The pills’ emergency use authorizations are written so that prescribing power is limited to doctors and certain health care workers often found in a physician’s practice. That could create an access merry-go-round where patients may need to visit a testing site, a doctor’s office and then a participating pharmacy just to get the drugs — a prospect one state health official said was akin to “sending you on a goose chase to try and find these meds.”

“That may mean three entries in and out of places,” said Anne Zink, Alaska’s chief medical officer and the Association of State and Territorial Health Officials’ president-elect. “And that’s assuming all three of those go well” — meaning patients can get appointments and avoid visiting multiple pharmacies to find the drugs.

The requirements also could wind up sending Covid-positive individuals into several public places. One state Nomi Health’s Newman works with had planned to replicate its Covid vaccine drive by making Paxlovid available in grocery store pharmacies — until officials realized that none of those locations has a drive-through option to allow Covid patients to stay outside.

“The whole distribution architecture of this is crazy,” Newman said.