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Paxlovid in Canada: Who can get it, and where – CTV News

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Pfizer’s antiviral medication Paxlovid is designed to reduce the risk of hospitalization in patients with COVID-19, and it’s approved for use across Canada.

Although it has the potential to take some pressure off hospitals during coronavirus surges, some doctors and pharmacists believe it isn’t being used as widely as it should.

Dr. Brian Conway is the medical director of the Vancouver Infectious Diseases Center and an assistant professor in the University of British Columbia’s Department of Pharmacology and Therapeutics. He said the lack of uptake could be due to a number of factors, including restrictions on who can prescribe it and a lack of awareness about the treatment, both among the public and medical professionals.

“It may be that we’re not prescribing it broadly enough,” Conway told CTVNews.ca. “My sense is when I speak to family physicians who might be the first line, they aren’t aware of it. Many pharmacists I’ve had to work with and explain to them what this stuff is. There hasn’t been a big push to make sure everyone knows what it is.”

HOW IT WORKS

According to Health Canada, Paxlovid is an antiviral medication in pill form that works best to limit the severity of COVID-19 when taken early in the course of an infection with mild to moderate symptoms.

Patients take two doses each day for five days, and each dose consists of two pink nirmatrelvir tablets and one white ritonavir tablet. Nirmatrelvir is an antiviral drug that inhibits a SARS-CoV-2 protein to stop the virus from replicating, while ritonavir delays the breakdown of nirmatrelvir to help it work in the body for longer.

Eligible patients take the drug at home after testing positive for COVID-19. According to the Ontario COVID-19 Science Advisory Table, side-effects are generally mild and may include an altered sense of taste, diarrhea, muscle pain, vomiting, high blood pressure and headache. 

WHO IS ELIGIBLE

In Canada, Paxlovid is approved for people who have tested positive for COVID-19 and who are at increased risk of developing serious COVID-19 symptoms that could require hospitalization.

It’s up to provinces and territories to prioritize who is eligible, but Health Canada says age is the strongest risk factor for severe illness and hospitalization, with unvaccinated seniors or seniors whose vaccinations are not up to date facing the most risk.

Other eligible adults include those who are immunocompromised and those who have serious underlying conditions such as obesity or diabetes, and people over 60 living in underserved, rural or remote communities or congregate care settings.

Paxlovid is not approved for people who have not tested positive for COVID-19, patients who are already being treated in-hospital for COVID-19 or anyone under 18.

The drug interacts with dozens of common medications, including some heart medicines, certain antibiotics, hormonal contraceptives and those used to treat erectile dysfunction, blood cholesterol and seasonal allergies.

It is also not recommended at full-strength for people with kidney problems. Anyone with kidney problems or who is taking a medication that might interact with Paxlovid should consult their health-care provider.

Provinces and territories are in charge of prioritizing access to Paxlovid, so anyone with questions about their own eligibility should contact their local or provincial public health service or their health-care provider.

WHO CAN PRESCRIBE AND DISPENSE IT

Provinces and territories have the authority to decide who can prescribe and dispense Paxlovid, which Conway said has created a patchwork of policies that range from simple and streamlined to complicated and bureaucratic.

“So different provinces have different approaches, the most simple being that if someone tests positive on a rapid test, they can communicate that result to a pharmacist or the pharmacist may do the test onsite, and then the pharmacist can link to a physician, a brief interaction occurs, and the medication is prescribed,” Conway said. “So that’s the simplest.”

Provinces where pharmacists can prescribe Paxlovid to patients with positive COVID-19 tests include Quebec, Alberta, Saskatchewan, and Newfoundland and Labrador.

In other provinces, pharmacies can dispense Paxlovid, but only doctors and nurse practitioners can prescribe it. This is the case in Ontario and British Columbia.

“The most complicated [system] is potentially the one we have here in British Columbia, where there is a form that needs to be completed and they’ve established criteria for eligibility for Paxlovid, and the individual has to meet these requirements,” Conway said.

