A COVID Answer Raises a Question

Are wait times for antivirals limiting access?

By Candace Pedraza

NEW HOPE: Antivirals can combat COVOD-19 symptoms but New Yorkers have had trouble getting them. (Unsplash/Karolina Grabowska)

When Octavius Moore tested positive for COVID-19 in two at-home tests, he got advice from co-workers about how to go about treating his symptoms. 

They let him know that he could call a city hospitals system hotline to get a prescription for an oral antiviral treatment.

“So yeah, I called…which was horrific. It took me three times calling the number to actually get it,” said Moore, a 28-year-old Flatbush resident working at a nonprofit called Tech:NYC, who spent 30 minutes on three separate calls trying to get in touch with someone to get a prescription filled at a pharmacy near him. 

Since he was on the phone for close to an hour and tried three separate times to reach an operator, he added that he fell asleep due to the fatigue from his Covid-19 symptoms. An operator who eventually picked up had to yell into the receiver so Moore would respond. 

Moore’s experience—experiencing a lengthy wait on the phone to get a prescription and needing a friend to pick up the prescription since he was too sick to go himself—has not been unique. Issues with delayed service from the one digital pharmacy contracted by the city to deliver the antiviral drug Paxlovid have been common, NY1 reported. 

“I’m hoping there’s an easier way… I don’t know if they’re understaffed or if the queue is that long for people to get in contact with them,” Moore said. “But yeah, it took me at least a full 24 hours to get in contact with them and pick up the prescription.” 

When asked about these phone delays, Dr. Ted Long, a senior vice president at New York City Health + Hospitals who is executive director of the NYC Trace & Test Corps, called the hotline a “phone tree.” When residents call the designated number, they have a few steps to go through before reaching the right operator.

“There’s no wait for dialing that and seeing what the options are, based on what option you select. If you select option nine, it’s our virtual ExpressCare platform,” he said during a press conference on April 1. “You could think of it as a virtual version of the emergency department. There are sometimes during the day where the emergency department is busier, sometimes where it’s less busy.”

Folks who are older might not have access to the same information you have on social media.

Dr. Oni Blackstock

Founder and executive director, Health Justice

According to data provided by the U.S. Centers for Disease Control, there are 600 New York City pharmacies distributing antiviral treatments like Paxlovid, Remdesivir and Molnupiravir. Most distributors are chains such as CVS and Walgreens or hospital-system pharmacies.

These treatments, pills that need to be taken over the course of five days or medication provided intravenously that have to be given to a patient for three consecutive days, have to be used quickly after someone tests positive. Otherwise, they lose their effectiveness, making a functioning phone tree and distribution system all the more important.

“The thing that I think people find frustrating is when people end up in the hospital and you find out that they did go to a provider, they did ask about antivirals. And their provider said, ‘Oh, let’s wait and see. Maybe you won’t have a severe case,’ ” said Dr. Anna Bershteyn, a professor of population health at New York University. “And with these drugs, you really shouldn’t wait and see—you should just do it.”

Bershteyn added that the city could consider additional “creative” approaches, such as having pharmacy workers recognize when someone has come in with symptoms and offering them a test. More surveillance testing, in which random pools of tests are used to determine neighborhood infection rates, would also help, she said.

Dr. Oni Blackstock, founder and executive director of the New York-based Health Justice consultancy, said the city should seek to improve its messaging on antiviral treatments. Much of the promotion for the pills is done through social media—something that not all New Yorkers use every day.

“Folks who are older might not have access to the same information you have on social media,” Blackstock said. “I do think that the city does need to do more, maybe more targeted outreach to community members who are in these different groups, who would benefit the most from it.”

People 65 and older and those who are immunocompromised are considered top candidates for antiviral treatments. Those who test positive and have symptoms but aren’t immunocompromised can still qualify for certain treatments, according to Health + Hospitals.

With the city now seeing a “high” level of transmission because of an increase in COVID cases—and the White House anticipating a new surge this fall and winter—antivirals are seen as vital in preventing hospitalizations and deaths.

An earlier version of this story was published in City & State.