SEATTLE — For people with coronavirus, one of the only places they’ll get treatment is in the hospital.
But by then, Dr. Josh Schiffer of Seattle’s Fred Hutch said, “They already have a three-alarm fire in their lungs.”
Schiffer is advocating a new approach: intervening between when people first feel symptoms and when they need to go to the hospital for help breathing.
That window of opportunity is roughly a week.
Along with colleagues at Fred Hutch and the University of Washington, Schiffer just published a commentary in Open Forum Infectious Diseases calling for an “early test and treat strategy.”
At the first sign of any mild symptom, like a fever or cough, he envisions a person getting a COVID-19 test, ideally with nasal self-swabbing at home.
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A quickly delivered positive test result would lead a doctor to send medication to the patient’s home. The person would start taking pills right away to head off the worst of the disease.
"It does require reconsidering how we deliver health care," Schiffer said.
It also requires drugs that work for outpatient COVID-19 treatment.
Schiffer said there are several possibilities, including repurposed cancer and psychiatric drugs.
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He advocates clinical trials that focus not on preventing death, but on preventing the need to go to the hospital at all.
"So the whole thing happens at home, the infection risk is much lower, and hopefully they're prevented from ever requiring hospitalization," Schiffer said.
Fred Hutch hopes to have an outpatient clinical trial center running in August so people with the coronavirus can enroll in studies.
Schiffer said it’s possible that some outpatient treatments could be ready by the end of the year.