Conway says the process is so convoluted that some doctors have opted not to prescribe Paxlovid to avoid filling out the paperwork.

In a media release on July 11, Dr. Danielle Paes, chief pharmacist officer of the Canadian Pharmacists Association, called on provincial governments to empower pharmacists to provide point-of-care testing and prescribe COVID-19 treatments such as Paxlovid

“Quebec was the first jurisdiction in the world to enable pharmacists to prescribe for Paxlovid and saw a marked increase in use of the COVID-19 antiviral, helping to keep patients out of hospitals. Other provinces have followed suit, but many have not yet enabled this critical service,” Dr. Paes said.

“Pharmacist-prescribed Paxlovid is just one example of the kind of innovative community care that will reduce the strain on our hospitals while expanding access to the services and care Canadians rely on.”

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Family says Bill Blaikie, who served as NDP MP for nearly 30 years, dies

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WINNIPEG — Manitoba politician Bill Blaikie, who spent nearly 30 years as a member of Parliament with the federal New Democrats, has died.

His son, NDP finance critic Daniel Blaikie, posted a family statement on social media saying his father died Saturday at home in the presence of his wife, Brenda.

Bill Blaikie had announced publicly earlier this month that he was entering palliative care.

“We thank everyone for their kind words and gestures over the last week since Bill publicly announced he was transitioning to palliative care,” the family’s statement said.

“Street-side pipers, food, flowers and especially stories of how Bill inspired and entertained people over the years were a comfort to him and us in his final days.”

Blaikie was first elected to the House of Commons in 1979 representing a Winnipeg riding for the NDP, and at one point was the longest-serving MP in the House of Commons.

He left Ottawa in 2008, won a seat in the Manitoba legislature the following year and was named the province’s minister of conservation before leaving politics in 2011.

The family statement says funeral details will follow in the days ahead.

NDP Leader Jagmeet Singh, in a condolence message to Blaikie’s family, called the former MP a “giant” in the party.

“His unwavering commitment to social and economic justice, his legendary knowledge of Parliament, and his sense of humour will be missed by all,” Singh posted to social media.

“Rest in power Bill.”

Blaikie, an ordained United Church minister, also held a position as an adjunct professor in theology at the University of Winnipeg.

He was voted Parliamentarian of the Year by his fellow MPs, due largely to his reputation as a hard worker who avoided partisan cheap shots in debates.

In 2003, he lost his bid for leadership of the federal party to Jack Layton in a contest that pitted Layton and the trendy new left against Blaikie and the traditional, Prairie populist wing.

Blaikie finished his parliamentary career as deputy Speaker of the Commons, explaining he retired from federal politics because he did not want to continue commuting between Winnipeg and Ottawa.

His switch to provincial politics caught many off guard, some party insiders remarked at the time. He said he sought the nomination after former Manitoba NDP premier Gary Doer asked him to consider it when a member of Doer’s caucus quit to run for Blaikie’s vacated federal seat.

Former NDP MP Pat Martin lauded Blaikie as the first to raise the issue of climate change in the House of Commons back in 1983.

Manitoba NDP Leader Wab Kinew called Blaikie a “lion” of the party.

“He fought with passion, intelligence and faith for working people in Transcona and across the country,” Kinew posted on Twitter.

“The Blaikie family has been so good to us, on behalf of our movement we send you our deepest condolences.”

This report by The Canadian Press was first published Sept. 24, 2022.

 

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Fiona hits Newfoundland: Houses collapse, resident rescued after she is swept to sea

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CHANNEL-PORT AUX BASQUES, N.L. — Neighbours pulled a woman from the waters off southwestern Newfoundland early Saturday after a storm surge caused by post-tropical storm Fiona enveloped her home, causing it and several others to collapse into huge waves driven by hurricane-force winds.

RCMP Cpl. Jolene Garland said police were also investigating reports that a second woman had been swept into the Gulf of St. Lawrence under similar circumstances, but the Mountie said the status of that woman had yet to be confirmed.

