Treatment for COVID-19 in NYC

Treatment for COVID-19 including oral antiviral pills is currently available for at-risk New Yorkers free of charge. Monoclonal antibody (also known as mAb) treatments are covered by Medicaid and Medicare plans at no cost. NYC Health + Hospitals provides care regardless of immigration status or ability to pay.

Both oral antiviral treatments and monoclonal antibodies are available. Two oral antiviral pills are available for COVID-19 in New York City: Paxlovid and molnupiravir.

Paxlovid is prescribed as three pills taken twice a day for five days, while molnupiravir is prescribed as four pills taken twice a day for five days.

Both pills are available through a selected number of pharmacies across the city. You can find a list of those nearby on a federal website.

Monoclonal antibody treatment, which is a one-time intravenous (IV) treatment, is also available for use to eligible individuals. Locate nearby sites offering this kind of treatment using the HITE locator website.

If you are moderately or severely immunocompromised or unable to get vaccinated because you are allergic to the vaccine or any of its components, talk to your doctor about Evusheld — an injectable drug that increases your protection against COVID-19.

Find additional information on COVID-19 treatments available:

• US Food & Drug Administration – Know Your Treatment Options for COVID-19
• NYC Department of Health & Mental Hygiene – COVID-19 Treatments Are Available

For most of the treatments, at-risk individuals are eligible. Those who are considered at-risk include people who have tested positive for COVID-19, have mild to moderate symptoms and those who are at increased risk of developing severe illness.

People ages 12 and older who test positive for COVID-19 (using any type of test) and have symptoms that began within the last five or seven days are eligible for oral antivirals or monoclonal antibody treatments, respectively. Ask about treatment, especially if you:

• Are age 65 and older
• Have an underlying health condition, such as obesity, diabetes, heart conditions, chronic lung conditions, chronic kidney disease, a weakened immune system, or are pregnant

For Evusheld, individuals should not have COVID-19 disease or have had recent close contact with someone who has COVID-19. People who are eligible should be moderate to severely immune compromised or unable to be vaccinated.

Individuals older than 12 and weighing more than 40 kilograms, or around 88 pounds, are eligible to receive Paxlovid and Evusheld but you have to be at least 18 years old to take molnupiravir.

People with severe kidney or liver disease may not be eligible for Paxlovid but moderate disease is not a contraindication. Molnupiravir cannot be used during pregnancy, and if you are pregnant or breastfeeding, you should talk to your provider before taking Paxlovid.

To see if you qualify for monoclonal antibody treatment, use the Monoclonal Antibody Eligibility Screening Tool.

It is important for individuals to talk with their providers about the medications they are taking or planning to take, as they could negatively interact with available treatments.

Oral antiviral treatments have been proven to reduce hospitalization and death from COVID-19 if taken soon after the onset of symptoms.

Paxlovid reduced the risk of hospitalization and death in high-risk, unvaccinated people by 88% when taken within five days of the onset of symptoms as shown in a Pfizer trial published in December 2021, before the first Omicron wave.

Molnupiravir reduced the risk of hospitalization and death in high-risk, unvaccinated people by 30% when taken within five days of the onset of symptoms, according to an analysis from Merck that was published in November 2021.

In a study using real-world efficacy data evaluating oral antivirals during Omicron, Paxlovid has been shown to reduce the risk of hospitalizations or death by 46% with similar effectiveness in both vaccinated and unvaccinated patients. In another study, Paxlovid has also been shown to reduce the risk of hospitalization in patients 65 years or older by 67%, and reduce their risk of death by 81%. Similarly, in a study evaluating efficacy data during Omicron, Molnupiravir has been shown to reduce the risk of hospitalization and death by 44%.

Evusheld, which can be administered as often as every six months, was found to be strongly effective in preventing the development of symptomatic COVID-19 or death according to a clinical trial conducted by AstraZeneca.

Monoclonal antibodies have also been shown to be highly effective in preventing severe illnesses and hospitalizations.

Both Evusheld and monoclonal antibody treatments have also been shown to be effective against the latest Omicron variants.

Oral antiviral pills such as Paxlovid and Molnupiravir work by targeting specific proteins on the SARS-CoV-2 virus (the virus that causes COVID-19) to prevent its replication within the body.

For more information on Paxlovid and other oral antivirals, you can refer to an information sheet provided by the U.S. Department of Health and Human Services.

Monoclonal antibodies are made in a laboratory and work as substitute antibodies that can help fight an infection before the body mounts its own immune response.

Evusheld is a combination of two long-acting monoclonal antibodies, tixagevimab and cilgavimab, that bind to the spike protein of the virus and prevents it from entering and infecting cells. Evusheld is administered through intramuscular injection and should be re-administered every six months to ensure enough antibodies are present in the body to fight an infection in case an individual is exposed.

Paxlovid is tolerated well by patients. Side effects that have been seen in small numbers in clinical trials include bad taste, diarrhea, hypertension, and soreness.

No serious side effects have been reported for Molnupiravir. Possible side effects could include diarrhea, dizziness, and nausea.

Because monoclonal antibodies are given intravenously, some people may experience a rash at the injection site.