No Americans should die of COVID-19 with treatments available, experts argue
As mask mandates are lifted, and mitigation measures are increasingly dropped across the nation, a stark reality continues to hinder the nation's return to a pre-pandemic sense of normality. Hundreds of Americans are still losing their lives to COVID-19 every day.
However, with the growing availability of coronavirus vaccines and antiviral treatments, many health experts assert that, given the United States' tremendous medical advancements in the fight against the virus at this point in time, few Americans should still be dying of COVID-19.
"It should be pretty close to 'no one,'' Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center, told ABC News.
Infectious disease experts say that the vast majority of those still dying are the unvaccinated. In February, unvaccinated adults were 10 times more likely to die of COVID-19 compared to vaccinated individuals and five times more likely to require hospitalization.
When compared to fully vaccinated and boosted adults, unvaccinated people were about 20 times more likely to die of COVID-19 and seven times more likely to require hospitalization.
"We have vaccines that, for people with normal immune systems, are about 90% effective at preventing hospitalization, and, for those who get COVID-19 and have even a single risk factor for progression to severe disease, we have treatments, like Paxlovid and Bebtelovimab, that are 90% effective at preventing progression to hospitalization," Doron said. "Add those together and not only should no one be dying, but no one should be getting hospitalized, if we are using those tools as we should."
Despite widespread medical approval of the drugs, federal officials say that many of those resources, in more than ample supply, are not being used as widely as they should be, and as a result, thousands of lives are being unnecessarily lost.
On Tuesday, the White House announced that it would take new actions to increase access to Paxlovid, Pfizer's antiviral COVID-19 pill.
"We now have more tools than ever before to protect people from the virus, including highly effective treatments," the Biden administration said in a statement Tuesday.
Paxlovid, which reduces the risk of hospitalization and death by 90%, currently gets prescribed to about 55,000 Americans a week, which is about 2.5 times more than a month ago. But over the past week, the U.S. has seen an average of 44,000 new infections each day.
The administration's plan is to double the number of pharmacies that stock the drug to 40,000 sites nationwide in the coming weeks, as it was previously limited to 20,000 due to insufficient supply.
Officials will also work to provide physicians with more guidance and tools to understand and prescribe the treatments.
Despite the plan to increase the availability of critical drugs to combat COVID-19, some health experts are concerned that it will still not be enough to save lives, given the many barriers that stand in the way of ensuring that those drugs and treatments are widely accessible to all those who need them.
Issues of access remain critical
Although therapeutics and vaccines will be important tools to prevent serious illness and deaths, experts say decreasing the number of daily COVID-19 fatalities will also be a function of equitably increasing access to these preventive measures and treatments.
"Equitable access is a huge barrier at this point in time, especially to effective treatments such as Paxlovid," Colleen Kelley, an associate professor in the division of infectious diseases at Emory University School of Medicine, told ABC News.
Lack of access to transportation to proper pharmacies can have major consequences for public health.
According to ABC News' analysis last summer of pharmacy locations across the country, there are 150 counties where there is no pharmacy, and nearly 4.8 million people live in a county where there's only one pharmacy for every 10,000 residents or more.
Based on Census data, there are far fewer pharmacies per person -- especially chain pharmacies -- in rural parts of the country compared to urban areas.
In addition, the access inequities underscore the racial gap prevalent throughout the country in both rural and urban areas, with more pharmacies per person in whiter and wealthier neighborhoods than in poorer, predominantly nonwhite neighborhoods.
Persisting disparities throughout the pandemic have also resulted in a higher likelihood of death from COVID-19 for Black and brown Americans.
According to federal data, adjusted for age and population, the likelihood of death because of COVID-19 for Black, Asian, Latino and Native American people is about one to two times higher, compared to white Americans.
Although some minority communities initially lagged behind in the nation's vaccination efforts, the rates of Black and brown Americans have significantly caught up proportionally to their respective populations.
A recent report, produced by the Poor People's Campaign in collaboration with the U.N. Sustainable Development Solutions Network, also revealed the "devastating and disproportionate" impact of the virus on low-income communities in the U.S.
The report found that death rates in the lowest income group were double the death rates of those in the highest income group
"Widespread equitable access would drive hospitalization and death rates way down," Doron said, adding that not enough individuals know that treatments are available and end up in the hospital.
"Those who are more medically literate and do their own research know how important it is to suspect COVID at the first sign of symptoms, have easier access to testing, and know to call their doctor for a prescription for an antiviral or for an infusion of monoclonal antibody or remdesivir," Doron said.
Education pertaining to treatments as well as widespread, equitable access to COVID-19 vaccines, tests and effective treatments are critical to boosting our way out of the pandemic by ultimately driving down hospitalizations and death rates, Dr. Jay Bhatt, an internist and adjunct faculty at the UIC School of Public Health, told ABC News.
"This would likely reduce spread and cases of chronic disease triggered by COVID-19 infection and likely hospitalizations and death," Bhatt said.
COVID-19 funding will play an important role in treatment access
Equitable access to drugs also remains critical for the millions of Americans, who are moderately or severely immunocompromised, and thus have a weakened immune system, putting them at increased risk of severe COVID-19 illness and death, according to the CDC.
According to physicians, a large proportion of the few fully vaccinated Americans who are getting breakthrough infections and dying are those with underlying conditions or those who are being treated with immunosuppressive drugs.
"There may be a small number of individuals with chronic disease and those that are immunocompromised infected with COVID-19 that may not survive infection even though they have had appropriate treatments and be vaccinated. It is also possible that COVID-19 flares chronic conditions that may lead to complications and death," Bhatt said.
Matthew Cortland, a disability rights advocate, stressed the importance of getting those drugs to those at higher risk.
"If you are at higher risk, having a reduced viral load can only benefit you," Cortland said. "There's still a shortage and a scarcity mindset. Paxlovid has to be readily available basically everywhere."
The push to make treatments more widely available only further underscores the need for COVID-19 funding, Cortland added.
"Congress will need to fund more purchases" of these treatments, Cortland said. "That's the only way that we get to as few COVID deaths as possible."
