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.
RELATED STORIES
“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.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
