The Department of Health and Human Services maintains a list of locations where the Pfizer pill is available. For now, supply is so limited that state health officials are recommending it be used only for the patients at highest risk.
The National Institutes of Health, which formulates treatment guidelines for physicians, recommended last month that when supply is limited, antiviral pills and antibody treatments should be prioritized for the highest-risk unvaccinated patients, as well as people of any vaccination status with weakened immune systems.
Many state officials have already taken cues from that guidance, saying they are carefully distributing the pills they have received to people most in need. Arizona, for instance, advised that Paxlovid be given only to people over 70 who also have severe health conditions like end-stage heart disease, or to younger patients with weakened immune systems.
In West Virginia, health officials have shipped around 20 treatment courses to each of 14 locations and reserved about 20 more in case of an outbreak, said Dr. Clay Marsh, the state’s Covid-19 czar.
And in Louisiana, health officials met last week with hospital executives from across the state, who pitched a plan that the state adopted this week, distributing its most recent allocation of 342 courses of Paxlovid among hospital outpatient pharmacies.
Dr. Joseph Kanter, Louisiana’s top health official, said the idea was to ease the strain on overflowing emergency departments and intensive care units, allowing physicians in such settings to discharge at-risk patients after prescribing them the pill.
That will shorten the time between when a patient is identified as a candidate for Paxlovid and when the patient starts taking it, Dr. Kanter said.
“You have to put it in the hands of providers and pharmacists and provide the best guidance you can,” he said, “then step back and hope it gets to people who most need it.”