Simply after 1 p.m. on Tuesday final week, my cellphone buzzed with a textual content message from my mom: “Effectively, got here down with chilly, aches, cough and many others over wknd.” She had taken an at-home coronavirus check. It was constructive.
Having spent the previous 12 months writing about Covid-19 vaccines and coverings for The New York Occasions, I knew rather a lot concerning the choices obtainable to folks like my mom. But I used to be about to go on a seven-hour odyssey that will present me there was rather a lot I didn’t grasp.
My mom, Mary Ann Neilsen, is absolutely vaccinated, together with a booster shot, which sharply lowered the percentages that she would develop into severely unwell from the virus. However she has a number of threat components that nervous me. She’s 73. She has twice crushed breast most cancers.
Her age and most cancers historical past made her eligible to obtain the most recent remedies which were proven to stave off the worst outcomes from Covid. The difficulty, as I knew from my reporting, was that these remedies — together with monoclonal antibody infusions and antiviral drugs — are onerous to return by.
Demand for the medication is surging because the Omicron variant of the coronavirus infects report numbers of Individuals. However provides are scarce. The 2 most generally used antibody manufacturers don’t seem to work in opposition to Omicron, and the antiviral drugs are so new and had been developed so shortly that not many have reached hospitals and pharmacies.
I got down to monitor down considered one of two remedies: GlaxoSmithKline’s antibody infusion or Pfizer’s antiviral drugs, often known as Paxlovid. Each have been discovered to be protected and extremely protecting in opposition to extreme Covid when given to high-risk sufferers inside just a few days of the onset of signs. Each are potent in opposition to Omicron.
Considered one of my first steps was to look on-line for lists of pharmacies and clinics close to my mom’s house in Santa Barbara, Calif., that may have one of many medication in inventory. (I dwell in Washington State, so my quest was performed, like a lot else today, remotely.)
Some states, like Tennessee and Florida, have helpful on-line instruments for locating a facility with monoclonal antibodies in inventory. However I couldn’t discover one for California. I checked a federal database, which had just one itemizing inside 25 miles of my mom.
Once I referred to as that well being system, I used to be instructed that it had run out.
I additionally hunted for Paxlovid. From my reporting, I knew a few federal database of pharmacy chains, hospital methods and different suppliers which have positioned orders for the drugs. A Occasions colleague downloaded the information, as anybody can do, and despatched it to me in a extra simply searchable format.
The checklist turned up just a few prospects, largely pharmacies, close to my mom. I dialed the closest one, a CVS, however an worker knowledgeable me that the shop had shortly run out of the primary cargo of drugs and didn’t know when extra would come.
After just a few extra calls, I discovered a Ceremony Help, greater than an hour’s drive from my mom’s house, that had Paxlovid in inventory. The pharmacy warned me that the availability was going quick.
Nonetheless, this was excellent news. I figured I had simply surmounted the hardest impediment, and solely two hours had handed since my mom examined constructive. Now I simply wanted to get her a prescription.
I had already requested my mom to name her physician’s workplace and request a cellphone name along with her doctor so she might ask for a prescription for one of many remedies. She reported again to me that the receptionist had instructed her that they “don’t do” both the Glaxo or Pfizer remedies.
That didn’t make sense to me: The Meals and Drug Administration has approved the medication. Why wouldn’t docs be prescribing them? Pissed off, I referred to as her physician’s workplace to get a proof. (I didn’t determine myself as a Occasions reporter, in that cellphone name or the others I made that day, partially as a result of I didn’t wish to create the looks of searching for preferential remedy.)
The worker who answered the cellphone instructed me that the docs there had but to conduct their very own medical evaluation of Paxlovid and, as a matter of coverage, couldn’t but prescribe it. Furthermore, the worker instructed me, my mom would want an appointment to talk to a health care provider, and there have been no slots till per week later.
I started attempting to find one other physician who would promptly write a prescription.
I attempted scheduling visits with a number of telemedicine suppliers, together with CVS and Teladoc, however I stored seeing a equally worded notification on the consumption kinds: They weren’t writing prescriptions for Paxlovid or molnupiravir, the same antiviral tablet from Merck.
(Later, I requested each corporations about these insurance policies. A CVS spokeswoman mentioned suppliers had been prescribing the antiviral drugs to sufferers they noticed in particular person at some shops however not by way of telemedicine. A Teladoc spokesman mentioned the corporate believed at this level that “it’s most applicable” for the antiviral drugs to be prescribed in particular person.)
I began calling pressing care clinics and well being methods close to my mom to see if they might write her a prescription. At one level, we even acquired her on a video name with a health care provider at a close-by well being system.
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Maddeningly, we had been repeatedly instructed the identical factor: Their docs couldn’t write prescriptions for Paxlovid throughout digital appointments. My mom must be evaluated in particular person — seemingly defeating the aim of a distant physician’s appointment.
In any case, this was a nonstarter, as a result of my mom lives alone and doesn’t drive, and the clinics weren’t inside strolling distance. She wouldn’t contemplate taking a taxi or a bus and threat exposing others to the virus. On this regard, my mom isn’t alone. Tens of thousands and thousands of Individuals depend on public transportation. And people with vehicles threat spreading the virus whereas searching for prescriptions in particular person.
Different medical services I referred to as that afternoon offered me with info that was simply plain flawed. One particular person instructed me that no monoclonal antibody remedies had been obtainable in California. One other insisted that Paxlovid was just for hospitalized sufferers.
Ultimately, my scramble to discover a prescriber turned out to be pointless. Within the early night, my mom acquired an sudden name from a health care provider along with her major care supplier. She instructed the physician about her signs and concerning the Ceremony Help I had discovered with Paxlovid in inventory.
The physician instructed her that he was stunned that we had been capable of monitor down Paxlovid. He phoned in a prescription to the Ceremony Help.
Now we simply wanted to choose up the drugs earlier than the pharmacy closed in about an hour.
Uber got here to the rescue. I requested a pickup on the Ceremony Help and listed the vacation spot as my mom’s house, some 60 miles away.
As soon as a driver accepted the journey, I referred to as him and defined my uncommon request: He’d must get the prescription on the pharmacy window after which drive it to my mom’s. I instructed him I’d give him a one hundred pc tip.
The driving force, who requested me to not use his title on this article, was sport. He delivered the valuable cargo simply after 8 p.m. My mom swallowed the primary three drugs — the start of a five-day, 30-pill routine — inside minutes of the driving force’s arrival.
“Taking meds & very grateful to have them,” she texted within the household group chat.
By some measures, my search was profitable. My mom began taking the drugs solely two and a half days after her signs started and inside eight hours of testing constructive.
Inside just a few days, she began feeling higher. She completed the routine this previous weekend.
However the truth that the method was so onerous for a journalist whose job it’s to know how Paxlovid will get delivered shouldn’t be encouraging. I fear that many sufferers or their household would quit when instructed “no” as many occasions as I used to be.
I used to be additionally reminded that even a “free” remedy can include important prices.
The federal authorities has purchased sufficient Paxlovid for 20 million Individuals, at a price of about $530 per particular person, to be distributed freed from cost. However I spent $256.54 getting the drugs for my mom. I paid $39 for the telemedicine go to with the supplier who instructed my mom that she would to go to in particular person. The remainder was the Uber fare and tip. Many sufferers and their households can’t afford that.
President Biden just lately referred to as the Pfizer drugs a “sport changer.” My expertise suggests it gained’t be fairly so easy.