Nova Scotia now has 900 treatments of Pfizer’s Paxlovid drug on hand. The oral pill is used to treat those with mild COVID-19 symptoms to prevent more severe illness and hospitalization.
“It’s what’s called a protease inhibitor, so that’s a drug that inhibits the way the virus makes copies of itself,” said Dr. Lisa Barrett, an infectious disease specialist at Dalhousie University.
“It really works hard in the early stages of infection to take down the virus levels and prevent them from getting higher, which is what causes later disease.”
But Dr. Barrett cautions people against considering this drug as a “game changer.” Not only is supply limited, but there are also limits to who is best suited for the drug.
The initial study found that it’s best suited for those who have underlying medical conditions, are immunocompromised or under- or unvaccinated.
The drug itself is also something that interacts with many other common drugs, from blood thinners to naturopathic medications. Dr. Barrett says while individuals on certain drugs may still be able to take Paxlovid, it will require a plan.
“That takes a little bit of time on behalf of the prescriber and of the pharmacists to make sure things are going well,” said Barrett.
While Nova Scotia has supply, no pills have been prescribed yet. The process in determining who will be prioritized is currently underway.
Health Canada recommends provinces take three things into consideration when figuring out how to distribute their initial supply:
- Prioritizing individuals who are at highest risk for severe illness and hospitalization.
- Consider making greater supply available for use in rural and remote communities.
- Infection must be confirmed and treatment initiated within 5 days of symptom onset.
For the first batch of pills in Nova Scotia, those who are able to prescribe the medication will be limited. Nova Scotians should not go to their doctor or pharmacist expecting to get a prescription.
“The province is working on a way of bringing the lab information, the self-reporting information, details from emergency doctors and other specialists around the province together to be able to refer people,” said Barrett.
“The goal is not to limit and keep the drug in a warehouse, for sure. It is to use it when it’s needed.”
Nova Scotians deemed most vulnerable and at highest risk will be contacted after testing positive if they qualify and are chosen to take the pill. Barrett says the most important thing at-risk Nova Scotians can do is take a COVID test as soon as symptoms develop, and fill out the online form if it’s a rapid at home test, as the medication needs to be started within five days.
Unvaccinated are main priority group
For the most part it’s the unvaccinated or under-vaccinated population most at risk of ending up in hospital and the initial study for the drug was on unvaccinated individuals. That’s why the majority of people receiving the medication will be unvaccinated.
“One of the things we need to do is protect our health system at a time when cases are still very high and we have no space in hospital,” said Barrett.
“A key core goal at a population level for us is to make sure they don’t go to hospital, and if those are unvaccinated people for whatever reason, if giving them this medication keeps them out of hospital and allows someone who has another medical problem like a heart attack or a stroke to get care because the bed is not filled then that has its other benefits as well.”
While the drug was found to have an 84 per cent decrease in the number of people who ended up in hospital, it should not be considered as an alternative to getting vaccinated.
“The pill is not going to change things for most of the world. Vaccination will. It’ll change your risk of getting infected and your risk of death and hospitalization regardless of this pill,” said Barrett.
“The pill is the backup to the backup to the backup.”