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What should you do to stay safe? What are the common symptoms? How many vaccines are there?

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Centers for Disease Control and Prevention

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Important update: Healthcare facilities

CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more

Different COVID-19 Vaccines

Vaccine Brand Name [ 1 ]
Pfizer-BioNTech

Ages Recommended
5+ years old

Primary Series
2 doses
Given 3 weeks (21 days) apart[ 3 ]

Booster Dose
Everyone ages 18 years and older should get a booster dose of either Pfizer-BioNTech or Moderna (COVID-19 vaccines) 5 months after the last dose in their primary series.
Teens 12-17 years old should get a Pfizer-BioNTech COVID-19 Vaccine booster 5 months after the last dose in their primary series.

When Fully Vaccinated ⁴
2 weeks after 2 nd dose

Vaccine Brand Name [ 1 ]
Moderna

Ages Recommended
18+ years old

Primary Series
2 doses
Given 4 weeks (28 days) apart[ 3 ]

Booster Dose
Everyone ages 18 years and older should get a booster dose of either Pfizer-BioNTech or Moderna (COVID-19 vaccines) 5 months after the last dose in their primary series.

When Fully Vaccinated ⁴
2 weeks after 2 nd dose

Vaccine Brand Name [ 1,2 ]
Johnson & Johnson's Janssen

Ages Recommended
18+ years

Primary Series
1 dose

Booster Dose
Everyone ages 18 years and older should get a booster dose of either Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) at least 2 months after the first dose of J&J/Janssen COVID-19 vaccine. You may get J&J/Janssen in some situations.

When Fully Vaccinated ⁴
2 weeks after 1 st dose

Johnson & Johnson's Janssen [ 1,2 ]

Primary Series
2 doses
Given 3 weeks (21 days) apart[ 3 ]

Primary Series
2 doses
Given 4 weeks (28 days) apart[ 3 ]

Booster Dose
Everyone ages 18 years and older should get a booster dose of either Pfizer-BioNTech or Moderna (COVID-19 vaccines) 5 months after the last dose in their primary series.

Teens 12-17 years old should get a Pfizer-BioNTech COVID-19 Vaccine booster 5 months after the last dose in their primary series.

Booster Dose
Everyone ages 18 years and older should get a booster dose of either Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines) at least 2 months after the first dose of J&J/Janssen COVID-19 vaccine. You may get J&J/Janssen in some situations.

When Fully Vaccinated ⁴
2 weeks after 2 nd dose

When Fully Vaccinated ⁴
2 weeks after 2 nd dose

When Fully Vaccinated ⁴
2 weeks after 1 st dose

Vaccine Types and How They Work

Understanding How COVID-19 Vaccines Work
Learn how the body fights infection and how COVID-19 vaccines protect people by producing immunity. Also see the different types of COVID-19 vaccines that currently are available or are undergoing large-scale (Phase 3) clinical trials in the United States.​

COVID-19 mRNA Vaccines (Pfizer-BioNTech and Moderna)
Information about mRNA vaccines generally and COVID-19 vaccines that use this technology.

Viral Vector COVID-19 Vaccines (J&J/Janssen)
Information about viral vector vaccines generally and COVID-19 vaccines that use this technology.

hand holding medical light icon

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Important update: Healthcare facilities CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more Different COVID-19 Vaccines Vaccine Brand Name [ 1 ] Pfizer-BioNTech Ages Recommended 5+ years old Primary Series 2 doses Given 3 weeks (21 days) apart[ 3 ] Booster Dose Everyone ages 18 years and older should get a booster dose of either Pfizer-BioNTech or Moderna (COVID-19 vaccines) 5 months after the last dose in their primary series.

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What temperature kills the virus that cuases COVID-19?
The virus that causes COVID-19, is sensitive to elevated temperatures, with over 99.99% inactivation in only a few minutes at 70°C (158°F)

https://www.cdc.gov/coronavirus/2019-ncov/community/ventilation.html#:~:text=Research%20on%20the%20impact%20of,damage%20some%20building%20materials.

