COVID Arsenal Needs Pills as Well as Shots

More than 60 million Americans are fully vaccinated for Covid-19, and the number rises daily. But some people aren’t willing or easily able to get vaccinated, and others won’t be able to get the shot for medical reasons, such as immune suppression. Another good weapon for the Covid arsenal would be a safe and effective drug that could be taken at home. Such outpatient drugs exist to prevent and treat the flu, and one public-health focus should be developing a Covid pill that could be taken after exposure, or soon after symptoms appear, to stop the infection from progressing.

So far outpatient treatment options have been either therapeutic antibodies or repurposed medicines off the shelf. Antibodies, when given early, are very effective at preventing Covid hospitalizations and reducing the severity of symptoms. But they’re hard to administer outside a hospital setting, currently requiring time-consuming infusions. Manufacturers and public-health leaders should focus on research to make these infusions fast and easier, and to develop one-time shots that could also be used for prevention.

A few repurposed drugs work, such as remdesivir and the steroid dexamethasone, which reduces the risk of death in patients who require oxygen or mechanical ventilation. More studies will help suss out the benefits of repurposed drugs, but so far many of these options have failed to show benefit in preventing mild Covid from progressing when studied in well-designed trials.

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