COVID-19 pills show promise, but will they be a game changer?

Two treatments are on the way — one from Pfizer and one from Merck.

The new COVID-19 treatments from the drugmakers will have both medical and psychological benefits, which have the potential not only to reduce the seriousness of the virus but can also reduce the fears and help society move back to normalcy.

Both Pfizer’s and Merck’s treatments are oral antiviral pill regimens that people will have to take for five days after a COVID-19 positive test. The pills will be a protease inhibitor, a type of medicine class, which works by inhibiting an enzyme the virus needs to replicate in human cells, similar to treatments that revolutionized HIV care in the 1990s.

While Pfizer’s version, which is likely to be available early next year, appears to be the more effective, with an efficacy rate of 89% found in a research trial, Merck’s version, which should be available sooner, reduced risk by 30%, the two companies claimed.

On Tuesday, an FDA panel of experts voted narrowly — 13 to 10 — to recommend the approval of the Merck treatment, molnuporavir; however, the agency has not yet said when its experts might vote on Pfizer.

30 pills, 5 days

Pfizer CEO on Tuesday told CNBC that the drugmaker would produce pills to treat as many as 20 million people in the first half of 2022 and another 60 million in the second half. The Biden administration has also agreed to buy 10 million courses of the treatments, Paxlovid, at the cost of about $530 each.

Roughly 10 million courses can cover every American aged 65 and above who tested positive for COVID-19 in the past year, and still millions of doses will still be there for treating others.

Merck expects to produce more than 10 million treatments of molnupiravir by the end of this year and at least 20 million more in 2022. The federal government has agreed to buy 3.1 million courses for around $700 each.

Both treatments will present logistical challenges as people will need to have a COVID-19 positive report and then receive a doctor’s prescription.

At least for the next several months, only vulnerable people — those who are older or have medical conditions — may be eligible.

While, in Pfizer’s case, the treatments involve a detailed schedule of pill-taking: three pills, twice a day, for five days, for Merck, two more pills per day.

Pandemic side effects

In reality, the virus has already been primarily defanged for most Americans, unless there would be significant health threats due to Omicron.

While currently, the death rate for vaccinated adults under 50 is almost zero, the hospitalization rate is similar to typical flu. For children vaccinated and not, the risks are even smaller, according to data published by the U.S. government.

Moreover, it is hard to return to normalcy after living with a pandemic for nearly two years, especially with uncertainty about Omicron. Once the treatments are widely available, they can offer reassurance as a last line of defense against severe COVID-19 threats.

Of course, the medical benefits will be even more significant than the psychological benefits for people who still remain vulnerable to coronavirus.

Deaths are mostly occurring among the unvaccinated, although vaccinated Americans older than 65 — especially those with pre-existing health issues — are also at some risk.

While the major advantage of antiviral pills is that people can take them at home, unlike current two-dose vaccines, which are typically administered in a hospital, there is also another advantage.

The oral pills do not attack the spike protein of coronavirus, the part of the virus that changes most with each new variant, giving scientists hope that the treatments will work even as the virus evolves.

Picture Credit: SCMP