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Centers for Disease Control and Prevention

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Actions that communities can take to slow the spread of COVID-19.

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How many variants of COVID-19 are there?

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Featured Experts:

In December 2020, news media reported a new variant of the coronavirus that causes COVID-19, and since then, other variants have been identified and are under investigation. The new variants raise questions: Are people more at risk for getting sick? Will the COVID-19 vaccines still work? Are there new or different things you should do now to stay safe?

Stuart Ray, M.D., vice chair of medicine for data integrity and analytics, and Robert Bollinger, M.D., M.P.H., Raj and Kamla Gupta professor of infectious diseases, are experts in SARS-CoV-2, the virus that causes COVID-19. They talk about what is known about these new variants, and answer questions and concerns you may have.

Coronavirus Mutation: Why does the coronavirus change?

Variants of viruses occur when there is a change - or mutation - to the virus's genes. Ray says it is the nature of RNA viruses such as the coronavirus to evolve and change gradually. "Geographic separation tends to result in genetically distinct variants," he says.

Mutations in viruses - including the coronavirus causing the COVID-19 pandemic - are neither new nor unexpected. Bollinger explains: "All RNA viruses mutate over time, some more than others. For example, flu viruses change often, which is why doctors recommend that you get a new flu vaccine every year."

What is the delta variant?

Since the beginning of the COVID-19 pandemic, the SARS-CoV-2 coronavirus that causes COVID-19 has mutated (changed), resulting in different variants of the virus. One of these is called the delta variant (arising from Pango lineage B.1.617.2). The delta coronavirus is considered a "variant of concern" by the WHO and CDC because it appears to be more easily transmitted from one person to another. As of September 2021, delta is regarded as the most contagious form of the SARS-CoV-2 coronavirus so far.

Here is what you should know:
The CDC recommends that everyone wait until they are fully vaccinated for COVID-19 before traveling internationally. Traveling internationally if you are not fully vaccinated for COVID-19 is not recommended, because it puts you at risk for coronavirus infection, including the SARS-CoV-2 delta variant. This includes unvaccinated children.

Delta rapidly became the dominant variant of the SARS-CoV-2 virus in the U.S. in 2021.

Delta variant SARS-CoV-2, the virus that causes COVID-19, is now in most countries where SARS-CoV-2 is circulating, and people traveling internationally are likely to encounter it.

Unvaccinated adults and children should strictly follow mask, distancing and hygiene safety precautions and avoid international travel if possible.

Being fully vaccinated for COVID-19 can protect you from the delta variant, but breakthrough infections sometimes occur.

All three of the F.D.A.-authorized COVID-19 vaccines can protect you from the delta variant. For Pfizer and Moderna vaccines, you need both doses for maximum protection. People should know that vaccines are very effective at preventing the most severe forms of COVID-19, but breakthrough infections can occur and caution is still warranted after becoming vaccinated.

While the authorized COVID-19 vaccines are not perfect, they are highly effective against serious coronavirus disease and reduce the risk of hospitalization and death.

Other vaccines available in other countries may not be as effective in protecting you from the delta variant and other mutations of the coronavirus.

Although vaccines afford very high protection, infection with the delta and other variants remain possible. Fortunately, vaccination, even among those who acquire infections, appears to prevent serious illness, hospitalization and death from COVID-19.

How many strains of COVID are there?

"We are seeing multiple variants of the SARS-CoV-2 coronavirus that are different from the version first detected in China," Ray says.

"Different variants have emerged in England, Brazil, California and other areas. More infectious variants such as beta, which first appeared in South Africa, may have increased ability to re-infect people who have recovered from earlier versions of the coronavirus, and also be somewhat resistant to some of the coronavirus vaccines in development. Still, vaccines currently used appear to offer significant protection from severe disease caused by coronavirus variants."

What is a variant of concern?

Coronavirus variants are classified in different categories by organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

A variant of interest is a coronavirus variant that, compared to earlier forms of the virus, has genetic characteristics that predict greater transmissibility, evasion of immunity or diagnostic testing or more severe disease.

