A pill to treat COVID-19 appears to be the country’s best hope, outside of vaccines and strong public health measures, to keep hospitals from being overrun with cases of the virus now and in the future, doctors say.
But with infections surging across the country, experts say the patchwork distribution system for Paxlovid in various parts of Canada may inhibit those who most need the drug from getting it in time.
Paxlovid, an antiviral, has shown a 90 per cent reduction in hospitalizations among unvaccinated patients with the Delta variant who received the drug within five days of symptom onset.
Those who might need the drug the most would do well to learn ahead of time how they might access it, the country’s chief public health officer said this week.
“My message to all Canadians who may be at high risk, such as the immunocompromised: figure out in your community, right now, how you can get access to that medication should you need it because it is a bit different across different areas of Canada,” Dr. Theresa Tam said on Tuesday.
The federal government has distributed about 150,000 courses of Paxlovid to the provinces and territories, Tam said. Most of the provinces have a centralized distribution system for the drug, often through hospitals and assessment centres, and eligibility varies across the country.
“I think all of us would like to see Paxlovid being mobilized more widely,” Tam said, adding that Health Canada is working with various jurisdictions on the issue.
“We will be using these kinds of medications in a more significant way as we have more access to antivirals in the future, which is great news. We just need to know how to get it out to people fast.”
Quebec’s pharmacists can prescribe Paxlovid, although those who are at the highest risk for severe disease are the only ones who can get it.
Ontario had a centralized distribution system, largely through hospitals and assessment centres, until the province announced Monday it would allow select pharmacies to distribute the drug to those who have a prescription.
The move was applauded by infectious disease experts.
“It’s a good move because it makes it a lot easier for people who are eligible and are prescribed packs,” said Dr. Gerald Evans, an infectious disease professor at Queen’s University and the medical director of infection prevention and control at Kingston Health Sciences Centre.
At Evans’ hospital, doctors only had two ways of getting patients the drug: getting them to drive to the hospital or couriering it to them, even if they live an hour’s drive from Kingston, Ont.
“The drug is inaccessible for many patients,” he said.
He cautioned that Paxlovid, which must be started within the first five days of symptoms, does not work for everybody and said the best protection remains vaccination against COVID-19.
Other provinces should follow Quebec and Ontario’s lead, said Dr. Zain Chagla, an associate professor of infectious disease with McMaster University in Hamilton.
“The drug needs to be decentralized,” Chagla said.
1:52 COVID-19: More Albertans can now be treated with antiviral pill
COVID-19: More Albertans can now be treated with antiviral pill
Ontario this week also expanded eligibility parameters for Paxlovid to anyone 70 and older, people 60 and older with fewer than three doses of a COVID-19 vaccine, and people 18 and older with fewer than three vaccine doses and at least one risk factor such as a chronic medical condition.
“We have a drug that can significantly mitigate hospitalization,” Chagla said. “We need the community to now start being prescribers and providers to make sure that their patients aren’t hospitalized.”
In Ontario, hospitalizations and intensive care unit capacities have been the key drivers for the imposition and lifting of public health measures in past COVID-19 waves. The provincial government lifted nearly all public health measures, including masking in most public spaces, in mid-March.
Ontario is now in its sixth wave – driven by the lifting of those public health measures, according to Public Health Ontario – and hospitalizations are rising.
Chagla said he has prescribed Paxlovid to about 150 people over the last month and cautioned that it interacts with many medications, including blood thinners, cholesterol medications, birth control and seizure medications.
“About 95 per cent of these potential interactions can be dealt with in just a few minutes of my time,” he said. “It’s not insurmountable by any means. The vast majority of people can hold their medications or deal with medication changes for a week to get on this.”
In Quebec, those who are deemed “high risk” for complications from COVID-19 and meet certain criteria are eligible for Paxlovid, although some doctors believe the criteria are too strict.
“It really comes down to how is high risk defined,” said Dr. Emily McDonald, an associate professor of medicine at the McGill University Health Centre. “I or someone else might define high risk differently than how the government has defined it.”
1:45 Sixth COVID-19 wave worries rise ahead of Easter long weekend
Sixth COVID-19 wave worries rise ahead of Easter long weekend
But McDonald said that is a trade-off to be able to give the pharmacists the ability to prescribe Paxlovid.
