(Image: Private Media/Mitchell Squire)

Treating and managing COVID-19 will look very different in 2022 as Australia is likely to hit 80% vaccination rates for those over 16 in weeks. Instead of driving to a clinic to be tested, Australians may be able to test themselves at home after the Therapeutic Goods Administration approved rapid antigen tests last week. 

Managing symptoms will be easier too. Vaccines reduce the likelihood of developing severe illness and over-the-counter pills will soon be available now the government has secured 300,000 courses of molnupiravir, an antiviral capsule that helps prevent serious illness. (The drug manufacturer, Merck, is charging the US government 40 times what it costs to make the drug.)

But it’s not all sunshine, roses and limited sniffles: treatments are still limited, at-home testing kits have limitations, and vaccines are still our best bet.  

What medications are there?

Sales of hydroxychloroquine, an antimalarial and anti-rheumatic drug, and ivermectin, an anti-parasitic drug used on large farm animals, grew in Australia across the first year of the pandemic, despite limited evidence of effectiveness. Instead of dosing up on horse medication (the TGA cracked down on ivermectin prescriptions last month), Australians will soon be able to use a range of medications.

Fifteen thousand doses of sotrovimab, an antibody treatment that mimics the natural antibodies produced by the immune system, have landed on our shores. When intravenously administered within five days of COVID symptoms appearing, it reduces the likelihood of being hospitalised or dying by 79%. 

The government has snatched up doses of molnupiravir, which is in late-stage clinical trials. Studies show it could reduce the risk of hospitalisation and death by 50%. The pill is taken twice a day for five days for those with COVID symptoms. 

Yesterday the TGA also granted provisional determination to an oral antiviral treatment being developed by Pfizer — designed to block the activity of a key enzyme the virus needs to replicate — and tocilizumab, a treatment for patients on ventilators. 

​Remdesivir and dexameth​asone have also been used for those hospitalised with COVID, and tocilizumab too, although there are critical shortages of this arthritis drug. 

As simple as swabbing at home? 

The TGA’s approval of rapid antigen testing will not replace the lab PCR tests which have been used across Australia. PCR test results generally take six hours to run and are analysed in a lab; rapid antigen testing can give results in as little as 10 minutes. But rapid antigen testing is less reliable than PCR tests, returning false negatives to those with a low viral load and false positives to the uninfected.

The Royal College of Pathologists of Australasia has called for caution in the use of these tests, which can only be done by those who have undertaken training. Someone who returns a positive rapid antigen test will still have to get a PCR test.

Despite their limitations, rapid antigen testing is promising. Their fast turnaround time means they can be used in airports, transport hubs, schools and eventually homes, and widespread use in outbreak areas can get positive cases into isolation faster.

Vaccines still our best bet

Vaccines are still the best measure at protecting against COVID-19 — but their efficacy does wane. From Sunday the Israeli government will strip more than a million citizens who received their second vaccine more than six months ago of their vaccine passports.

Israel was the first nation to use the Pfizer vaccine and the first to widely introduce booster shots for the elderly and immunocompromised as infections started to rise in August. 

Australia has yet to release details around the vaccine booster program.

The TGA has also recognised China’s Sinovac and India’s Covishield, locally manufactured versions of AstraZeneca, for incoming international travellers. The vaccines haven’t been approved for use in Australia but will allow travellers to quarantine at home within months. 

Would you be comfortable using rapid antigen tests rather than PCR tests? Let us know your thoughts by writing to letters@crikey.com.au. Please include your full name if you would like to be considered for publication in Crikey’s Your Say column. We reserve the right to edit for length and clarity.