A variant of concern has been observed to be more infectious, more likely to cause breakthrough or re-infections in those who are vaccinated or previously infected. These variants are more likely to cause severe disease, evade diagnostic tests, or resist antiviral treatment. Alpha, beta, gamma, and delta variants of the SARS-CoV-2 coronavirus are classified as variants of concern.

A variant of high consequence is a variant for which current vaccines do not offer protection. As of now, there are no SARS-CoV-2 variants of high consequence.

Will the COVID-19 vaccines work on the new variants?

Ray says, "There is evidence from laboratory studies that some immune responses driven by current vaccines could be less effective against some of these variants. The immune response involves many components, including B cells that make antibodies and T cells that can react to infected cells, and a reduction in one does not mean that the vaccines will not offer protection.

"People who have received the vaccines should watch for changes in guidance from the CDC [Centers for Disease Control and Prevention], and continue with coronavirus safety precautions to reduce the risk of infection, such as mask wearing, physical distancing and hand hygiene."

"We deal with mutations every year for flu virus, and will keep an eye on this coronavirus and track it," says Bollinger. "If there would ever be a major mutation, the vaccine development process can accommodate changes, if necessary," he explains.

How are the new coronavirus variants different?

"There's evidence that some genetic changes in SARS-CoV-2 can result in a more contagious variant," Bollinger says. "This is particularly true for the delta variant."

He notes that some of the mutations seem to affect the coronavirus's spike protein, which covers the outer coating of SARS-CoV-2 and give the virus its characteristic spiny appearance. These proteins help the virus attach to human cells in the nose, lungs and other areas of the body.

"Researchers have preliminary evidence that some of the new variants seem to bind more tightly to our cells" Bollinger says. "This appears to make some of these new strains 'stickier' due to changes in the spike protein and therefore more easily transmitted."

Are coronavirus variants more dangerous?

Bollinger says that some of these mutations may enable the coronavirus to spread faster from person to person, and more infections can result in more people getting very sick or dying. In addition, studies are underway to determine whether some variants could be associated with more severe disease.

"Therefore, it is very important for us to expand the number of genetic sequencing studies to keep track of these variants," he says.

Bollinger explains that it may be more advantageous for a respiratory virus to evolve so that it spreads more easily. On the other hand, mutations that make a virus more deadly may not give the virus an opportunity to spread efficiently. "If we get too sick or die quickly from a particular virus, the virus has less opportunity to infect others. However, as we have seen with delta, more infections from a faster-spreading variant will lead to more hospitalizations and deaths," he notes.

Could a new COVID-19 variant affect children more frequently than earlier strains?

Ray says that widespread infection with the delta variant has resulted in an increased number of cases in children, including uncommon severe infections and deaths.

"There is no convincing evidence that any of the variants have special propensity to infect or cause disease in children. We need to be vigilant in monitoring such shifts, but we can only speculate at this point," he says.

Will there be more new coronavirus variants?

Yes. As long as the coronavirus spreads through the population, mutations will continue to happen, and the delta variant family continues to evolve.

"New variants of the SARS-CoV-2 virus are detected every week," Ray says. "Most come and go - some persist but don't become more common; some increase in the population for a while, and then fizzle out. When a change in the infection pattern first pops up, it can be very hard to tell what's driving the trend - changes to the virus, or changes in human behavior. It is worrisome that similar changes to the spike protein are arising independently on multiple continents."

Are there additional COVID-19 precautions for the new coronavirus variants?

Bollinger says that as of now, none of the new coronavirus variants call for any new prevention strategies. "We need to continue doing the basic precautions that we know work to interrupt spread of the virus," he says.

Ray concurs: "There is no demonstration yet that these variants are biologically different in ways that would require any change in current recommendations meant to limit spread of COVID-19," he says. "Nonetheless, we must continue to be vigilant for such phenomena. For now, the greater infectiousness we're seeing means we must redouble our efforts using the preventative tools that we have in a multi-layered approach."

