WEST PALM BEACH, Fla. — It's not a one-size-fits-all situation, but local hospitals have developed standard protocols for treating COVID-19.
The medicines you receive at the hospital if you are admitted with COVID-19 symptoms depends on many factors.
It also depends on what hospital you go to.
SPECIAL COVERAGE: Coronavirus
Four infectious disease specialists affiliated with Palm Beach County hospitals broke down what the standard protocol is to treat COVID-19 if you're admitted to the hospital.
"For people who get in the hospital, we only have one medication that actually fights the virus, and that's remdesivir," said Dr. Larry Bush, infectious disease specialist affiliated with Wellington Regional Medical Center.
But why do some people get admitted to the hospital and others with symptoms do not?
"When someone gets COVID infection, it's hard to predict how they're going to do, but each person begins their own COVID journey," said Dr. David Dodson, an infectious disease specialist affiliated with Good Samaritan and St. Mary's medical centers.
Doctors said most patients who have oxygen levels at 95 percent or above are not admitted.
"If they go home, maybe they'll get Z-Pak. If they are mildly hypoxic, maybe they'll get steroids and those are options for them. Sometimes they give them inhalers if they have wheezing or bronchial spasms and good old Tylenol," said Dr. Leslie Diaz, infectious disease specialist affiliated with Palm Beach Gardens Medical Center and Jupiter Medical Center.
Monoclonal antibody therapy is the only outpatient treatment available for COVID-19. It's given intravenously or in shots under the skin.
The treatment is a lab-made protein designed to produce antibodies and block the virus from attaching to cells. But doctors said it's only effective early on in the disease.
"If it's given early enough, it seems to decrease hospitalization by 70 to 80 percent but then 30 percent it doesn't do enough," Dodson said.
Bush, Diaz, Dodson and Dr. Olayemi Osiyemi all agree that you're likely going to receive steroids and remdesivir to treat COVID-19.
If the illness progresses, you'll also receive anti-inflammatory medications like baricitinib, which is used to treat rheumatoid arthritis but has been given emergency use authorization along with remdesivir to work in combination to fight the effects of the virus.
But as Osiyemi explained, there may be some scenarios where you aren't given these drugs.
"There might be a reason why we can't give a drug, such as remdesivir if you have bad kidney failure or liver problems you can't give the drug," said Osiyemi, who is affiliated with JFK North, Good Samaritan and St. Mary’s Medical Center.
Then there are the drugs that most doctors are not even prescribing anymore, which include ivermectin and hydroxycloroquine.
"These are drugs that are called repurposed in other words. They had a specific purpose like rheumatoid disease or pyrocytic diseases, and now the government looked at the information and said, 'We think it may be beneficial. We're going to recommend it under emergency use, but going forward we're going to keep studying it,'" Bush said.
Ivermectin is used to treat parasites and hydroxycloroquine is used to treat autoimmune conditions and malaria.
Some doctors are still prescribing it to fight COVID-19, but most hospitals are not using it anymore.
"Why aren't they being used as a protocol of care in the hospital?" asked WPTV Senior Reporter Michelle Quesada.
"Hydroxycloroquine has been extensively studied since last year and [there is] no clinical benefit. We do not recommend it. We do not use it," Dodson said. "Ivermectin, the way this started, was that it showed in the test tubes some antiviral activity. The problem is that the amount to get an antiviral activity is far and above in a human is way above toxic levels."
Bush, Dodson and Osiyemi also said that convalescent plasma is another form of treatment that is also not widely used anymore.
"The data from what we know so far, from our experience from all the research that has been done, the plasma can be effective in some scenarios but not always," Osiyemi said.
But Diaz said it's still another tool in her COVID-19 fighting toolbox. She said in some cases she'll also give ivermectin.
"I think that we can't knock anybody down for using stuff like you said. Sometimes it's just hope for the patient and unless you're doing them harm, which you're really not, in some of these very benign medications, I think, it's just another tool that you can use and show them we're going to try this and see if it makes a difference,” Diaz said.
The doctors all said vaccinations are still the best way to prevent hospitalization from COVID-19 and offer hope that in the near future there may be more options to treat the virus at home.
"The next evolution in COVID infection is if we can come up with some anti-viral pill relatively [early] on before they got to the hospital that would be kind of game changer in all of this," Dodson said. "They are working on it, but it's not here yet."
