I knew right away that it was going to be bad.
It was a hot, humid night — almost 90 degrees — but my body was freezing. Putting on a sweatshirt and diving under a blanket couldn’t warm me up. My head, on the other hand, was on fire. I had a temperature over 100 degrees and needed ice packs piled on my forehead to cool down. The coughing wouldn’t stop.
I didn’t need a test to tell me that I had finally caught COVID.
For more than two years I basically lived like a hermit to avoid just this scenario. Sure, after getting vaxxed and boosted I didn’t think COVID would kill me. But I don’t exactly have a gold medal immune system; even a common cold gives me a rough time. I imagined COVID would lay me out with symptoms that could drag on for weeks or possibly months. So I stayed away from the office, indoor gatherings and restaurants. The gym? No thanks. Fifteen extra pounds was worth it to avoid getting sick.
But this summer was my sister’s 40th birthday. She and the rest of my family live on the East Coast and were throwing a big party. So I decided to leave my cave and fly to see them.
Sure enough, someone else showed up to the festivities quietly sucking cough drops, assuring anyone who asked that her unusually nasal intonation was just a cold.
It wasn’t. And I was dumb enough to sit right next to her.
As soon as the first symptoms hit, I knew I was in trouble. So I decided to do my damnedest to get a prescription for Paxlovid, the antiviral drug cocktail that can prevent the coronavirus from replicating in your body during the early stages of infection. I wasn’t technically eligible because I’m under 65 without any serious comorbidities. But having chills, a brutal cough and a sky-high fever had to count for something, right?
Apparently not.
Local pharmacists wouldn’t have anything to do with me. Neither would urgent care. I called my health care provider back in San Francisco for a prescription, but it too told me I wasn’t eligible for Paxlovid and had to rest and ride it out.
So ride it out I did for the next 12 days coughing, sweating, snotting and sleeping up to 16 hours a day. Instead of spending time with my family, I had to avoid them at all costs to keep them from getting sick — other than to beg for food and supplies; there are no delivery services in the rural community they live.
After a wasted vacation, a changed flight and a few extra sick days, I finally got home a couple of weeks ago.
That same day, my partner started showing symptoms of COVID.
She too was ineligible for Paxlovid and spent the next 10 days hacking away in isolated misery. She just finally tested negative, but neither of us are back even close to full speed. A mildly hilly walk in Golden Gate Park the other day had me huffing like I just ran a marathon. I was in bed by 8:30 that night.
I don’t know for sure which variant laid us out, but, based on infection data, it was almost certainly BA.5. Now, as BA.4.6 gains ground — and future variants follow — are we going to have to go through all this again if we want to live freely like we did before the pandemic? Because I don’t have the sick days or the stomach for that. And I can’t be the only one.
I’m hopeful the new omicron booster can break this cycle. But what if it doesn’t?
This begs the question: if an antiviral drug like Paxlovid exists that could potentially ease people’s COVID symptoms by preventing the virus from replicating in our bodies before it spreads, why are we being so precious about who we give it to? A pharmacist in Canada recently refused to fill a Paxlovid prescription for a 20-year-old with Down syndrome and a history of respiratory infections. How is that sensible public health policy?
I asked UCSF infectious disease specialist Monica Gandhi why those of not wanting to feel like garbage for weeks at a time, and who need to work or see vulnerable family members, can’t get easy access to the drug? We give antivirals widely to ease flu symptoms, why not COVID?
She replied that Paxlovid is currently being used to prevent death and hospitalizations, and that studies of people in my age range have shown no discernible benefits in this regard to taking the drug.
However, “there are other benefits of Paxlovid,” she said. “You were likely to have felt better sooner if your viral load was brought down more quickly. But there just have not been any studies on this in vaccinated people.”
My read on this is that even as public health guidance is evolving to tell us COVID is now endemic and we can start getting back to normal, in many unhelpful ways it still treats the virus like a deadly disease.
We can’t have it both ways.
Many doctors, Gandhi said, recognize the obvious utility in giving people the chance to recover faster. Given that the known side effects of Paxlovid are few and mild, some doctors are comfortable bending the rules to prescribe the drug to those who might not technically meet the public health guidance. That works in America because the feds are currently footing the bill — and they aren’t rigorously checking who does or doesn’t have dire comorbidities. But Paxlovid is expensive. And as the federal government cuts off funds and insurance companies start taking on the cost of the drug, you can expect those eligibility requirements to lock in tighter than they are now.
What happens then if the omicron booster shots prove ineffective at preventing breakthrough infections like the one that waylaid me? Are we willing to let perpetual sickness be the cost of normalcy?
Based on America’s COVID response thus far, I’m fairly certain the answer to that is yes — unless folks start agitating. Are we going to rely on insurance company actuaries and the power of positive thinking to guide us back to normal, with all the attendant consequences? Or are we going to insist that public health officials study all tools in the arsenal that could get us there with as little misery as possible?
Matthew Fleischer is The San Francisco Chronicle’s editorial page editor. Email: matt.fleischer@sfchronicle.com
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Omicron got me after 2 years as a COVID hermit. Then, doctors made it worse - San Francisco Chronicle
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