I would like to ask the group for some advice.
I am going on a cruise for my husband’s 70th Birthday. It is round Europe. 14 Days. If I catch Covid whilst on the cruise how do I access the antiviral medication needed that I have to take within 5 days as I have CLL. Has anyone had this experience.
Hi 21Bedlam21,
My wife and I cruised the Aegean with Viking in early 2023. We bought the travel & health insurance package that Viking offered that gave us access to the on-board clinic at no extra cost.
One month before departure, I tried to get a clear answer whether that clinic had Paxlovid aboard ship, but never got a satisfactory response. So my USA hem/onc prescribed it and I carried it with me, but did not need it.
When my wife got a cold, the clinic nurse tested her to show it was not COVID. I tried to get an answer from the nurse whether they had Paxlovid, but got another murky / vague response.
I am not certain that the NHS rules would allow your UK doctors to entrust you with an emergency bottle of Paxlovid to take with you, but you might try.
Len
Thank you for that. I don’t think they will give me any Paxlovid to take with me. We are on Cunard and I can’t get a satisfactory answer from my Travel Agent as to their policy on board. I do have an appointment with my Haematologist on the 3rd October. I intend to ask the questions then. 🤞🏻I trust the users of this site and wanted to ask their opinions and experiences.
Can you obtain it before you go? If I am going away I always ask my GP for advanced prescription to take with me.
I intend to ask at my next appointment. Will a British prescription be valid abroad or would the onboard nurse be able to get it for me.
I would dispense this at my own pharmacy and take the drugs with me together with a list of prescriptive meds in case asked at customs. No, I don't think a precription would be recognised in any other country abroad, but just my opinion.
Thank you I shall enquire with my Dr. Hopefully she will give me a prescription.
Given circumstances I don't think she will refuse......good luck !
🤞🏻
I got impression jury was out on effectiveness of Paxlovid - and potentially issues with rebound ?
I haven’t heard anything about that.
Research released earlier this year showed that, although Paxlovid may not do much to change the course of the illness in fit, well vaccinated people, "the medication is still beneficial to some people—especially older or immunocompromised people who are at a high risk of hospitalization from COVID". scientificamerican.com/arti...
Here's a link to the study: Jennifer Hammond, Carla Yunis, Robert J. Fountaine, Gerald Luscan, Aimee M. Burr, Wuyan Zhang, Wayne Wisemandle, Holly Soares, Mary Lynn Baniecki, Victoria M. Hendrick, Veselin Kalfov, Rienk Pypstra, James M. Rusnak, Oral Nirmatrelvir–Ritonavir as Postexposure Prophylaxis for Covid-19, New England Journal of Medicine, 391, 3, (224-234), (2024). nejm.org/doi/full/10.1056/N...
At the time the study was released, The New England Journal of Medicine also published a commentary article titled "Treating Acute Covid-19 — Final Chapters Still Unwritten".
The commentary references an earlier study as well as the one released in 2024 and explains the findings this way:
"Nirmatrelvir–ritonavir (Paxlovid [Pfizer]) is used as first-line therapy for nonhospitalized persons with Covid-191 on the basis of the results of the Evaluation of Protease Inhibition for Covid-19 in High-Risk Patients (EPIC-HR) trial, which showed that this medication reduced the risk of hospitalization or death by 88%.² The EPIC-HR trial enrolled adults who had not received a SARS-CoV-2 vaccine and who were at high risk for progression to severe Covid-19. Given those results, the question arose as to whether nirmatrelvir–ritonavir conferred a benefit in persons who had been vaccinated or who did not have risk factors for severe disease.
The manufacturer-sponsored Evaluation of Protease Inhibition for Covid-19 in Standard-Risk Patients (EPIC-SR) trial, . . . sought to answer these questions . . .
What can we conclude from these two trials about nirmatrelvir–ritonavir for the treatment of Covid-19?
Clearly, the benefit observed among unvaccinated high-risk persons does not extend to those at lower risk for severe Covid-19. This result supports guidelines that recommend nirmatrelvir–ritonavir only for persons who are at high risk for disease progression."
"What about treating people who have risk factors for severe Covid-19 but have received SARS-CoV-2 vaccines?
Some observational studies suggest that treating vaccinated persons is beneficial,⁶ but these studies are not definitive because of possible residual confounding. The EPIC-SR trial did not show evidence for benefit but enrolled only a small percentage of persons at the highest risk for progression — older persons, those who are immunocompromised, and those with serious coexisting conditions (e.g., heart or lung disease) — who constitute most of the patients hospitalized with Covid-19. As with many medical interventions, there is likely to be a gradient of benefit for nirmatrelvir–ritonavir, with the patients at highest risk for progression most likely to derive the greatest benefit. Thus, it appears reasonable to recommend nirmatrelvir–ritonavir primarily for the treatment of Covid-19 in older patients (particularly those ≥65 years of age), those who are immunocompromised, and those who have conditions that substantially increase the risk of severe Covid-19, regardless of previous vaccination or infection status."
On the question of rebound, the commentary notes:
"What is common to all such studies, however, is that rebound is generally brief and mild. Therefore, concerns about rebound should not be a reason to withhold nirmatrelvir–ritonavir in those who may benefit. Trials of different treatment durations for acute Covid-19 and of a second course in those who have rebound are under way (ClinicalTrials.gov numbers, NCT05567952 and NCT05438602)"
While recommending Paxlovid for those who are immunocomprised, the commentary highlighted the fact that: "Severely immunocompromised persons are among the populations at highest risk for severe Covid-19; we need trials that evaluate different treatment durations and combination therapies as compared with monotherapies to understand how best to treat such patients."
Rajesh T. Gandhi, Martin Hirsch, Treating Acute Covid-19 — Final Chapters Still Unwritten, New England Journal of Medicine, 390, 13, (1234-1236), (2024). doi.org/10.1056/NEJMe2402224
(my emphasis)
CLLerinOz
Thank you for that information. I will try to persuade my GP to give me some.
I don’t know about Europe but I just had covid in Canada and can no longer access antivirals there anymore you have to have a health care card from BC and we eventually found one drug store that still had stock sheer luck and it cost us 1700.00 Australian. Now looking if it is at all possible to take them with me if that is even possible. So if you can get them from your home and take them with you is the ideal. I have recently in the last year been on r4 trips 3 times I got covid and the 4th time I got a cold. So you are doing the right thing being prepared before you go.
Thank you. 🤞🏻that I can get them.
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