Garland said the first woman, who she did not name, was given medical treatment and is believed to be fine. As for the second woman, police have yet to confirm reports that the rising waters pulled her from her basement in Port aux Basques, N.L.

“It’s too dangerous for us to enter into a search for that woman at this point,” Garland said in an interview. “We can’t substantiate her current location.”

Meanwhile, Garland confirmed that other homes in the coastal community were evacuated as Fiona closed in on Newfoundland’s west coast.

Both incidents were reported between 9 a.m. and 10 a.m. local time, when a storm surge raised water levels at Port aux Basques to a record level. At the time, two peak gusts were recorded at 133 kilometres per hour, according to the weather office in Gander, N.L.

“We’re all used to wind and rain here, but this is not a normal amount of wind and rain,” Garland said. “The ocean waves that surged onto residential properties is abnormal. It has caused a lot of electrical fires … and many are without power as a result. And there’s a lot of flooding.”

Earlier in the day, the town of 4,200 declared a state of emergency.

Rene Roy, editor of the weekly newspaper in Port aux Basques, said he saw evidence that nine homes, including a two-storey apartment building, had been washed out to sea as wind-driven waves hit the rocky shoreline and soared about 25 metres into the air.

“Lower Water Street is devastated with damage,” said Roy, who is also sales director at Wreckhouse Press Inc., which is named after an area in southwestern Newfoundland where howling winds are common. “There are homes gone. There are homes in the street.”

Roy said the small island at the head of the town’s harbour, which includes the Channel-Head lighthouse, usually protects Water Street East from the Gulf of St. Lawrence. But that didn’t happen early Saturday as the waves broke over the island.

“The water was smashing in, 80, 90 feet high,” he said. “It just took that apartment building.”

He said it was unclear what happened to the building, but recalled it backed on a 10-metre-wide lawn that once stood about two metres above the water in the town’s bay. It had about a dozen units, he said.

From his cousin’s home on Mouse Island, Roy said he could see three houses “now a pile of rubble in the ocean.”

Powerful gusts are common in Port aux Basques, which is at the island’s southwestern tip and is home to a busy port that includes daily visits from ferries that link Nova Scotia with Newfoundland.

The homes in the low-slung, coastal community are built to withstand the worst that the ocean has to offer, Roy said, adding he once used a device known as an anemometer to measure gusts reaching 130 kilometres per hour on his street.

Born in Port aux Basques, Roy moved away but returned home seven years ago. The former firefighter said a 52-year-old neighbour who has lived in the community his entire life confirmed that he had never before witnessed such a powerful storm.

“It’s one for the ages,” Roy said.

David Neil, a meteorologist at the Gander weather office, said Fiona’s extraordinarily low barometric pressure — which set a Canadian record when the storm made landfall in Nova Scotia between 3 a.m. and 4 a.m. — would have been responsible for raising water levels at Port aux Basques to a record 2.73 metres at 10 a.m.

The low pressure at the centre of the storm acts like a suction cup, lifting the water well above its normal level. When coupled with the high tide, the result can be disastrous. It’s called the “inverse barometer” effect.

As well, Neil said the waves were reaching 12 metres high close to shore.

“This storm was extreme, even for that area,” he said. “It was a perfect combination to hit that area hard.”

— By Michael MacDonald in Halifax.

This report by The Canadian Press was first published Sept. 24, 2022.

 

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Federal government unlikely to declare victory on COVID as travel restrictions loosen

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OTTAWA — The thundering sound of hoofbeats charging toward the end of the track was met with a chorus of cheers from thousands of revellers in cowboy hats and jeans, dazzled by the colourful lights of the midway in the distance.

The Calgary Stampede attracted 500,000 visitors in 2021 after a year of pandemic isolation and uncertainty, epitomizing Alberta Premier Jason Kenney’s “best summer ever.”

