What to Ask Your Doctor About COVID Treatment (Before Infection)

When you first realize you’ve tested positive for COVID-19, you may experience rushing thoughts and feelings, including:

• How can I prevent this from getting worse?
• How can I get the treatment I need if I can’t leave the house?
• Am I even entitled to treatment, and if so, which one?

It can be a lot to deal with when you’re already feeling bad, but not getting the answers you need can affect your results and the severity of your infection. That’s why it’s important to work out a treatment strategy with your doctor before you get infected, especially if you’re immunocompromised and at high risk for serious illness.

“There’s no doubt that if you find yourself infected, you can be very anxious about what happens or what to do next,” says William Schaffner, MD, professor of infectious diseases at Vanderbilt University Medical Center. “It’s very reassuring to have a plan worked out in advance with your supplier, because you can bring it forward and then proceed in the best way.”

This is true even if you have already contracted COVID-19 and recovered. You can be infected with COVID-19 more than once, and although reinfections are often mild, they can to be severe, according to US Centers for Disease Control and Prevention (CDC). Starting treatment a few days after symptoms appear can help reduce your risk of serious illness from reinfection.

“Anyone can get recurrent COVID-19, as we have seen with many patients,” says Norman B. Gaylis MD, FACP, MACRa rheumatologist based in Aventura, Florida. “There are a number of strains of the virus, and those who are immunocompromised are at higher risk and should therefore work with their doctor on a treatment plan for potential future infections.”

It can also reduce your stress when you are sick. Dr. Schaffner talks about his own experience of being infected by his wife last summer. Although he knew what to do next, he didn’t have a specific plan, which led to additional concerns and difficulties, particularly because he has an immunocompromised family member who also tested positive.

“The next two hours were anxiety-provoking until my wife and I got our prescriptions for Paxlovid and our immunocompromised family member came to the clinic and received his treatment,” says Dr. Schaffner. “If we had a plan in place, including writing down who to call and what the phone numbers were, a lot of anxiety would have been spared.”

To avoid finding yourself in a similar situation, here are five simple questions to ask your doctor today to create a plan of treatment options.

How and when should I test for COVID-19 if I have symptoms?

Although you may have testing sites near you, traveling outside the home may be the last thing you want to do when you’re not feeling well (and may reduce the likelihood that you’ll test in time for receive treatment). If you can, stock up on test kits at home, so you don’t have to scramble to find tests when you start to feel sick.

“Discuss with your doctor what symptoms should prompt you to get tested,” says Dr. Schaffner. “And if there are any symptoms showing up in your family members or carers, ask when they should be tested.”

Symptoms of COVID-19 may appear two to 14 days after exposure and may include, depending on the Mayo Clinic:

• notorious fever
• Cough
• Fatigue associated with infection
• Nausea
• Diarrhea
• Pink eye or rash

If you have an underlying condition that’s causing symptoms like fatigue, keep a symptom diary so you know when you’re having something out of the ordinary. Talk to your doctor about the symptoms that should prompt you to take a COVID-19 test — and when in doubt, play it safe by testing.

Keep in mind that the U.S. Food and Drug Administration (FDA) has extended the expiration dates for most home tests, so even if you’ve had a few stashed away for a while, you’ll be able to may still be using them.

To find out, see this table from the FDA. If the retention period has been extended, you will find a link to the updated expiration dates. If the table does not say that the shelf life is extended, you must always observe the expiry date indicated on the label of the box of the test.

What treatments am I entitled to?

Whatever your vaccination status, the advice of the CDC notes that symptomatic immunocompromised individuals, household members and close contacts should be tested for SARS-CoV-2 infection as soon as possible and receive treatment within five to seven days of onset of symptoms.

Early treatment of mild to moderate COVID-19 with a recommended treatment such as nirmatrelvir (Paxlovid) or ritonavir-boosted remdesivir (Veklury) – or the second-line treatment, molnupiravir (Lagevrio) – has been shown to reduces the risk of severe COVID-19. 19, including hospitalization and death, according to the CDC.

