Treating and managing COVID-19 will look very different in 2022 as Australia is likely to hit 80% vaccination rates for those over 16 in weeks. Instead of driving to a clinic to be tested, Australians may be able to test themselves at home after the Therapeutic Goods Administration approved rapid antigen tests last week.
Managing symptoms will be easier too. Vaccines reduce the likelihood of developing severe illness and over-the-counter pills will soon be available now the government has secured 300,000 courses of molnupiravir, an antiviral capsule that helps prevent serious illness. (The drug manufacturer, Merck, is charging the US government 40 times what it costs to make the drug.)
But it’s not all sunshine, roses and limited sniffles: treatments are still limited, at-home testing kits have limitations, and vaccines are still our best bet.
What medications are there?
Sales of hydroxychloroquine, an antimalarial and anti-rheumatic drug, and ivermectin, an anti-parasitic drug used on large farm animals, grew in Australia across the first year of the pandemic, despite limited evidence of effectiveness. Instead of dosing up on horse medication (the TGA cracked down on ivermectin prescriptions last month), Australians will soon be able to use a range of medications.
Fifteen thousand doses of sotrovimab, an antibody treatment that mimics the natural antibodies produced by the immune system, have landed on our shores. When intravenously administered within five days of COVID symptoms appearing, it reduces the likelihood of being hospitalised or dying by 79%.
The government has snatched up doses of molnupiravir, which is in late-stage clinical trials. Studies show it could reduce the risk of hospitalisation and death by 50%. The pill is taken twice a day for five days for those with COVID symptoms.
Yesterday the TGA also granted provisional determination to an oral antiviral treatment being developed by Pfizer — designed to block the activity of a key enzyme the virus needs to replicate — and tocilizumab, a treatment for patients on ventilators.
Remdesivir and dexamethasone have also been used for those hospitalised with COVID, and tocilizumab too, although there are critical shortages of this arthritis drug.
As simple as swabbing at home?
The TGA’s approval of rapid antigen testing will not replace the lab PCR tests which have been used across Australia. PCR test results generally take six hours to run and are analysed in a lab; rapid antigen testing can give results in as little as 10 minutes. But rapid antigen testing is less reliable than PCR tests, returning false negatives to those with a low viral load and false positives to the uninfected.
The Royal College of Pathologists of Australasia has called for caution in the use of these tests, which can only be done by those who have undertaken training. Someone who returns a positive rapid antigen test will still have to get a PCR test.
Despite their limitations, rapid antigen testing is promising. Their fast turnaround time means they can be used in airports, transport hubs, schools and eventually homes, and widespread use in outbreak areas can get positive cases into isolation faster.
Vaccines still our best bet
Vaccines are still the best measure at protecting against COVID-19 — but their efficacy does wane. From Sunday the Israeli government will strip more than a million citizens who received their second vaccine more than six months ago of their vaccine passports.
Israel was the first nation to use the Pfizer vaccine and the first to widely introduce booster shots for the elderly and immunocompromised as infections started to rise in August.
Australia has yet to release details around the vaccine booster program.
The TGA has also recognised China’s Sinovac and India’s Covishield, locally manufactured versions of AstraZeneca, for incoming international travellers. The vaccines haven’t been approved for use in Australia but will allow travellers to quarantine at home within months.
Would you be comfortable using rapid antigen tests rather than PCR tests? Let us know your thoughts by writing to letters@crikey.com.au. Please include your full name if you would like to be considered for publication in Crikey’s Your Say column. We reserve the right to edit for length and clarity.
Understand Israel has found waning effectiveness for Pfizer after 6 months and has started doing booster shots, but according to Haaretz six weeks ago, the issue was also about dealing with still unvaccinated:
‘As of August 21, the Health Ministry recorded 215.9 severe COVID-19 cases per 100,000 people among the unvaccinated over the age of 60, compared to 21 per 100,000 people among those who had received two doses of the Pfizer vaccine. This makes unvaccinated older people more than 10 times as likely to experience a severe case than their immunized counterparts.’
Vaccines and effective roll outs to a high percentage of the population are essential to protect against Covid, both old and now the younger end. However, nations need to be careful about dropping all restrictions, quickly for ‘freedom’, to cover gaps by significant numbers who remain unvaccinated.
This means social contract still needs to be upheld and is not helped by PMs etc. promising some ‘freedom day’ nirvana and sunlit uplands without responsibility (using as a political opportunity to attack those exercising caution) …. As some EU nations do, keep masking on transport, public buildings, supermarkets and education settings (important: unvaccinated kids and youth were deemed to be high spreaders in some nations, when older people were the priority for vaccination), showing vaccination certificate to enter public buildings, events and museums.
Big yep – we are being set up for ‘covid is just the flu’ Aus style with ‘freedom day’ etc rhetoric imo. The ‘social contract’ is being/has already been re-engineered into ‘dance freely for my profits until you drop drones’ as significant numbers of people now regard covid control measures rather than covid as the problem that needs to be addressed. The Doherty Institute saw cause to write: “We’ve learned from watching countries that have removed all restrictions that there is no ‘freedom day’. We will need to keep some public health measures in place . . .and it is unlikely that we will need generalised lockdowns.” https://www.doherty.edu.au/news-events/news/statement-on-the-doherty-institute-modelling Potential for future lockdowns also appear in Phase C (over 80%) of the National Plan but never gets a mention, our over 16s vax rates are repeatedly misrepresented as being the equivalent of ‘don’t ya wannbe free like’ countries’ percents of total pop (our 80% = 64% total) etc etc and while I have yet to read the article to know the nature of the inflammatory rhetoric being used to portray states wanting funding to expand hospital capacity as the enemies of ‘freedom’ it may yet top the woeful list of agenda serving public betrayals as it is dogs balls obvious that more cases require more medical resources. Israel found that 59% of those hospitalized were fully vaccinated – hence the requirement for 3 shots – but “boosters are unlikely to tame a Delta surge on their own, says Dvir Aran, a biomedical data scientist at Technion. In Israel, the current surge is so steep that “even if you get two-thirds of those 60-plus [boosted], it’s just gonna give us another week, maybe 2 weeks until our hospitals are flooded.” https://www.science.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta There is also no funding for worker’s comp nor for supporting kids with long covid and we rush to open despite that delta isn’t alpha for kids and if we waited a couple of months they could be vaccinated and protected. And NSW plans to shift focus to the economic “positives” instead of on the unpleasant realities the non-elite will be suffering . . .
I’m not sure what the Qld joke in the graphic refers to. Surely not just another gratuitous drive-by?