CAMBRIDGE — When the province released an expanded listed of local pharmacies able to dispense antiviral medication to treat COVID-19, Kim Morouney jumped at the opportunity to get her mother treated.
Morouney’s 88-year-old mother had been experiencing body aches, exhaustion and a cough, which she said continued to worsen since her mother tested positive for COVID-19 on a rapid test on April 10.
As of Thursday, people with a positive COVID-19 test and a prescription could access Paxlovid locally. The antiviral drug is used to treat COVID-19 within five days of experiencing symptoms, and helps keep people out of hospital. Eligibility for the drug is determined during an assessment.
“On the (provincial) website, it says one of the categories is 70 or above and so she’s 88 — is that enough?” she asked.
He mother appeared to fit the province’s criteria, but Morouney was confused about the steps required to get the medication and if her mother was even eligible.
After going to the Cambridge Assessment Centre on Holiday Inn Drive, her mother was sent home without a prescription, and was told she would get a phone call from St. Mary’s General Hospital the next day. The experience left her even more confused.
Although Morouney was able to get a prescription after the phone call — where the doctor checked on her mother’s symptoms and possible interactions between Paxlovid and previously prescribed drugs — the unclear process made Morouney worry about missing the five-day treatment window.
The province’s expanded guidelines on who should be treated with antivirals has created confusion between who’s eligible and who will actually receive a prescription, and the process to access the drugs is also unclear.
Dr. Dave Arnott, the physician co-lead at Cambridge’s COVID-19 Assessment Centre, said people with mild to moderate symptoms are encouraged to call a primary care provider or go to the assessment centre. After visiting the assessment centre, if the patient qualifies and wants a referral for Paxlovid, a referral is made to St. Mary’s General Hospital.
“In this instance, it may feel that two assessments are occurring for a patient,” Arnott said in an email statement.
“Patients are likely to feel similar when a community prescription occurs as both the referring physician and pharmacist will need to determine eligibility and safety.”
But Arnott said in most cases, treatment with Paxlovid is not recommended.
“The messaging from the Ministry of Health is such that it recommends everyone who meets the new expanded criteria be tested and referred for treatment,” Arnott said.
“This does not align with the science that we have present. The expanded criteria includes many groups that the Ontario Science Table has not recommended for treatment.”
Despite the lack of clarity around the expanded criteria, the goal is to push people to ask more questions if they experience symptoms, instead of not taking action, said Kelly Grindrod, an associate professor at University of Waterloo School of Pharmacy.
“The reason the government made the criteria much broader than that was that there’s been a problem with people who do qualify assuming that they don’t, so they don’t ask,” she said.
So you’re experiencing COVID-19 symptoms. Now what?
For people with mild to moderate symptoms, Arnott encourages them to call a primary care provider or attend the assessment centre if they feel an assessment is needed, or the online provincial COVID-19 treatment screener said they are eligible for treatment.
After visiting the assessment centre, if the patient qualifies and wants a referral for Paxlovid, a referral is made to St. Mary’s General Hospital.
Other treatment options include steroid inhalers, which are given at the assessment centre.
If you are turned away for an antiviral, Grindrod said you should feel assured that your vaccines are helping to lower your risk.
“One of the challenges here is the use of these medications is fairly complicated as are the actual clinical criteria you would use to choose a treatment,” said Grindrod.
