Hong Kong Covid-19 patients who are aged 60 and above or who have severe immune deficiency, as well as other unvaccinated high-risk individuals, could be treated with oral drugs molnupiravir and Paxlovid, the Hospital Authority has said. Both antiviral drugs have been shown to reduce risk of hospitalisation with Covid-19.

The use of the two Covid-19 oral tablets was broadened in Hong Kong after experts from the Hospital Authority reviewed the clinical use of the antiviral drugs, the statutory body confirmed to HKFP on Tuesday. The first shipment of the Pfizer-made Paxlovid pills arrived in the city on March 14 amid the fifth and worst wave of Covid-19 infections.

Paxlovid Covid-19 oral drug pill
The first shipment of the Covid-19 oral drug Paxlovid arrived in Hong Kong on March 14, 2022 and was distributed to the Hospital Authority for application on March 15, 2022. Photo: GovHK.

Under the updated guidelines, doctors may prescribe the drugs to Covid-19 patients aged 60 or above, regardless of their vaccination status. The oral tablets may also be used to treat people with immunodeficiency, as well as high-risk individuals under 60 who have not received a dose of Covid-19 vaccine.

Previously, the drugs were offered to patients aged 70 or above, while restrictions linked to vaccination status have been lifted.

Doctors should make their judgements based on the clinical condition of their patients, the Hospital Authority said, including their physical condition and the date of symptoms onset to lower the chances of side effects from the oral drugs.

“The Hospital Authority would try its best to prescribe the oral drugs to suitable patients, in order to lower the chances of deterioration,” a spokesperson for the Hospital Authority said.

hospital authority logo (3)
The Hospital Authority logo. Photo: Tom Grundy/HKFP.

Both oral drugs could be used to treat patients with mild symptoms, and should be administered within five days of symptoms appearing and before any obvious respiratory failure, infectious disease expert Professor David Hui of the Chinese University of Hong Kong said at a press briefing last Monday.

According to Hui, research showed that the German-made Paxlovid could lower the risk of hospitalisation and death by close to 90 per cent. But it often comes with side effects including diarrhoea, slightly high blood pressure or muscle fatigue. Pregnant and lactating women could use the drug safely, but it is not suitable for those with serious kidney and liver failure, he said.

Produced by US pharmaceutical firm MSD, molnupiravir is known to reduce the chances of hospitalisation by 30 per cent, the CUHK scholar said. Hui warned that the tablet should not be used to treat pregnant women as it may affect the growth of the foetus. The drug is not suitable for women who are breastfeeding and people aged under 18, as the latter may suffer from impaired bone development.

Paxlovid Covid-19 oral drug pills
The first shipment of the Covid-19 oral drug Paxlovid arrived in Hong Kong on March 14, 2022 and was distributed to the Hospital Authority for application on March 15, 2022. Photo: GovHK.

The drug may also cause side effects including diarrhoea, minor headaches, a rash and nausea.

Last month, health minister Sophia Chan told the legislature that the Hospital Authority purchased “appropriate quantities” of molnupiravir and Paxlovid, according to expert advice. But she refused to disclose the drug prices, citing “commercial sensitivity.”

As of Monday, Hong Kong has registered more than 1 million cases of Covid-19 while its death toll reached 6,119.

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Ho Long Sze Kelly is a Hong Kong-based journalist covering politics, criminal justice, human rights, social welfare and education. As a Senior Reporter at Hong Kong Free Press, she has covered the aftermath of the 2019 extradition bill protests and the Covid-19 pandemic extensively, as well as documented the transformation of her home city under the Beijing-imposed national security law.

Kelly has a bachelor's degree in Journalism from the University of Hong Kong, with a second major in Politics and Public Administration. Prior to joining HKFP in 2020, she was on the frontlines covering the 2019 citywide unrest for South China Morning Post’s Young Post. She also covered sports and youth-related issues.