The war in Ukraine has pushed the pandemic from the headlines, but the Biden administration is warning that the $1.9 trillion COVID relief fund is running out. After House Democrats removed $15 billion for COVID relief from a larger government funding bill, President Joe Biden predicted “severe consequences” if additional funding is not provided.
Meanwhile, the consumer price index shows inflation rising 7.9% over the last year, hitting a four-decade high, and the producer price index shows a 10% rise. The national debt is over $30 trillion.
Our nation’s finances are long overdue for a belt-tightening, and COVID prevention and treatment are easy places to start without any drop-off in effectiveness.
While early treatment is the best outcome for any illness, prevention is an even better strategy. The White House should take a page out of former first lady Michelle Obama’s playbook and encourage people to eat well, exercise, lose weight, and ensure sufficient Vitamin D (and other) stores. These factors demonstrably strengthen natural immunity and have been shown to prevent serious COVID outcomes. Nearly 40% of U.S. adults age 20 and over are obese, meaning millions more people are at higher risk of hospitalization and death from COVID.
For those who do contract COVID, there are more treatment options. For example, fluvoxamine is an FDA-approved generic medicine that is cheap, widely available, and proven effective in gold-standard, randomized, controlled trials published in the Journal of the American Medical Association and the Lancet. Known best for its treatment of obsessive-compulsive disorders, fluvoxamine costs $4 for a 10-day dose.
Compare that to Pfizer’s experimental antiviral drug Paxlovid, the only treatment name-checked by the administration in its “new” national COVID-19 Preparedness Plan and the State of the Union address.
The federal government is spending about $530 for each five-day course of Paxlovid. After the drug was granted emergency use authorization in December 2021, the Biden administration agreed to an advance purchase of 10 million packs of Paxlovid at a cost of about $5.3 billion.
Despite the high price tag, Paxlovid comes with a catch: It takes more than six months to produce. From the beginning, the drug was only available in very limited quantities. In December 2021, an initial batch of 65,000 courses was made available in the United States. At the same time, new U.S. COVID cases were hitting their all-time highs — more than 265,000 per day. While supply has caught up to demand as the omicron variant fades, questions remain about Paxlovid’s readiness during future COVID spikes.
Moreover, Paxlovid was approved after a single trial with questionable results. It cannot be taken by those on certain antidepressants, anti-seizure, anti-psychotic, cholesterol, blood pressure, or several other classes of medications. This exclusionary criterion encompasses a significant portion of the overall population, given that almost half of all adults in the U.S. have some type of cardiovascular disease.
To distribute Paxlovid, the Biden administration is pushing a “Test to Treat” initiative that requires pharmacies to have a prescriber on-site. But the American Medical Association has labeled “dangerous in practice and precedent” the prescription of pills without knowledge of a patient’s history, especially given the numerous and worrisome drug interactions with which this pill is associated. Doctors should use their expertise and knowledge of their patients rather than rely on what an anonymous bureaucrat far away believes is the best treatment.
More than two years into the pandemic, we are armed with more knowledge. We know COVID is highly preventable and treatable using well-studied, repurposed medications. We know that relying on vaccines won’t stop the spread, especially with the COVID variants. Some of the most heavily vaccinated populations, such as Israel, have similar or higher case counts than those countries with far lower vaccination rates.
We must also not rely solely on Paxlovid, given its costs, questions about effectiveness and supply, and the fact that a large share of the population cannot take it.
Yet the administration is once again putting profits before public health. In mentioning the Pfizer drug by name in the State of the Union address, the president is showing the clear bias the government has for expensive, high-profit drugs while ignoring lower-cost readily and widely available treatments such as fluvoxamine, ivermectin, and hydroxychloroquine.
Only with a change of course and broader focus will Biden succeed in truly tackling the pandemic, which is a cause every American can get behind.
Pierre Kory, M.D., is president and chief medical officer of the Front Line COVID-19 Critical Care Alliance.
