Although patients typically have a prescription in their hands when they stop in a pharmacy to pick up medication, a Niagara pharmacist said it might make more sense for patients to contact their pharmacy first if the medication they need is Paxlovid.
Because time is of the essence when using the coronavirus-fighting drug, said pharmacist Donnie Edwards — an Ontario Pharmacists Association board member.
“The sooner you get this drug after symptoms, the better,” he said.
Edwards said the drug only works within five days of the onset of symptoms, and the earlier the drug is taken the more effective it is. If people wait for doctor appointments, it might be too late to benefit from taking it.
He said the Easter long weekend is an example of how access to the medication can be delayed.
“The physician’s offices are closed tomorrow (Good Friday), a lot of pharmacies are closed. And if someone comes in this afternoon needing Paxlovid, it has to be started within five days of symptoms appearing and you want that patient to get the drug at the right time,” Edwards said. “That’s important, the right drug for the right person at the right time.”
Although the drug requires a prescription, Edwards said pharmacists can facilitate that, too.
The pharmacy Edwards co-owns in Ridgeway is one of roughly 58 throughout Niagara that received limited supplies of Paxlovid after the province increased eligibility for the treatment this week. Throughout the region, there are 24 pharmacies in St. Catharines, nine in Niagara Falls and eight in Welland, and five in Fort Erie stocking Paxlovid, as well as a few pharmacies in each of Niagara’s smaller communities.
Edwards said pharmacists first assess if patients qualify for Paxlovid, including anyone over 70 who has tested positive for the virus, people 60 and up with fewer than three vaccine doses, and people 18 and over who are immuno-compromised, or have had fewer than three vaccine doses and have at least one risk condition such as pregnancy, obesity, diabetes, heart disease or developmental disabilities.
If patients qualify, he said pharmacists will then contact the patient’s doctor or primary health-care provider and ask the physician to write a prescription. The pharmacists can also assist patients who do not have a family doctor.
Edwards said Paxlovid can interact with at least 100 other medications, “and we want to make sure it’s safe for people to take.”
“Being the drug experts, I think we would be able to advise a physician or prescriber the best with that,” he said.
Ultimately, if infections continue to increase along with demand for the drug, Edwards said “it would make sense for the pharmacists just to be able to prescribe it and send a note to their (the patient’s) physician saying I’ve dispensed Paxlovid for your patient.”
Despite expanded access to treatment, Niagara’s acting medical officer of health Dr. Mustafa Hirji said, “major barriers remain.”
“There are still barriers in people not knowing about treatment options, not knowing that they need to seek treatment as soon as they become sick even when symptoms are mild — it is no longer effective a few days later when one gets worse,” he said.
“The province’s materials are very complex on treatment and so those who don’t speak English as their first language, who have less education, etc., will struggle to access treatment. People without a family doctor will continue to have a huge barrier to getting treatment. For people who don’t have paid sick time, they will struggle to find the time to make the appointments needed to get treatment and meanwhile might be working and spreading infection.”
Hirji said the province needs to better promote the treatment, simplify information and processes to make it easier for people to obtain care, increase transportation support, ensure workers have ongoing paid sick leave and to ensure high-risk individuals have access to primary care options.
Meanwhile, cases of infection and hospitalizations continue to increase in Niagara, with Niagara Region Public Health reporting 195 new cases Thursday, as well as 1,864 active infections.
Niagara Health on Thursday reported the death of a patient who was being treated for coronavirus — the fourth this month. The hospital system said the patient, a Niagara resident, died Wednesday. There are now 64 people hospitalized with the virus, including five in intensive care.
Niagara Health’s medical director for infection prevention and control, Dr. Karim Ali said COVID-19 therapeutics such as Paxlovid are also available for eligible patients at the hospital system’s Clinical Assessment Centre located at its Niagara Falls site. However, clinic appointments are only available through referrals.
“We have come a long way in learning about the virus and how to provide cutting edge therapies to manage patients in our care,” he said in an email.
Ali said patients with mild to moderate symptoms of COVID-19 are assessed for antiviral treatment options based on guidance from the Ministry of Health as well as the Ontario COVID-19 Science Advisory Table.
Niagara Health also administers Remdesivir infusion for patients who qualify based on provincial criteria, he said.
“The Ministry of Health’s expansion of patient eligibility and support of primary care providers to assess and prescribe antivirals will enable more patients who meet the criteria to access this treatment,” Ali said.
Staying safe on Easter weekend
After seeing infections of COVID-19 spike following almost every long weekend for the past two years, Niagara’s acting medical officer of health Dr. Mustafa Hirji is bracing for an increase yet again as families and friends gather for Easter celebrations.
“We have seen increases in COVID-19 in past years after long weekends for exactly this reason. With the current sixth wave, there is substantial risk of infection spreading at these events,” Hirji said. “However, we also now have more tools to make it safer to attend these.”
Hirji advised:
- Make sure vaccinations are up to date before participating in any Easter events, with three doses for most people.
- Do not attend celebrations if you do not feel well.
- If it’s a larger event, take a rapid test before attending to be sure you don’t bring infection to others.
- Hold celebrations outdoors where the risk of infection is reduced by better ventilation.
- Consider wearing masks at larger celebrations.
- Allow room for physical distancing as well, including spacing out seating at tables where people will be dining “to limit the chance of infection spreading.”