Ray stresses that both vaccination and human behavior are important. "It is striking to note that the majority of COVID-19 deaths are now occurring in unvaccinated people, even when most adults in the USA have been vaccinated," he says.

"The more people who are unvaccinated and infected, the more chances there are for mutations to occur. Limiting the spread of the virus through maintaining COVID-19 safeguards (mask wearing, physical distancing, practicing hand hygiene and getting vaccinated) gives the virus fewer chances to change. It also reduces the spread of more infectious variants, if they do occur.

"Vaccines are the medical miracle of 2020, but we need to re-emphasize basic public health measures, including masking, physical distancing, good ventilation indoors and limiting gatherings of people in close proximity with poor ventilation. We give the virus an advantage to evolve when we congregate in more confined spaces," he says.

Regarding coronavirus variants, how concerned should we be?

"Most of the genetic changes we see in this virus are like the scars people accumulate over a lifetime - incidental marks of the road, most of which have no great significance or functional role," Ray says. "When the evidence is strong enough that a viral genetic change is causing a change in the behavior of the virus, we gain new insight regarding how this virus works. The virus seems to have some limitations in its evolution - the advantageous mutations are drawn from a relatively limited menu - so there is some hope that we might not see variants that fully escape our vaccines.

"Updated versions of the current vaccines are being evaluated, but there is no clinical trial evidence yet that variant-specific vaccines would provide significantly greater protection. Though SARS-CoV-2 is changing gradually, it's still much less genetically diverse than influenza."

"As far as these variants are concerned, we don't need to overreact," Bollinger says. "But, as with any virus, changes are something to be watched, to ensure that testing, treatment and vaccines are still effective. The scientists will continue to examine new versions of this coronavirus's genetic sequencing as it evolves."

"In the meantime, we need to continue all of our efforts to prevent viral transmission and to vaccinate as many people as possible, and as soon as we can."

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Featured Experts: In December 2020, news media reported a new variant of the coronavirus that causes COVID-19, and since then, other variants have been identified and are under investigation. The new variants raise questions: Are people more at risk for getting sick? Will the COVID-19 vaccines still work?

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Do covid rates go up in the summer?
No because the flu is spread easier in damp/ humid climates so it depends on where in the world you are but lowest rates are in dry/ warm areas
https://ccdd.hsph.harvard.edu/will-covid-19-go-away-on-its-own-in-warmer-weather/

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Seasonality of SARS-CoV-2: Will COVID-19 go away on its own in warmer weather?

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(tl;dr) Probably not. Several people, including the US president, have suggested that the novel coronavirus SARS-CoV-2 and the disease it causes, COVID-19, will go away on its own in the warmer weather that will come in the Northern Hemisphere in coming months. Some have even suggested that the experience with SARS in 2003 provides evidence for this assertion.

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What are some ignored side effects of Covid-19?

Answer: Some people may experience post-covid "brain fog." This means some people may have memory loss, a poor attention span and fatigue.
https://www.cedars-sinai.org/blog/covid-19-brain-fog.html#:~:text=A%20full%20year%20has%20passed,inability%20to%20think%20straight.

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A full year has passed since the COVID-19 pandemic began, and the mind-boggling aftermath of the virus continues to confuse doctors and scientists. Particularly concerning for doctors and patients alike are lingering side effects, such as memory loss, reduced attention and an inability to think straight.

Wondering how a respiratory virus can lead to cognitive effects that last for weeks? It turns out, some sort of mental fallout after an infectious illness is not uncommon.

"What we're seeing with COVID-19 is similar to infectious complications we've seen with other viruses, such as SARS and H1N1," explains Dr. Rachel Zabner, an infectious disease specialist and co-director of Cedars-Sinai's COVID-19 Recovery Program along with Dr. Catherine Le.

It may be months before the data provides a clear picture of this post-COVID-19 "brain fog," but experts suspect that the stress of navigating COVID-19 coupled with the virus's physical toll on the body is resulting in a significant cognitive hit for a subset of patients.