Paxlovid is Pfizer’s antiviral pill for COVID-19 and involves taking three pills twice a day for five days. The FDA has compiled a eligibility checklist to be used by prescribers as a tool to decide whether a patient should receive Paxlovid:

• A positive SARS-coV-2 test
• Be over 18 or over 12 and weigh at least 40 kilograms (approximately 88 pounds)
• Has one or more risk factors for progression to a severe form of COVID-19, such as immunocompromised disease or a weakened immune system
• Symptoms consistent with mild to moderate COVID-19
• Onset of symptoms within five days
• Not requiring hospitalization due to severe or critical COVID-19 at the start of treatment
• No known or suspected severe renal impairment
• No known or suspected severe hepatic impairment
• No history of clinically significant hypersensitivity reactions to active ingredients or other components of the product

(Learn more about what to know if you are prescribed Paxlovid.)

Meanwhile, Veklury (remdesivir) is still being used by many US hospitals, even though the World Health Organization (WHO) advised against it after releasing data that showed disappointing results in late 2021, per Yale Medicine. Although initially authorized for critically ill patients receiving oxygen treatment, this authorization was later extended to other groups, and in January 2022 it was authorized to treat non-hospitalized patients. Remdesivir is given by injection or IV.

Finally, there is the antiviral pill Lagrevio, developed by Merck and Ridgeback Biotherapeutics. It involves taking four capsules every 12 hours for five days and, like Paxlovid, it must be taken within five days of the onset of symptoms.

When creating your action plan with your doctor, ask about the role your current medications may play in your susceptibility to COVID-19 and what treatments you may be prescribed if you become infected.

“Patients should ask their doctor if they are able to tolerate the treatment plan itself,” says Dr. Gaylis. “They should ask if they are more susceptible to COVID-19 and, if they do get it, if they can continue other treatments such as those for rheumatic conditions.”

Who do I call to get these medications prescribed if my test is positive?

It is important to get treatment as soon as possible after symptoms appear. If you have to wait days for a doctor’s appointment to get a prescription, you’re missing your window of opportunity.

“Know what you need to do next after testing positive, including who you should call or email, and whether you’re eligible for Paxlovid or another treatment,” says Dr. Schaffner. “Write everything down as part of the plan – and make sure you know who to contact to initiate treatment and prevent more serious illness.”

Medicines for COVID-19 must be prescribed by a healthcare professional, in accordance with the US Food and Drug Administration. (As of July 2022, the FDA state-licensed pharmacists to prescribe Paxlovid.)

Also ask your doctor about the best way to communicate with them about your symptoms, so that you know when treatment needs to be stepped up. For example: should you contact your doctor via a patient portal, call his office, send an e-mail or something else? What should you do if it’s a weekend or a holiday and their office is closed?

What options are available to access these treatments?

You can get prescriptions for a treatment like Paxlovid from your healthcare professional, pharmacies, hospitals and health clinics.

Some pharmacies can deliver drugs like Paxlovid. If that’s not an option for you, ask a family member or close friend to pick up your prescription for you and leave it at your doorstep if you have COVID-19.

There are also test-to-treat sites where you can test for COVID-19 and get treatment, if eligible, all in one place – you can find one using this locator.

Am I up to date on all vaccine recommendations?

Talk to your doctor now about all the precautions you can take to avoid serious illness. Asking if you are up to date on your vaccinations and boosters should be part of a larger conversation about your risk mitigation efforts.

“Everyone, including immunocompromised people, should use standard precautions to protect themselves from COVID-19,” says Dr. Gaylis. “Top of the list would be to avoid situations involving crowds of people where distancing is not an option.”

When Evusheld was no longer licensed to prevent COVID-19 due to its waning effectiveness against new variants, the CDC emphasized the importance of preventative measures for immunocompromised patients — which include learning about locations and options. treatment Before get sick.

By taking these steps, you will be more likely to recover from COVID-19 quickly and without serious symptoms.

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