Each province has different eligibility criteria and that, when coupled with a paucity of communications about the drug, leaves the public in the dark, McDonald said.
“It’s a matter of access and communication and we have to address both,” she said. “A simpler message is more likely to be successful.”
MILAN (AP) — Bologna’s preparations for its Champions League debut are not going well though it managed to spoil Como’s first Serie A home match in 21 years on Saturday.
Bologna came from two goals down to salvage a 2-2 draw to gather three points from its opening four matches.
Bologna hosts Shakhtar Donetsk on Wednesday. Its only other appearance in Europe’s top competition was in 1964 in the preliminary round of the old European Cup.
AC Milan is also winless as it prepares for a Tuesday Champions League match against Liverpool. The Rossoneri hosted promoted Venezia later. Juventus drew at Empoli 0-0.
Como made a great start in the fifth minute when Patrick Cutrone attempted to roll the ball across the six-yard box but it took a huge deflection off Bologna defender Nicolò Casale for an own goal.
Bologna thought it was gifted a way back into the match on the stroke of halftime when referee Marco Piccinini signalled for a penalty following an Alberto Moreno handball, but he revoked his decision and instead gave a free kick because the handball was just outside the area.
Bologna improved after the break but found itself further behind when Cutrone raced onto a through ball and cut inside past a defender and fired into the far bottom corner.
Tommaso Pobega hit the post for Bologna, which finally pulled one back in the 76th through substitute Santiago Castro.
Another substitute helped the visitors snatch a point when Samuel Iling-Junior curled a fine strike into the top left corner in stoppage time.
Unbeaten sides
Juventus, and more surprisingly Empoli, are among six unbeaten sides.
Empoli held Monza and Bologna to draws either side of a shock 2-1 win at Roma. Juventus’ perfect start to the season was ruined by Roma in a goalless draw before the international break.
On Saturday, there were few clearcut chances in Empoli although home goalkeeper Devis Vásquez made spectacular saves to fingertip out a Federico Gatti header and deny Dusan Vlahovic in a one on one with the Juventus forward.
Empoli had a good opportunity in the 73rd minute following an Alberto Grassi one-two with Pietro Pellegri but the finish was straight at Mattia Perin.
The host could have won it right at the death but Gatti flew in with a great sliding block to keep out Emanuel Gyasi’s close-range effort.
Juventus hosts PSV Eindhoven in the Champions League on Tuesday.
MANCHESTER, England (AP) — Not good enough. That was Arne Slot’s verdict after his first defeat as Liverpool manager on Saturday.
A shock 1-0 loss at home to Nottingham Forest in the English Premier League ended Slot’s perfect record since succeeding Jurgen Klopp at Anfield at the end of last season.
“We had a lot of ball possession but only managed to create three (or) four quite good chances, so that is by far not enough if you have so much ball possession,” said the Dutchman, who suggested his team should not be losing to the likes of Forest.
“If you lose a home game it’s always a setback, especially if you face a team … we never know, maybe they will go all the way to fight for Champions League tickets, but normally this team is not ending up in the top 10, so if you lose a game against them that’s a big disappointment.”
Slot won his first three games in charge, including a memorable 3-0 victory against Manchester United before the international break.
But that run came to an end after Callum Hudson-Odoi struck in the 72nd with a curling effort from the edge of the box and beyond goalkeeper Alisson.
Liverpool’s defeat leaves Manchester City as the only team with a 100% record in the league after a 2-1 win against Brentford kept the defending champion at the top of the table.
United won at Southampton 3-0 to end its two-game losing streak.
Unstoppable Haaland
Erling Haaland moved to 99 goals for City after scoring twice against Brentford.
The Norwegian’s double came after Yoane Wissa fired Brentford ahead with just 22 seconds on the clock.
Haaland scored his 98th and 99th goals in his 103rd City appearance in all competitions. And he was the width of the post away from his third consecutive hat trick after trebles against Ipswich and West Ham.
“He’s been really, really good. Yeah, I would say he’s the best (he’s been), but it’s only four fixtures (this season),” City manager Pep Guardiola said.
