Would a drug like Paxlovid be available in HAL medical centers?

[Caribbean Chris]

I am assuming this drug is not currently offered to anyone who tests positive during a cruise. Only in recent weeks has it been readily available in the US, and I believe it is authorized for use to high risk people but not yet approved for the general population. 
 

We were on a cruise recently (not HAL) and my symptoms began on disembarkation day with a mild sore throat. We drove home, I tested positive the next morning, spouse never did. Called my doctor next day and within a few hours DH picked up my free prescription at our neighborhood pharmacy for Paxlovid, the 5-day course of antiviral pills. The illness was milder than a typical cold and mostly over within a few days.

 

Ever since, .I’ve been hoping that crew members and passengers testing positive on board will routinely be offered this treatment soon. I began wondering just how much of a pharmacy even exists aboard a typical cruise ship. 
 

Any thoughts?
 

 

 

 

 

 

[CruiserBruce]

I am not sure it is "readily available" at this point. It is becoming more available, but the program seeks to put it at "test and treat" pharmacies...of which there aren't many yet.

 

I would say its not going to be available on ships for awhile.

[syesmar]

@Caribbean ChrisI have asked this question several times over the last few weeks of those who’ve tested positive onboard. I have not yet heard of anyone being offered an antiviral.

 

I have heard how helpful this new one can be, though “the rebound effect” (negative, then positive/sick again) for some is a bit puzzling.

 

Thank you for sharing your experience! I hope the antivirals are available for those who need them. 

All the Best!

[Caribbean Chris]

3 hours ago, CruiserBruce said:

I am not sure it is "readily available" at this point. It is becoming more available, but the program seeks to put it at "test and treat" pharmacies...of which there aren't many yet.

 

I would say its not going to be available on ships for awhile.

 

You are right, I should have said "more readily available" although I was quite surprised that the Walgreen's in my small suburb of a mid-sized city (pop. 60,000) had it in stock. I read this week that there are currently 20,000 locations for the drug (pharmacies, clinics, hospitals, etc), with 30,000 coming in the next week or two and 40,000 the goal soon after. Some of those pharmacies, as you mentioned, will be test & treat. I just used the free home test kits (every home can order up to 8 free tests online).  

 

I also think you are right that it won't be on ships for a while. It's still in the emergency use category, not FDA-approved, and I think only for high-risk people (includes 65+ seniors).

[Caribbean Chris]

15 minutes ago, syesmar said:

@Caribbean ChrisI have asked this question several times over the last few weeks of those who’ve tested positive onboard. I have not yet heard of anyone being offered an antiviral.

 

I have heard how helpful this new one can be, though “the rebound effect” (negative, then positive/sick again) for some is a bit puzzling.

 

Yes, I just read about those rebound cases this morning. I finished the course of pills on the weekend. So far, so good!

[Laminator]

18 minutes ago, syesmar said:

@Caribbean ChrisI have asked this question several times over the last few weeks of those who’ve tested positive onboard. I have not yet heard of anyone being offered an antiviral.

 

I have heard how helpful this new one can be, though “the rebound effect” (negative, then positive/sick again) for some is a bit puzzling.

 

Thank you for sharing your experience! I hope the antivirals are available for those who need them. 

All the Best!

I am pretty sure we had this discussion a few weeks ago. I was going to ask my DR for a script for our upcoming cruise out of Amsterdam . Unfortunately we only saw the nurse practitioner. We did mention it to her though and will get an answer at my next appt. There are at least 5 pharmacies within 10 minutes of my of my house that has paxlovid. The NP seemed receptive as I was recently diagnosed as a diabetic. I will keep you updated. 

[ottahand7]

3 hours ago, Caribbean Chris said:

I also think you are right that it won't be on ships for a while. It's still in the emergency use category, not FDA-approved, and I think only for high-risk people (includes 65+ seniors).

Perfect reason to stock it on HA ships.  There is a golden window of 5 days so there may be situation where a person would be needing it and not making it to a port before the window closes.   

[DaveOKC]

A friend of mine got this two weeks ago and it was hard to find (even Walmart did not have it) in our good sized city (Oklahoma City).  He had to go to the local large hospital pharmacy.

 

[syesmar]

5 hours ago, Laminator said:

I am pretty sure we had this discussion a few weeks ago...I will keep you updated. 

Thanks, yes I remember we spoke recently and I'm very much interested in what they say! I know there's a set of criteria they have to attest to when prescribing, but I, too, would like to know how travel is handled.

If the ship didn't have it, and a doctor was unable to prescribe for someone in anticipation, in some cases I guess perhaps if a passenger on a US-based cruise tested positive, if they were able to contact their doctor and have the doctor call the prescription in to a pharmacy in port where someone could pick it up, that would be an option. I imagine it would be some hassle, but if all the many ducks lined up, another possibility. I wonder if the ship would allow a free phone call to the doctor in this case? Or if the ship's doctor could prescribe it to a local pharmacy if the ship didn't carry it?

Edited April 28, 2022 by syesmar

[syesmar]

5 hours ago, Caribbean Chris said:

 

...I finished the course of pills on the weekend. So far, so good!

That's good to hear! Wishing you a complete recovery.

All the Best!

[howiefrommd]

From what I have been hearing from my primary care colleagues, many seem reluctant to order in their older (over 65) patients due to potential interactions (especially with anti-hypertensives and anti-coagulants).  I think another challenging issue is that the FDA has approved this under their Emergency Use Authorization (EUA) abilities, so for the cruise lines I am pretty sure they are concerned about liability issues.

 

Interesting data is starting to come out about rebound infection several days post completion of treatment. As we learned from prior anti-virals, this med may be limited in its effectiveness past the first treatment cycle.  
 

 

[syesmar]

On 4/28/2022 at 9:43 AM, Laminator said:

…I was going to ask my DR for a script for our upcoming cruise out of Amsterdam…The NP seemed receptive as I was recently diagnosed as a diabetic. I will keep you updated. 

@Laminator see this Post about a similar situation.

All the Best!

[Laminator]

9 minutes ago, syesmar said:

@Laminator see this Post about a similar situation.

All the Best!

Thanks...I will update you after my next appt. That will be the do or die whether I can get it as we leave the following week.