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A full year has passed since the COVID-19 pandemic began, and the mind-boggling aftermath of the virus continues to confuse doctors and scientists. Particularly concerning for doctors and patients alike are lingering side effects, such as memory loss, reduced attention and an inability to think straight.

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What are the symptoms of COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

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Centers for Disease Control and Prevention

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Symptoms, testing, what to do if sick, daily activities, and more.

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should you get the vaccine?

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid19-vaccine-hesitancy-12-things-you-need-to-know

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Featured Experts:

Updated on November 10, 2021

Since the U.S. Food and Drug Administration (FDA) authorized the first COVID-19 vaccines, more than one hundred million people in the U.S. have been vaccinated. You may be considering what the COVID-19 vaccines mean for you and your family.

Johns Hopkins Medicine views all authorized COVID-19 vaccines as highly effective at preventing serious disease, hospitalization, and death from COVID-19. To support you as you make your decision, here are 12 facts and insights, shared by Sherita Golden, M.D., M.H.S., chief diversity officer at Johns Hopkins Medicine, who specializes in diabetes, heart conditions and patterns of disease in diverse communities.

1. Getting the COVID-19 vaccine can protect you from getting sick.

The COVID-19 vaccines work with your immune system so your body will be ready to fight the coronavirus if you are exposed to it - including coronavirus variants such as delta. As the COVID-19 pandemic continues, getting the vaccine is a powerful step in taking charge of your health. When given as directed, the FDA-authorized vaccines can prevent severe COVID-19 illness and death.

2. Diversity in COVID-19 vaccine testing helped assess safety and effectiveness.

COVID-19 affects everyone, so scientists made sure clinical trial participants for the vaccines were diverse. The clinical trials for the first two COVID-19 vaccines included Black (about 10% of participants) and Hispanic (about 20% of participants) people, older age groups (about 25%), and people with conditions such as obesity, diabetes, and heart and respiratory conditions. The U.S. study participants for the one-shot COVID-19 vaccine were 15% Hispanic/Latinx; 13% Black/African American; 6% Asian and 1% Native American.

3. Do you have allergies? You can probably still get the COVID-19 vaccine.

The CDC says people with allergies to certain foods, insects, latex and other common allergens can get a COVID-19 vaccine. If you have ever had a severe allergic reaction to a vaccine, be sure to discuss that with your doctor, who can evaluate you and assess your risk. However, if you are severely allergic to any of the coronavirus vaccines' ingredients, you should not be vaccinated.

4. People of color are especially vulnerable to severe COVID-19.

Generations of health inequities have caused Black and Hispanic/Latin Americans and other communities of color to be overrepresented in severe COVID-19 cases and deaths. People of color are vulnerable to COVID-19 risk factors, and are more likely to be working front-line, essential jobs that cannot be performed from home, increasing their chances of being infected. Getting vaccinated can provide protection for you and those you love.

5. If you've already had COVID-19, getting the vaccine will add extra protection.

A study published in August 2021 indicates that if you had COVID-19 before and are not vaccinated, your risk of getting reinfected is more than two times higher than for those who were infected and got vaccinated.

While evidence suggests there is some level of immunity for those who previously had COVID, it is not known how long you are protected from getting COVID-19 again. Plus, the level of immunity provided by the vaccines after having COVID-19 is higher than the level of immunity for those who had COVID but were not subsequently vaccinated.

Getting vaccinated provides greater protection to others since the vaccine helps reduce the spread of COVID-19.

6. More vaccinations for COVID-19 mean a chance to get back to normal.

After over a year of coronavirus pandemic closures, cancellations and postponements, everyone is eager to think about returning to work, school, sports, family celebrations and social activities. Though no one is sure when the pandemic will be over, every person who gets protection from the coronavirus by getting a vaccination helps us move closer to normal life.

7. Here's what we know about pregnancy, breastfeeding and fertility concerns with the COVID-19 vaccines.

Johns Hopkins Medicine agrees with and strongly supports the recommendations of the CDC and other organizations who recommend that all pregnant or lactating individuals, along with those trying to get pregnant, be vaccinated against COVID-19. Find out more about the vaccine and pregnancy .