Haaland, who has been nominated for the Ballon d’Or, has nine goals in four league games. He has topped the league scoring charts in each of his two seasons at City since joining from Borussia Dortmund in 2022 for $63 million.
Haaland’s first goal after 19 minutes evened the game following Wissa’s opener, which stunned the Etihad Stadium crowd. Haaland turned and swept a shot past goalkeeper Mark Flekken after a slight deflection off Ethan Pinnock.
He was then too strong for Pinnock when shaking off the defender and running through for his second in the 32nd.
He was inches away in the 81st; the shot came back off the post after beating the keeper.
Rashford snaps run
Marcus Rashford snapped a 12-game barren run in front of goal as United beat Southampton.
Rashford doubled United’s lead at Saint Mary’s after Matthijs de Ligt’s scored his first for the club. Substitute Alejandro Garnacho scored a third in the sixth minute of stoppage time.
The win came after back-to-back defeats for United.
Rashford hadn’t scored since March in United’s win over Liverpool in the FA Cup quarterfinals. He curled in a shot from the edge of the area to put Erik ten Hag’s team 2-0 up at Southampton in the 41st minute.
Ten Hag said it could be a turning point for the forward.
“For every striker, they want to be on the scoring list. Once the first is in, more is coming. Like a ketchup bottle, once it’s going, it’s coming more,” he said.
De Ligt, who joined United from Bayern Munich in the offseason, headed in from Bruno Fernandes’ cross in the 35th.
It could have been a different story if Cameron Archer converted a penalty for Southampton in the 33rd. Instead, his effort was saved by goalkeeper Andre Onana.
Newly promoted Southampton was reduced to 10 men when Jack Stephens was sent off in the 79th for a high challenge on Garnacho.
Villa comeback
After three straight defeats to start the league, Everton looked set for its first win when leading Aston Villa 2-0.
Goals from Dwight McNeil and Dominic Calvert-Lewin put Sean Dyche’s team in control until Ollie Watkins struck twice to even the game.
Jhon Duran completed Villa’s comeback and sealed a 3-2 win in the 76th to leave Everton rooted to the bottom of the table and the only top flight team without a point.
Late drama
Jean-Philippe Mateta converted a stoppage time penalty to salvage a 2-2 draw for Crystal Palace against Leicester.
Leicester led 2-0 at Selhurst Park after goals from Jamie Vardy and Stephy Mavididi.
But Mateta sparked Palace’s response with a goal in the 47th, a minute after Mavididi doubled Leicester’s advantage.
Conor Coady fouled Ismaili Sarr in the box right near fulltime and Mateta was cool enough to convert.
West Ham left it even later to salvage a point in a 1-1 draw at Fulham.
Danny Ings struck in the fifth minute of added time after Raul Jimenez’s goal looked like earning Fulham the win.
Brighton boss Fabian Hurzeler, the manager of the month for August, was frustrated as his team was held to 0-0 at home by Ipswich.
CLEVELAND (AP) — Restricted free agent forward Isaac Okoro has agreed to re-sign with the Cleveland Cavaliers on a three-year contract, a person familiar with the negotiations told The Associated Press on Saturday.
Okoro’s new deal is worth $38 million, according to the person who spoke to the AP on condition of anonymity because the contract has not been signed or announced by the team.
ESPN.com first reported the agreement, citing Okoro’s representation.
The fifth overall pick in the 2020 NBA draft, Okoro is Cleveland’s best perimeter defender, often drawing the assignment of guarding the opponent’s top scorer. Okoro also has worked to improve his offensive game.
The 23-year-old averaged 9.4 points and 3.0 rebounds in 69 games — 42 starts — last season for the Cavs, who beat Orlando in the opening round of the playoffs before losing to eventual champion Boston.
Okoro shot a career-best 39% on 3-pointers, forcing teams to come out and guard him.
His agreement caps an extraordinarily busy summer for the Cavs that began with coach J.B. Bickerstaff being fired and replaced by Kenny Atkinson. All-Star guard Donovan Mitchell signed a three-year, $150 million extension in July, ending months of speculation that he wanted out of Cleveland.
Also, power forward Evan Mobley signed a five-year, $224 deal and center Jarrett Allen signed a three-year, $91 million extension.