Kenney beamed from behind a podium that spring as he declared that Alberta had “crushed” the spike of COVID-19 infections and heralded the return of backyard barbecues, dream weddings, concerts, parties and, of course, the stampede.

“Today we are truly near the end of this thing. We’re leaving the darkest days of the pandemic behind and walking into the warm light of summer,” Kenney declared.

Months after what came to be known as Kenney’s “mission accomplished” moment, Alberta was pummeled by the Delta wave. The province’s intensive care units were devastated.

The moment left a lasting impression on the country’s political psyche.

Such a jubilant, if premature, declaration is not likely to be seen again in Canada’s COVID-19 response, even as other world leaders appear ready to leave the pandemic behind.

“The pandemic is over,” U.S. President Joe Biden said last week, striding down the blue carpet of the Detroit Auto Show in Michigan during an interview with “60 Minutes.”

The president said there is still work to be done, but suggested the disaster had passed.

“No one’s wearing masks, everyone seems to be in pretty good shape and so I think it’s changing.”

Canada’s cautious political message about the virus has never ceded to such optimism.

“What we have seen consistently is that people are still struggling in hospitals across our country with the impacts of COVID,” Prime Minister Justin Trudeau said Thursday at a press conference at the UN General Assembly in New York.

He encouraged people to get up to date on their vaccine booster doses, assuring the public “we will make sure this pandemic gets behind us as quickly as we possibly can.”

Two senior government sources, speaking on the condition they not be named because they were not authorized to speak publicly, told The Canadian Press that Trudeau has agreed in principle to let Canada’s vaccine mandates expire on Sept. 30.

When the order expires, the ArriveCan app will no longer be mandatory for international travellers, either.

The decision to put an end to some of the last vestiges of federal COVID-19 restrictions is expected to be announced officially on Monday.

Trudeau has yet to speak publicly about the change, but the tenor of that announcement could be telling as to how the federal government plans to navigate this new transitional phase of the pandemic.

The last time the Liberals loosened restrictions in June, removing vaccine mandates for domestic travellers, the tone was decidedly circumspect.

Rather than proclaim the mandates were no longer needed, federal officials said they were merely “suspended,” and warned they would “bring back” necessary policies if there’s a resurgence of the virus in the fall.

“I think part of the restraint that provincial and territorial governments and the federal government have, as far as walking past COVID, is because we have our memory of how that didn’t actually work out well,” said Dr. Alika Lafontaine, president of the Canadian Medical Association.

Of course, Alberta’s cautionary tale isn’t the only reason for the federal government’s political COVID-19 message.

“In Canada, our focus has been, every step of the way, on listening to science, to responding to the facts on the ground,” Trudeau said Thursday, repeating a similar message when questioned by reporters in Ottawa Friday.

The Conservatives, meanwhile, allege the Liberals are more focused on “political science.”

“There’s a lot of questions that Canadians have, why the government appears to be making decisions not based on medical science, but based on political calculations,” Conservative health critic Michael Barrett said last week.

The official opposition has accused the Liberals of using the pandemic and federal restrictions as a political wedge since the last election, when Trudeau first floated the idea of vaccine mandates.

“There’s no question of whether politics plays a role in the decision-making,” said Julianne Piper, a research fellow with the international Pandemics and Borders project at Simon Fraser University.

“I think there are different political, geographic, public health factors that play into those decisions.”

That alchemy of politics and public health has the potential to set the tone for the rest of the country, she said.

“I think it signals the general feelings around the pandemic and potentially signals what different actors who would be impacted are going to expect,” she said.

Lafontaine said it will be important for politicians to keep that in mind during this next phase of the pandemic.

“I think it’s really important for politicians to realize that the things they say have an enormous impact,” he said.

“We need, more than ever, for people to be clear about the problems that we’re facing, to declare crises when there are crises and to talk about plans for after crises when it’s time to walk through those problems, into what comes next.”

This report by The Canadian Press was first published Sept. 24, 2022.

 

Laura Osman, The Canadian Press

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