8. How can you decide if you should get the COVID-19 vaccine?

Do your research: Your questions are important, and getting the right answers from reliable sources can add to your peace of mind. Talk to your family doctor and people you know who have been vaccinated and learn all you can about the COVID-19 vaccine so you can make the most informed decision about getting vaccinated.

Overcoming COVID-19 Vaccine Hesitancy | Aminah Leekins Shares Her Story

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COVID-19 Vaccine Hesitancy: 12 Things You Need to Know

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Featured Experts: Updated on November 10, 2021 Since the U.S. Food and Drug Administration (FDA) authorized the first COVID-19 vaccines, more than one hundred million people in the U.S. have been vaccinated. You may be considering what the COVID-19 vaccines mean for you and your family.

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What can you do to stay safe?https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-frequently-asked-questions#:~:text=%E2%80%A2%20Wash%20your%20hands%20often,is%20offered%20to%20you.

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Will they ever come up with a cure https://amp.cnn.com/cnn/2021/09/27/health/covid-treatment-pill-khn-partner/index.html

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(KHN) Within a day of testing positive for covid-19 in June, Miranda Kelly was sick enough to be scared. At 44, with diabetes and high blood pressure, Kelly, a certified nursing assistant, was having trouble breathing, symptoms serious enough to send her to the emergency room.

When her husband, Joe, 46, fell ill with the virus, too, she really got worried, especially about their five teenagers at home: "I thought, 'I hope to God we don't wind up on ventilators. We have children. Who's going to raise these kids?"

But the Kellys, who live in Seattle, had agreed just after their diagnoses to join a clinical trial at the nearby Fred Hutch cancer research center that's part of an international effort to test an antiviral treatment that could halt covid early in its course.

By the next day, the couple were taking four pills, twice a day. Though they weren't told whether they had received an active medication or placebo, within a week, they said, their symptoms were better. Within two weeks, they had recovered.

"I don't know if we got the treatment, but I kind of feel like we did," Miranda Kelly said. "To have all these underlying conditions, I felt like the recovery was very quick."

The Kellys have a role in developing what could be the world's next chance to thwart covid: a short-term regimen of daily pills that can fight the virus early after diagnosis and conceivably prevent symptoms from developing after exposure.

"Oral antivirals have the potential to not only curtail the duration of one's covid-19 syndrome, but also have the potential to limit transmission to people in your household if you are sick," said Timothy Sheahan, a virologist at the University of North Carolina-Chapel Hill who has helped pioneer these therapies.

Antivirals are already essential treatments for other viral infections, including hepatitis C and HIV. One of the best known is Tamiflu, the widely prescribed pill that can shorten the duration of influenza and reduce the risk of hospitalization if given quickly.

The medications, developed to treat and prevent viral infections in people and animals, work differently depending on the type. But they can be engineered to boost the immune system to fight infection, block receptors so viruses can't enter healthy cells, or lower the amount of active virus in the body.

At least three promising antivirals for covid are being tested in clinical trials, with results expected as soon as late fall or winter, said Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, who is overseeing antiviral development.

"I think that we will have answers as to what these pills are capable of within the next several months," Dieffenbach said.

The top contender is a medication from Merck & Co. and Ridgeback Biotherapeutics called molnupiravir, Dieffenbach said. This is the product being tested in the Kellys' Seattle trial. Two others include a candidate from Pfizer, known as PF-07321332, and AT-527, an antiviral produced by Roche and Atea Pharmaceuticals.

They work by interfering with the virus's ability to replicate in human cells. In the case of molnupiravir, the enzyme that copies the viral genetic material is forced to make so many mistakes that the virus can't reproduce. That, in turn, reduces the patient's viral load, shortening infection time and preventing the kind of dangerous immune response that can cause serious illness or death.

So far, only one antiviral drug, remdesivir, has been approved to treat covid. But it is given intravenously to patients ill enough to be hospitalized, and is not intended for early, widespread use. By contrast, the top contenders under study can be packaged as pills.

