My COVID symptoms started on Monday 3 October 2022. Wednesday of that week, I finally used a rapid test, and it came back positive. I explain all of that in detail here.
My purpose for seeking treatment was that I am overweight and have asthma. As I am not seriously overweight, the weight issue is of lower concern for COVID complications. Asthma, on the other hand, is of serious concern. I was already far sicker than a number of people I knew of had been when they dealt with COVID, and I didn't want to risk it ending up severe and with me in the emergency room.
Thursday, 6 October, I received a PCR test through CVS. The turnaround on it was estimated 1-2 days after lab arrival. I had a chance to meet with one of my practitioners, and she suggested going to urgent care to seek treatment. There were, as far as we understood it, two outpatient treatment options, Paxlovid and Remdesivir, both of which are anti-viral medications. She told me based on my existing medications, I could not take Paxlovid, and therefore to ask for Remdesivir instead. I made an urgent care appointment immediately after that. It was cancelled and turned into a virtual appointment, which I waited for, and was then told I would have to go in to get a PCR test through their lab before they would be willing to provide treatment. The provider indicated that with a positive test, I could then get the Remdesivir I was asking for. I was informed it was too late to schedule an in-person appointment at that point, and therefore I would have to wait until tomorrow. So I was scheduled for an appointment at 11am the following day.
Friday I went to urgent care to get my second PCR test. They were confused by my request for Remdesivir, and said they don't do the COVID treatment prescribing in the clinic anyway, that must be done via virtual appointment, and I was instructed to go home and wait for the results. If it was positive, I would receive a call. I went home, logged into my account with them, and hit refresh regularly on the lab results page until my results showed up. Positive. I assumed I was supposed to wait for the call before I could schedule another virtual appointment. I waited two hours with no phone call before I gave up and scheduled a virtual appointment. It is worth noting that it was now 4:30pm on a Friday. The provider for this appointment looked into it and said they don't prescribe Remdesivir outside an ER environment, which was a piece of information I feel like the original provider should have had. This provider offered another treatment option: a monoclonal antibody infusion. She said she would try to find an infusion clinic to call me and get me in. It's now 4:50pm. Of course, I never received that call either.
At this point, I was basically out of options. COVID treatments must be provided within a certain amount of time from onset of symptoms, with some treatments being a maximum of five days. My symptoms started Monday night, and therefore I would no longer be eligible for these treatments after Saturday night. It was obvious that no infusion center was going to call me on a weekend.
Saturday morning, with help, I looked into exactly why my practitioner suggested I shouldn't take Paxlovid. The conclusion would be that only one of my medications was serious enough to warrant concern, and the dosage could be decreased to resolve that. With that information, I decided to seek Paxlovid as a treatment option.
So, Saturday afternoon, I scheduled another virtual appointment, explained my situation, and asked for Paxlovid. This provider did not look at my existing medications, and was willing to provide Paxlovid as long as I understood there was a chance of a rebound, and that no treatment would be provided for the rebound. The only other thing she said was, "I don't think you need this, I think you could ride it out and be fine." At my request, she prescribed it anyway.
This series of events led to me ending up with a treatment that wasn't right for me. There are a number of things I should have done differently.
- I should have sought treatment earlier in the week, so I wasn't so quickly losing weekday time when the delays began happening.
- I should have immediately driven to the urgent care clinic anyway when my in-person appointment was cancelled and converted to virtual.
- I should not have waited for a phone call when my second PCR came back positive, and instead scheduled the followup virtual appointment immediately following the results becoming available.
All of this would have left more time for looking into and obtaining a more appropriate treatment option.
I hope this provides some suggestions on how to navigate an urgent care system when attempting to seek time-sensitive treatment. It comes down to advocating for yourself. Keep pushing for what you need. Avoid waiting for things to happen to you. Take control of what parts of the situation you can control, and accept the parts you cannot. Finally, don't blame yourself if it doesn't work out. Do what you can and hope for the best.