The Perfect Enemy | 5,000 US COVID deaths may have been averted in winter 2022 under higher Paxlovid use
February 19, 2024

5,000 US COVID deaths may have been averted in winter 2022 under higher Paxlovid use

About 4,800 lives could have been saved during the winter 2021-22 Omicron wave if just 5% of COVID-19 patients had taken the antiviral drug, modelers estimate.

COVID patient in hospital
US Navy / Flickr cc

About 4,800 US lives could have been saved during the winter 2021-22 SARS-CoV-2 Omicron wave if 5% of COVID-19 patients had taken the antiviral drug Paxlovid, estimates a modeling study published late last week in JAMA Health Forum.

Brown University and Stanford University researchers modeled declines in hospitalizations and deaths under 5% Paxlovid uptake (the current rate) from December 2021 to March 2022. Paxlovid was authorized for use in high-risk adults and children 12 years and older in December 2021.

The team conducted sensitivity analyses by building models to estimate decreases in hospital admissions and deaths (models 2 and 3), subpopulation analyses (models 4 to 6), projections if even more patients had taken Paxlovid (models 7 and 8), and required tests and Paxlovid courses to avert severe outcomes (models 9 and 10).

Just 5% uptake may have cut deaths by 3%

Assuming 78% of infections requiring hospitalization were detected within 5 days, 5% Paxlovid uptake, effectiveness of 67% against hospitalization and 81% against death, 2.7% fewer hospitalizations and 3.2% fewer deaths may have occurred.

In sensitivity analyses, estimated COVID-19 hospitalizations declined 0.5% to 7.5%, and deaths fell 0.6% to 7.5%. In nursing homes, higher Paxlovid uptake may have lowered hospitalizations and deaths 7.7% and 9.3%, respectively (model 4).

If Paxlovid uptake were 40% (model 7), hospitalizations and deaths may have fallen 21% and 25%, respectively. If uptake were 80% (model 8), hospitalizations and deaths may have declined 42% and 51%, respectively.

If Paxlovid uptake were 40%, hospitalizations and deaths may have fallen 21% and 25%, respectively.

At 5% Paxlovid uptake (model 1), 4.8 million symptomatic tests and 2.5 million Paxlovid courses would have been needed to avert 2.7% of hospitalizations and 3.2% of deaths. At 80% uptake (model 8), 75.3 million tests and 39.8 million Paxlovid courses would have been needed to avert 41.8% of hospitalizations and 50.5% of deaths.

We estimated that had current Paxlovid uptake been achieved in January 2022, 4.8 thousand deaths would have been averted,” the authors wrote. “We provide a simple, flexible framework for understanding the resource requirements and benefits associated with future expansions of the test-to-treat initiative.”