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COVID-19 antiviral access difficult

Connecting the Dots
Web Headshot Anne Dec. 2020
Anne Davison

The oral antiviral treatment Paxlovid has the potential to become an important tool in the fight against this virus. Social restrictions and mandates have kept us apart but have undoubtedly saved lives. Restrictions and mandates are ending. Vaccines have had a huge influence on the course of the pandemic but have not eradicated the disease like they did in the past with polio or smallpox. This virus has proven to be adaptable, sidestepping our acquired immunity with new resistant variants.

Infection rates are rising since we have decided to open our society again. Recent variants of the disease have proven to result in a less serious outcome for most, but a large increase in cases will inevitably lead to an increase in serious outcomes. People are still dying of Omicron.

Paxlovid is a combination of two antiviral agents, one of which is newly developed by Pfizer and a second antiviral that enhances the activity of the first. According to an interim analysis, Paxlovid reduced the risk of COVID-19-associated hospitalization or death by 89% in those who received treatment within three days of symptom onset. This could be of critical importance in protecting the immune compromised and unvaccinated and protecting our health care system from another overload, but if treatment does not begin within a few days of infection effectiveness drops off.

This is a problem. Recent data shows that in Manitoba only 6.5 per cent of the doses that have been provided have been dispensed. The reason could be found in the process required to get a prescription. While doctors and pharmacists are doing their best to get the medication to those who need it, the eligibility requirements are complex and confusing, and distribution is limited to a few larger communities.

One person I know had symptoms and tested positive. He had two vaccinations but not a booster and was over the age of 70. He is overweight but otherwise in good health. He went through the examination, a blood test, another rapid COVID-19 test and filled out a long form. The doctor faxed the form to the health official in charge of arranging the delivery of the drug. This official called the patient and asked questions about medical history and other prescriptions. The patient then talked to the pharmacist to arrange to receive the medication. Since it is not available in rural communities the patient drove to Brandon to pick it up. Remember timing is critical for success with this drug.

Another person I know was in a similar situation but there were two differences. This person had far more serious medical conditions but also had received a booster. Although this patient tested positive and had symptoms, he did not qualify because the booster vaccination disqualified him, yet did not fully protect him. In this case, is vaccination status really relevant to eligibility?

We are not making the best use of this tool. We need to streamline access rather than restrict it. In this fight we need to use every weapon.