All hospital staff with mild-to-moderate COVID-19 should have access to the antiviral molnupiravir as this would reduce the infection burden and help alleviate staff shortages, Australian researchers suggest.
Currently, most healthcare workers are not eligible for COVID-19 oral antivirals via the PBS, which are only available to people under the age of 70 diagnosed with COVID-19 if they have risk factors for severe disease.
However, group of Infectious Diseases and Public Health staff from Barwon Health in Geelong, Victoria, argue that expanding molnupiravir access to healthcare workers could ease the “immense strain” on the system during future waves of COVID-19 by reducing illness severity and duration.
In a paper published in PLoS One they note that when commenced within five days of COVID-19 symptom onset, the antiviral can reduce illness severity and duration in people without identified risk factors for severe disease, and also reduce infectiousness and transmission by rapidly reducing viral load. There is also emerging evidence that oral antiviral treatment may reduce the risk of long-COVID, they say
In support of these clinical benefits, the clinicians report on a case series [link here] of 30 staff members at a tertiary hospital, including seven doctors and 15 nurses, who were offered molnupiravir (Lagevrio) outside of the PBS but free of charge.
The program was approved by the Victorian department of health for a limited period during the Omicron BA.2 wave in June 2022 to help deal with workforce pressures.
Participants had a median age of 43, were mainly female (73%) and most reported having no comorbidities (80%).
While COVID-19 vaccination status was not collected, it was a legislative requirement at the time for all healthcare staff to have received three doses.
All 30 staff who received molnupiravir completed their treatment course (800mg dose twice daily for five days) and had low rates of adverse events, which were all deemed to be mild.
They each reported improvement in symptoms within 48 hours of starting antiviral treatment. The reported duration of illness ranged from 1-16 days with a median of four days.
A negative rapid antigen test on the final day of treatment was recorded in 81% of the 27 people who tested, increasing to 93% for those who took molnupiravir within 48 hours of symptom onset.