Two brand-new COVID-19 pills that were supposed to be an important weapon against the pandemic in the U.S. are in short supply and have played little role in the fight against the omicron wave of infections.
The problem is that production is not yet at full strength and that the pill considered to be far superior, Pfizer's, takes six to eight months to manufacture.
While the supply is expected to improve dramatically in the coming months, doctors are clamoring for the pills now, not just because omicron is causing an explosion of cases but because two antibody drugs that were once the go-to treatments don't work as well against the variant.
"This should be a really joyous time because we now have highly effective antiviral pills," said Erin McCreary, a pharmacist and administrator at the University of Pittsburgh Medical Center. "Instead, this feels like the hardest and most chaotic stretch of the pandemic."
The pills — and other COVID-19 drugs, for that matter — are being carefully rationed, reserved for the highest-risk patients.
"January is going to be a terrible month with a million cases a day," said University of North Carolina virologist Dr. Myron Cohen. "Most people will do perfectly well, but we have to select out the people who won't and give them the drugs we have available."
The Food and Drug Administration authorized the two pills from Pfizer and Merck late last month based on studies showing they cut the risk of severe disease and death when given shortly after symptoms appear. They are the first COVID-19 treatments patients can take at home, and thus could reduce the burden on hospitals.
The U.S. didn't make the kind of mass purchases in advance that it did with vaccines.
Because of the time it takes to manufacture Pfizer's pill, Paxlovid, the company says it can supply only about 250,000 courses of the treatment by the end of this month.
The U.S. has ordered enough Paxlovid to treat 20 million people, but the first 10 million orders won't be delivered until June.