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.”
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.”
EDMONTON – RCMP say a second suspect has been arrested in the killing of an Alberta county worker.
Mounties say 28-year-old Elijah Strawberry was taken into custody Friday at a house on O’Chiese First Nation.
Colin Hough, a worker with Rocky View County, was shot and killed while on the job on a rural road east of Calgary on Aug. 6.
Another man who worked for Fortis Alberta was shot and wounded, and RCMP said the suspects fled in a Rocky View County work truck.
Police later arrested Arthur Wayne Penner, 35, and charged him with first-degree murder and attempted murder, and a warrant was issued for Strawberry’s arrest.
RCMP also said there was a $10,000 reward for information leading to the arrest of Strawberry, describing him as armed and dangerous.
Chief Supt. Roberta McKale, told a news conference in Edmonton that officers had received tips and information over the last few weeks.
“I don’t know of many members that when were stopped, fuelling up our vehicles, we weren’t keeping an eye out, looking for him,” she said.
But officers had been investigating other cases when they found Strawberry.
“Our investigators were in O’Chiese First Nation at a residence on another matter and the major crimes unit was there working another file and ended up locating him hiding in the residence,” McKale said.
While an investigation is still underway, RCMP say they’re confident both suspects in the case are in police custody.
This report by The Canadian Press was first published Sept. 13, 2024.
RICHMOND, B.C. – The Integrated Homicide Investigation Team says the 26-year-old son of a man found dead on British Columbia’s Sunshine Coast has been charged with his murder.
Police say 58-year-old Henry Doyle was found badly injured on a forest service road in Egmont last September and died of his injuries.
The homicide team took over when the BC Coroners Service said the man’s death was suspicious.
It says in a statement that the BC Prosecution Service has approved one count of first-degree murder against the man’s son, Jackson Doyle.
Police say the accused will remain in custody until at least his next court appearance.
The homicide team says investigators remained committed to solving the case with the help of the community of Egmont, the RCMP on the Sunshine Coast and in Richmond, and the Vancouver Police Department.
This report by The Canadian Press was first published Sept. 13, 2024.
VANCOUVER – Mediated talks between the union representing HandyDART workers in Metro Vancouver and its employer, Transdev, have broken off without an agreement following 15 hours of talks.
Joe McCann, president of Amalgamated Transit Union Local 1724, says they stayed at the bargaining table with help from a mediator until 2 a.m. Friday and made “some progress.”
However, he says the union negotiators didn’t get an offer that they could recommend to the membership.
McCann says that in some ways they are close to an agreement, but in other areas they are “miles apart.”
About 600 employees of the door-to-door transit service for people who can’t navigate the conventional transit system have been on strike since last week, pausing service for all but essential medical trips.
McCann asks HandyDART users to be “patient,” since they are trying to get not only a fair contract for workers but also a better service for customers.
He says it’s unclear when the talks will resume, but he hopes next week at the latest.
The employer, Transdev, didn’t reply to an interview request before publication.
This report by The Canadian Press was first published Sept. 13, 2024.