Sheahan, who also performed preclinical work on remdesivir, led an early study in mice that showed that molnupiravir could prevent early disease caused by SARS-CoV-2, the virus that causes covid. The formula was discovered at Emory University and later acquired by Ridgeback and Merck.

Clinical trials have followed, including an early trial of 202 participants last spring that showed that molnupiravir rapidly reduced the levels of infectious virus. Merck chief executive Robert Davis said this month that the company expects data from its larger phase 3 trials in the coming weeks, with the potential to seek emergency use authorization from the Food and Drug Administration "before year-end."

Pfizer launched a combined phase 2 and 3 trial of its product Sept. 1, and Atea officials said they expect results from phase 2 and phase 3 trials later this year.

If the results are positive and emergency use is granted for any product, Dieffenbach said, "distribution could begin quickly."

That would mean millions of Americans soon could have access to a daily orally administered medication, ideally a single pill, that could be taken for five to 10 days at the first confirmation of covid infection.

"When we get there, that's the idea," said Dr. Daniel Griffin, an infectious diseases and immunology expert at Columbia University. "To have this all around the country, so that people get it the same day they get diagnosed."

Once sidelined for lack of interest, oral antivirals to treat coronavirus infections are now a subject of fierce competition and funding. In June, the Biden administration announced it had agreed to obtain about 1.7 million treatment courses of Merck's molnupiravir, at a cost of $1.2 billion, if the product receives emergency authorization or full approval. The same month, the administration said it would invest $3.2 billion in the Antiviral Program for Pandemics, which aims to develop antivirals for the covid crisis and beyond, Dieffenbach said.

The pandemic kick-started a long-neglected effort to develop potent antiviral treatments for coronaviruses, said Sheahan. Though the original SARS virus in 2003 gave scientists a scare - followed by Middle East respiratory syndrome, or MERS, in 2012 - research efforts slowed when those outbreaks did not persist.

"The commercial drive to develop any products just went down the tubes," said Sheahan.

Widely available antiviral drugs would join the monoclonal antibody therapies already used to treat and prevent serious illness and hospitalizations caused by covid. The lab-produced monoclonal antibodies, which mimic the body's natural response to infection, were easier to develop but must be given primarily through intravenous infusions.

The federal government is covering the cost of most monoclonal products at $2,000 a dose. It's still too early to know how the price of antivirals might compare.

Like the monoclonal antibodies, antiviral pills would be no substitute for vaccination, said Griffin. They would be another tool to fight covid. "It's nice to have another option," he said.

One challenge in developing antiviral drugs quickly has been recruiting enough participants for the clinical trials, each of which needs to enroll many hundreds of people, said Dr. Elizabeth Duke, a Fred Hutch research associate overseeing its molnupiravir trial.

Participants must be unvaccinated and enrolled in the trial within five days of a positive covid test. Any given day, interns make 100 calls to newly covid-positive people in the Seattle area - and most say no.

"Just generally speaking, there's a lot of mistrust about the scientific process," Duke said. "And some of the people are saying kind of nasty things to the interns."

If the antiviral pills prove effective, the next challenge will be ramping up a distribution system that can rush them to people as soon as they test positive. Griffin said it will take something akin to the program set up last year by UnitedHealthcare, which sped Tamiflu kits to 200,000 at-risk patients enrolled in the insurer's Medicare Advantage plans.

Merck officials predicted the company could produce more than 10 million courses of therapy by the end of the year. Atea and Pfizer have not released similar estimates.

Even more promising? Studies evaluating whether antivirals can prevent infection after exposure.

"Think about that," said Duke, who is also overseeing a prophylactic trial. "You could give it to everyone in a household, or everyone in a school. Then we're talking about a return to, maybe, normal life."

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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A pill to treat Covid-19: 'We're talking about a return to, maybe, normal life'

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Antivirals are already essential treatments for other viral infections, including hepatitis C and HIV. One of the best known is Tamiflu, the widely prescribed pill that can shorten the duration of influenza and reduce the risk of hospitalization if given quickly.

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How did it originate?
www.cdc.gov