As much of the U.S. attempts to return to a tentative “normal,” the national conversation has shifted from vaccinations and mask mandates to COVID-19 treatments. Even though new Omicron subvariants have rendered monoclonal antibodies ineffective, other COVID-19 treatments continue to work. From steroids to antivirals, many treatment options have experienced their moment in the spotlight—and their fair share of misinformation.
With improved treatments, many available for home use, some people have promoted the idea that vaccination is no longer important or that the pandemic is effectively over. That isn’t the case. Here’s a breakdown of what COVID-19 treatments are available and what they can and can’t do for people fighting COVID-19. Of course, only a health care provider can tell you which treatment is right for you.
Prevention is always better than treatment
It’s important to remember that in medicine and public health, a preventative method (the vaccine, in the case of COVID-19) is always preferable to any treatment. There’s no way of knowing how your body will react to a COVID-19 infection or treatments. Maybe you’ll have a mild fever and headache—or maybe you’ll wind up in the hospital with low oxygen and pneumonia or worse. Even with more effective drugs and treatment protocols available, COVID-19 remains deadly, killing hundreds of Americans every day. Additionally, not everyone is eligible for all COVID-19 treatments. Many are limited to people who are high-risk and must be taken within days of when symptoms set in.
Highly infectious Omicron subvariants have mutated enough from earlier variants of the virus that some standard treatments have become less effective. We can’t know in advance if the next variant will be more severe (like Delta) or more infectious (like Omicron). It’s better to protect yourself by getting vaccinated before new variants emerge. Vaccines take the guesswork out of the equation, dramatically reducing your risk of getting seriously ill.
Authorized or approved COVID-19 treatments
COVID-19 wreaks havoc on the body in two ways: One is the damage from the virus itself spreading throughout the body; the other is caused by the immune system going into overdrive, damaging the lungs and other organs. Steroid treatments are anti-inflammatory and target COVID-19’s second mode of damage, tempering the immune response. These treatments are used for people who are already quite ill with COVID-19 and whose immune systems are causing harm rather than fighting off the infection.
Dexamethasone is a corticosteroid that can reduce the risk of organ damage and death from COVID-19 inflammation. The National Institutes of Health (NIH) recommends the use of dexamethasone for hospitalized COVID-19 patients on supplemental oxygen or ventilators. In some severe COVID-19 cases, doctors prescribe dexamethasone in combination with remdesivir.
Antiviral treatments are drugs that prevent viruses from replicating and spreading in the body. Early antiviral treatment can shorten the length of COVID-19 infection and slow the progression of the disease. But the treatments have a relatively brief window of effectiveness against COVID-19 because, beyond a certain point, simply slowing replication will not be enough to reverse the course of the disease.
In December 2021, the FDA authorized the use of the antiviral pill Paxlovid, the first at-home treatment for mild-to-moderate COVID-19. The treatment reduces the risk of hospitalization and death by up to 88 percent. It’s authorized for use in recently diagnosed (within five days of symptom onset) COVID-19 patients ages 12 and up who are at high risk for severe illness. The treatment has remained effective against the latest variants of concern.
Remdesivir, the only drug that is approved by the FDA for COVID-19 treatment, is used to treat COVID-19 patients aged 28 days and older. As of April 2022, remdesivir is the only COVID-19 treatment approved for children under age 12. After Paxlovid, remdesivir is the preferred treatment for mild-to-moderate high-risk COVID-19 patients within seven days of symptom onset. The drug was originally developed as a potential Ebola treatment. In early studies, it was found to reduce the recovery time of COVID-19 patients. The most pronounced effect was seen in patients requiring supplemental oxygen but not ill enough to need ventilation. Doctors administer remdesivir intravenously in a hospital. Like Paxlovid, remdesivir appears to be effective against the latest variants of concern.
Molnupiravir is the third antiviral to receive FDA emergency use authorization and the second at-home COVID-19 treatment authorized to reduce the risk of hospitalization and death in mild-to-moderate cases. The FDA recommends molnupiravir only when other treatments are not available. When taken early in the illness, the treatment cuts hospitalization risk in half. It does so by blocking viral replication and preventing mild or moderate COVID-19 from progressing to severe illness.
No matter what you might hear, COVID-19 treatments are not a substitute for vaccination, which is still the best protection. Even the most effective treatment is no magic bullet; it’s just one more tool in the fight against COVID-19.