity within the body, according to the National Institutes of Health. They work best when taken early in the disease because they limit viral replication, which happens early in the course of the disease.
One antiviral therapy for Covid, remdesivir, has been fully approved by the U.S. Food and Drug Administration, but it is administered only through injection, typically in hospitals or clinical settings.
Two oral medications — Paxlovid and molnupiravir — have Emergency Use Authorizations from the FDA, and both are available in Vermont. The U.S. Department of Health and Human Services reported it distributed 220 units of Paxlovid and 72 units of molnupiravir to Vermont in the week ending April 17.
Of the two medications, Paxlovid is considered the more effective, with an estimated 88% reduction in hospitalization and death for patients who take it, according to the U.S. Centers for Disease Control and Prevention. Molnupiravir reduces severe outcomes by about 30%.
Another treatment option is monoclonal antibodies, which target specific spike proteins on the SARS-CoV-2 virus. Because their effectiveness depends on the viral strain, right now only bebtelovimab is distributed to Vermont. The health services agency reported it gave Vermont 140 doses of it last week.
Primary care providers are often the people who decide which medication to prescribe, or whether to direct someone to the hospital for treatment, said Georgia Maheras, vice president of policy at the Bi-State Primary Care Association. Which drug you get may depend on your demographics or the latest research.
“It feels like every day there’s new information about these therapeutics. It’s a pretty fluid scenario,” she said.
I tested positive for Covid. How do I get antiviral therapy?
The best way to find out if you qualify for antiviral treatment is to call your health care provider, Maheras said. “They know about all the other things that are going on in your body,” she said.
You can also find out if you’re in a high-risk category for Covid by going to the CDC website. Everyone over age 65 is considered high-risk, along with people who have chronic medical conditions such as cancer, diabetes, lung disease or kidney disease. Smokers and people who are overweight are also at higher risk of Covid complications.
Once you’ve learned that you qualify and receive a prescription for antiviral medication, the next step is finding a pharmacy that carries the drug. That can be complicated, Maheras said.
“It’s not like there’s tens of thousands of these therapeutics just pouring into the state,” she said. “A challenge that we’re all managing through is trying to make sure it gets to other parts of the state when there’s not an overabundance of supply.”
The U.S. health agency website has a list of places that carry antiviral pills.
According to Vermont Department of Health spokesperson Katie Warchut, the state works to make sure “select Kinney Drug locations, hospital emergency departments and a few independent pharmacies have a supply of antivirals on hand. Some other locations, like CVS, receive a separate federal supply,” she said via email.
What if I don’t have a doctor? Or insurance?
Maheras said that even if you don’t have a go-to primary care provider such as a family physician, you may be able to get treatment through a couple of different places.
You can call one of Vermont’s nine free and referral clinics, which provide free services to Vermonters who need help obtaining health care. The state also has federally qualified health centers that provide primary care services on a sliding-scale payment system. The health department recommends calling 2-1-1 for more information.
Urgent care clinics in your community might also be an option, Maheras said. You can also go to the emergency department of your local hospital, but she said that should be a last resort unless you have symptoms that need immediate treatment, such as difficulty breathing or a high fever.
Antiviral treatment should be free even if you are uninsured, Maheras said. Although Congress allowed funding for free Covid treatment to expire last month, other resources have gone directly to providers or to the state.
“There’s a few different layers that provide some level … of assurance that the individual should not be the one bearing the burden,” she said. “Eventually that could be problematic, but in the moment, I think folks should not let financial concerns be a barrier to getting this specific care.”
Still, she recommended making it “very clear” to explain that you’re someone with insurance.
She admitted it may be difficult for one particular population to obtain this therapy: People who are homebound or have another disability that makes it difficult for them to reach a pharmacy in person.
“I would hope that whoever you talk to … is also able to provide information around that, ‘oh, you know, a courier can deliver it’ or we can figure out (how to) tap into the transit system, or whatever those specific solutions are,” she said.
