By Frankie Snow
From PHN Issue 45, Winter 2021
The Search for the Right Treatments
Over the past year, many types of medications have been studied and tested as possible treatments for COVID-19. Currently there are some that are approved by the Food and Drug Administration (FDA) on an emergency basis and some that have been shown to be effective but are still being studied. It’s important to get health information from trusted sources and talk with a doctor about what is best for your health needs if you are seeking treatment for COVID-19.
Many people catch COVID-19 but do not require treatment because they do not have symptoms. Others may be able to recover on their own, with basic care like rest, drinking enough water, and acetaminophen (Tylenol). Other cases become more severe and require further treatment. Reports from Prison Health News readers and journalists have indicated that prisons are not offering the same treatments available on the outside. The information in this article is being shared to help our readers know what treatments should be available to them. When filing a grievance or lawsuit, it may be helpful to specifically list what medications have not been offered. The following are different treatment options available outside prison, based on the severity of symptoms.
Treatment Outside the Hospital for Mild Cases That Could Become Severe
For those at risk for developing severe COVID-19 symptoms, certain treatments have been recommended and are available outside the hospital.
These medications are still being studied but have been given an emergency authorization by the FDA. They work by attaching to a part of the virus and then helping the immune system to recognize and fight against the virus. They are recommended for those who have tested positive and have mild to moderate symptoms, but are at risk for severe symptoms and hospitalization because of a chronic health condition or older age. These medications are not authorized for anyone already hospitalized.
- Bamlanivimab & Etesevimab are medications developed with a human-made version of an antibody that naturally develops the body’s ability to fight the virus. They have been authorized for emergency use by the FDA as of 2/9/21. These medications include a protein created in a lab that is given intravenously with an IV as a single dose within 10 days of onset of symptoms.
- Casirivimab & Imdevimab are also antibodies made in a lab to help build up the body’s immune response. These medications are used in combination and given by IV.
- Convalescent Plasma: This treatment uses blood donated by people who have recovered from COVID-19 to help treat those who are still ill by building up their immune response. The plasma from the donated blood is transferred by IV, and it contains antibodies for COVID-19, helping the body understand how to fight the virus. This type of treatment—with the blood of recovered patients—has been used for over a century to treat illnesses like measles, chickenpox, polio, and SARS. This treatment has been shown to be most effective very early after symptoms develop.
- Acetaminophen (Tylenol) can be used to reduce a fever and help with muscle aches. It’s important to follow the directions. If taking multiple types of cold or flu medicines, some might also have acetaminophen in them, so be careful to not exceed the daily dose. The maximum dose for acetaminophen per day is 3,000 mg.
- Ibuprofen (Advil or Motrin) has been recommended by the World Health Organization as a treatment to help reduce fevers and muscle aches during COVID-19. Some doctors have concerns about taking them regularly; however, there is currently no data to support these concerns. For individuals with kidney issues and ulcers, it is best to consult with a doctor before taking ibuprofen. The maximum daily dose for ibuprofen is 3,200 mg, and it is important to monitor if taking multiple types of pain relievers.
Treatments During Hospitalization for Severe Cases
- Remdesivir (Veklury): This is the only drug that has been formally approved by the FDA to treat COVID-19 beyond just experimental and emergency use (as of January 31). In studies, it has reduced recovery time for COVID-19 by preventing the virus from multiplying and spreading throughout the body. The medication is given by IV.
- Baricitinib (Olumiant) in combination with remdesivir: Baricitinib is an arthritis medication that has been authorized for emergency use as treatment of COVID-19 when used with remdesivir. It helps to fight the virus by slowing inflammation and may also act as an antiviral medication. Baricitinib can be taken as a pill, though it is only recommended for those who are hospitalized with COVID-19 and are on a mechanical ventilator or receiving supplemental oxygen.
Blood Thinners or Anticoagulant Medications
- Heparin or Enoxaparin: Many people who are hospitalized for COVID-19 may receive blood thinners to prevent the development of blood clots. To prevent clots, a doctor would prescribe heparin or enoxaparin at a low dose, but to break down clots that have already developed, they would prescribe higher doses. The dose is important, because too high of a dose can also lead to internal bleeding.
These medications can help to prevent organ and tissue damage in severe cases of COVID-19 when the body’s immune system reacts very strongly. Anti inflammatory medications are only recommended for severe cases of COVID-19. In less severe cases, prescribing anti-inflammatory medications can worsen symptoms.
- Dexamethasone: Though it is not yet authorized by the FDA for COVID-19 treatment, studies have shown that it helps to prevent lung injury by reducing inflammation. Individuals on a mechanical ventilator or supplemental oxygen are the primary target for this treatment.
- Other anti-inflammatory medications: When dexamethasone is unavailable, other anti-inflammatory medications including prednisone, methylprednisolone or hydrocortisone have been used.
Other Treatments with Poor or Unclear Results
Effectiveness in COVID-19 unknown as of January 31: Amlodipine, ivermectin, losartan, zinc
Show no or little benefit as treatment for COVID-19: Famotidine, lopinavir, and ritonavir have been studied and are found NOT to be effective.
Can cause harm to patients: hydroxychloroquine and chloroquine have been found to be ineffective and have caused heart problems for patients.