02/22/23 Health Advisory: Increase COVID-19 Treatment Access, Prescribing and Uptake

| February 22, 2023

COVID-19 treatment is shown to reduce hospitalization. Yet it is under-used for high-risk patients with acute COVID-19. High-risk patients are:

  • Moderately to severely immunocompromised.
  • Pregnant.
  • 65 years or older.
  • 50 years or older with a chronic health condition.

COVID-19 continues to cause 2,000 to 3,000 deaths each week in the United States.

On Feb. 6, Washington State Department of Health (DOH) relaunched its free telehealth program. The program, in partnership with Color Health, expands on the federal government’s Test to Treat initiative. The program served more than 6,000 Washington patients July–December 2022. 70% of those patients received treatment.

Requested actions

  • Talk with symptomatic or COVID-19-positive patients about treatment options.
  • Encourage treatment for patients at high risk of severe illness.
    • Strongly consider treatment for people who are:
      • 65 years or older.
      • Pregnant, especially those with comorbidity.
      • 50–65 years old and have a chronic health condition (mainly if not up to date on COVID-19 vaccine or booster).
      • Moderately to severely immunosuppressed because of:
        • Congenital or acquired immunodeficiency.
        • Solid organ transplant.
        • Bone marrow transplant.
        • Active malignancy receiving chemotherapy.
        • Immunosuppressive therapy.
    • Consider treatment for people with certain medical conditions:
      • Chronic respiratory disease.
      • Cardiovascular disease.
      • Hypertension
      • Chronic kidney disease (eGFR ≥ 30 mL/min).
      • Diabetes.
      • Obesity (BMI ≥35 kg/m2).
      • Complex genetic or metabolic syndrome.
      • Severe congenital anomaly.
      • Neurodevelopmental disorder.
      • Sickle cell disease.
      • Medical technology dependence (e.g., tracheostomy).
    • Consider treatment for people who:
      • Have limited access to care.
      • Belong to a community COVID-19 disproportionately impacts.
  • Patients must take antivirals within 5 days of symptom onset (or positive test, if asymptomatic).
  • Prioritize antiviral use as follows:
  • See Administration for Strategic Preparedness and Response’s (ASPR’s) COVID-19 therapeutic distribution locator for current availability of COVID-19 treatments and Test to Treat locations.
  • Make sure patients know it is important to test as soon as they have COVID-19 symptoms and contact a healthcare provider right away if they are at high risk of severe illness.
  • Review patients’ other medications and health issues to determine if antivirals or other interventions are right for them.
    • For many patients, the benefit of treatment will outweigh the risk of side effects or the short-term holding of chronic medications that may interact with COVID-19 therapies.
  • See DOH’s therapeutics information for healthcare providers page for fact sheets, guidance and information about contraindications.
  • For updates on therapeutic products, see ASPR’s COVID-19 page.
  • Know how to access and direct COVID-19-positive patients who are 18 years or older to DOH’s free telehealth program. Especially promote the program with people who belong to socially vulnerable communities, like those in rural or underserved urban areas.

Resources