CAMBRIDGE – When the province released an expanded list of local pharmacies that can dispense antiviral drugs to treat COVID-19, Kim Moruni took the opportunity to treat her mother.
Moruni’s 88-year-old mother has experienced body aches, exhaustion and a cough that she says continues to worsen after her mother tested positive for COVID-19 in a quick test on April 10.
As of Thursday, people with a positive COVID-19 test and prescription can access Paxlovid locally. The antiviral drug is used to treat COVID-19 within five days of symptoms and helps keep people out of the hospital. Eligibility for the drug is determined during evaluation.
“The (provincial) website says one of the categories is 70 or older, so it’s 88 – is that enough?” She asked.
His mother seemed to meet the province’s criteria, but Moruni was confused about the steps needed to obtain the drug and whether her mother was eligible at all.
After going to the Holiday Inn Cambridge Evaluation Center, her mother was sent home without a prescription and told she would receive a phone call from St. Mary’s General Hospital the next day. The experience made her even more confused.
Although Moruni was able to get a prescription after the phone call – when the doctor checked her mother’s symptoms and possible interactions between Paxlovid and previously prescribed drugs – the unclear process made Moruni worry about missing the five-day treatment window.
The province’s expanded guidelines on who should be treated with antivirals have created confusion between who is eligible and who will actually receive a prescription, and the process for accessing medicines is also unclear.
Dr Dave Arnott, co-chair of the COVID-19 Assessment Center in Cambridge, said people with mild to moderate symptoms were encouraged to call a primary care provider or go to an assessment center. After visiting the assessment center, if the patient meets the requirements and requests a referral for Paxlovid, a referral is made to St. Mary’s General Hospital.
“In this case, it may appear that two patient assessments are being performed,” Arnott said in an e-mail statement.
“Patients are likely to feel the same way when a prescription is prescribed, as both the referring physician and the pharmacist will need to determine eligibility and safety.
But Arnott said Paxlovid treatment was not recommended in most cases.
“The announcement from the Ministry of Health recommends that anyone who meets the new expanded criteria be tested and referred for treatment,” Arnott said.
“This is not in line with the science we are presenting. The extended criteria include many groups that the Ontario Scientific Table has not recommended for treatment.
Despite the lack of clarity about the expanded criteria, the goal is to encourage people to ask more questions if they experience symptoms instead of taking action, said Kelly Grindrod, an associate professor at the Faculty of Pharmacy at the University of Waterloo.
“The reason the government has made the criteria much broader than that is that there has been a problem with eligible people, assuming they don’t, so they don’t ask,” she said.
So you are experiencing symptoms of COVID-19. Now what?
For people with mild to moderate symptoms, Arnott encourages them to call a primary care provider or visit an assessment center if they think an assessment is needed, or online provincial screening for COVID-19 treatment said they meet treatment conditions.
After visiting the assessment center, if the patient meets the requirements and requests a referral for Paxlovid, a referral is made to St. Mary’s General Hospital.
Other treatment options include steroid inhalers, which are given at the assessment center.
If you are denied an antiviral drug, Grindrod said you need to feel confident that your vaccines help reduce the risk.
“One of the challenges here is that the use of these drugs is quite complex, as are the actual clinical criteria you would use to choose a treatment,” Grindrod said.
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