Problem is, production is still not at its full strength. Also, Pfizer's pill, which is considered superior, takes six to 8 months to make.
Although the supply of the drugs is expected to increase dramatically over the next months, doctors are still clamoring for them. This is not because omicron is causing a surge in cases, but because two anti-omicron antibodies that were once the best haven't worked against it.
Erin McCreary (a University of Pittsburgh Medical Center pharmacist and administrator) said, "This should be an extremely joyful time because we now possess highly effective antiviral medications." "It feels like this is the most difficult and chaotic stretch of the pandemic."
The highest-risk patients are the ones who will be receiving these pills and any other COVID-19 drugs.
Dr. Myron Cohn, University of North Carolina virologist, said that January will be a difficult month with more than a million cases per day. "Most people will do well. But we need to pick out those who are not and give them the drugs that we have."
Based on research showing that they reduce the risk of death and severe disease when taken within a few hours of symptoms appearing, the Food and Drug Administration approved the Merck and Pfizer pills late last month. These are the first COVID-19 treatment patients can take at-home, which could help reduce hospitalizations.
The U.S. did not make mass purchases ahead of time like it did for vaccines.
The company claims it can only supply approximately 250,000 units of Paxlovid because of the time required to make the pill.
Although the U.S. has already ordered enough Paxlovid for 20 million patients, the first 10,000,000 orders won't arrive until June.
Jeff Zients, White House COVID-19 Coordinator, stated this week that Pfizer and the government worked together to speed up the development of the pill. He also said that officials are continuing to work with Pfizer in order to find ways to increase production.
Pfizer stated that it is increasing capacity. "We expect to utilize our strong manufacturing capabilities as well as our extensive supplier network in order to continue to increase output quickly."
Molnupiravir, the Merck pill, is simpler to make and more readily available.
Final testing revealed that it was not as effective as Pfizer's pill. It also carries significant risks including the possibility of birth defects if taken by pregnant women. It is therefore considered to be the last-choice option according to federal guidelines.
Merck stated that it has shipped 900,000 units of the drug and will ship the remaining 3 million orders by the U.S. before the end of this month.
The government has provided enough Pfizer tablets to 164,000 people since last month. They have also allocated them by population. Some states with higher caseloads are critiquing this approach.
Dr. Mary Bassett, Health Commissioner, stated that New York's allocation of money -- enough to treat approximately 20,000 people -- is not sufficient.
She stated that "we need more of these drugs to alter the course of this pandemic" and decrease hospitalizations.
According to state guidelines, doctors should give preference for drugs to patients at highest risk. This includes cancer patients, transplant recipients, and pregnant women with lung disease or other serious health problems. New York's guidelines recommend that certain racial or ethnic minorities be given priority due to their higher death and severe illness rates.
Different states distribute the pills in different ways.
All initial shipments to Michigan went to 10 pharmacies located in the most affected areas. Pennsylvania, Maryland and Texas have all distributed the drugs more widely than Texas, so at least one pharmacy is available in every county.
Some patients were able to obtain the pills despite the strict prescribing guidelines. This was largely due to luck and persistence.
Craige Campbell, a Desert Hot Springs website manager, started leaving messages with his doctor right away after he tested positive for COVID-19. He also developed a 101-degree fever. He was able to obtain a prescription quickly despite not having any underlying medical conditions.
Campbell had to have the drug picked up by a friend because the nearest pharmacy that sold it was over an hour away.
He said, "I felt a little privileged in some way." "The odds of it landing in my plate in the correct amount of time were quite extraordinary."
There is also a shortage in antibody medications, which are infused drugs or injections that can prevent death and hospitalization. GlaxoSmithKline's only effective drug against omicron is being rationed.
Federal officials have imposed a limit on the number of doses that can be shipped to it. They will only allow 50,000 per week. The government has announced that 600,000 doses will be added to the 400,000 it purchased in November.
The staff at the UPMC hospital in Pennsylvania can now treat fewer than 1000 patients per week with antibodies. This is a decrease from the 4,000 that were treated during the pandemic.
In the United States, doctors and nurses have devised complex methods to decide who should receive the rare medications. This is based on the patients' symptoms and underlying medical risks. They also consider where the patient lives and whether or not they are able to travel for infusions.
"What do you have?" Dr. Greg Schrank, University of Maryland Medical Center, answered the first question. "Which of these therapies is the most effective? And how do we make sure it reaches the people who are at greatest risk?
As hospital staff struggle to manage increasing admissions, the treatment situation becomes more complicated.
Nearly 128,000 Americans with COVID-19 were admitted to hospital on Sunday. This is more than the 125,000 who visited the hospital in January. Although COVID-19 patients are now less likely to require intensive care than before, hospitals are experiencing a surge in demand.
Schrank stated that Pfizer's pill arrived at the right time considering this threat.
He said, "It won't turn the tide on total cases, but it could help dampen the effect on hospitals."