Paxlovid Cuts Covid Death Risk. But Those Who Need It Are Not Taking It.

As Covid rises again, killing about 1,500 Americans each week, medical researchers are trying to understand why so few people are taking Paxlovid, a medicine that is stunningly effective in preventing severe illness and death from the disease.

A study of a million high-risk people with Covid found that only about 15 percent who were eligible for the drug took it. If half of the eligible patients had gotten Paxlovid, 48,000 deaths could have been prevented, authors of the study, conducted by the National Institutes of Health, concluded.

It’s not because people don’t know about the drug — most do — but the reluctance seems to come from doctors worried about interactions with other drugs and people wary of a possible rebound case or the metallic aftertaste.

Regional differences offer a clue, with uptake highest in the Democratic strongholds of the Northeast and Pacific Northwest regions of the United States and lowest in deep red areas including Florida and Indiana. Yet no careful study has clarified why so few people used the medication, which cut the risk of death by 73 percent for high-risk patients in the N.I.H. study.