Alberta patients and advocates call for greater access to Paxlovid antiviral COVID-19 | The Canadian News

Chris Lindsey has been very careful not to get COVID-19 for the past two years.

In late 2021, he was diagnosed with an autoimmune disorder that requires prescription immunosuppressive drugs.

In mid-2020, he had his gallbladder removed for a mass that turned out not to be cancerous.

That operation came less than a year after he began treatment for thyroid cancer.

And in May 2018 he was diagnosed with stage 3 lymphoma.

The fear of contracting COVID-19 was very real for Lindsey and her family.

“My family, obviously, has been on edge because they don’t want to bring something home, they don’t want me to get sick,” said Cochrane’s father, Alta.

“They don’t want to bring that into the house because they’re like, they’ll be fine, but they don’t want me to go through any more illnesses.”

Reanne Booker, president of the Canadian Association of Nurses in Oncology and Calgary Oncology and a palliative care nurse, said COVID-19 presents a significant threat to cancer patients.

“The case fatality rate in the general population is on the order of 1 to 2%. However, the case fatality rate for cancer patients, if they contract COVID-19, is around 25% or more,” he said.

“So we’re seeing significantly worse outcomes potentially in cancer patients.”

Despite Lindsey having undergone a full course of vaccination and a booster shot, the chances that he would end up in the hospital for a COVID-19 infection were very real for the immunosuppressed Albertan.

“It’s been a roller coaster, emotionally,” he said.

And then, 10 days before Lindsey received her fourth dose of vaccine, she got COVID-19.

She started having symptoms on a Monday and tested positive on a rapid antigen test on a Thursday.

“The cough was definitely different; it was very thick and hard to get rid of. But it wasn’t as bad as what I’ve heard from other people who have had it,” he told Global News.

“So I think the vaccination helped me minimize that risk.”

“Cancer patients and those on immunosuppressive medication do not always mount effective immune responses to COVID-19 vaccines,” Booker said. “So, again, they are especially vulnerable to the adverse effects of COVID-19 infection.”

Enter antiviral treatments.

Gilead Sciences’ Remdesivir, an intravenous antiviral treatment, and Pfizer’s Paxlovid, an oral prescription, are available for Albertans who fit into very specific criteria: long term care and assisted living residents, immunocompromised Albertans, and some unvaccinated or under-vaccinated persons..

It is supposed to be taken within five days of the onset of symptoms to prevent severe illness, hospitalization, and death.

Fashion Stories

• 

  Ban on donating blood to men who have sex with men may end: Health Canada

• 

  “Rolling Thunder” biker caravan to arrive in Ottawa. Here’s what you need to know

“It inhibits the replication of the virus in someone’s body,” Booker said. “We know that if there are large amounts of virus in someone’s body that can be associated with more severe disease.”

In early April, pharmacists could directly dispense Paxlovid with a prescription from an AHS physician. That prescription required a laboratory-confirmed test, a PCR test that the province restricted to the general population in January.

The molecular test is only available to those who have “clinical risk factors for serious outcomes” and work and live in “high-risk settings,” according to the province.

On Thursday night, after her rapid test showed she had COVID-19, Lindsey booked a PCR test online. On Friday, she underwent a swab at the Richmond Diagnostic Center, and within a couple of hours received the result.

After a sequence of phone calls, including checking the suitability of antivirals and a telephone consultation with a physician, Lindsey received a prescription for Paxlovid.

“As the phone calls came in, I definitely started to relax a little bit more because it was happening exactly as they said it would,” Lindsey said.

A friend was able to pick up the prescription at a nearby pharmacy, and on the fifth day of her symptoms, Lindsey began her treatment with Paxlovid, one of 1,300 issued across the province.

Provincial warehouses hold about 25,000 more, according to Alberta Health officials.

The combination of available supply, lab testing restrictions, confusing eligibility, and an opaque process has led medical professionals like Booker to call for expanding who can access the prescription antiviral.

“It’s frustrating to know that we have those options and they’re not being fully utilized. And part of that might just be better education, informing the public about the eligibility criteria and how to access them,” he said.

“As we learn more and more about the benefits of Paxlovid, I would like to see access expanded.”

On Wednesday, Health Minister Jason Copping announced that work was underway to allow doctors outside the province’s COVID-19 outpatient treatment program to prescribe Paxlovid.

“Family physicians are getting tools and training to make sure they are comfortable prescribing this medication, and I expect to announce very soon that prescribing will be fully transferred to them,” he said, acknowledging the increased demand for it.

That can be a challenge for some Albertans, Booker noted.

“Not everyone has a family doctor in Alberta. And that’s why I’m concerned, as I have been throughout the pandemic, about equity in access to treatment and testing,” he said.

“I worry about people who don’t have a family doctor or who are perhaps too unwell from their underlying medical conditions to be able to navigate these processes.”

Booker also noted potential problems if a patient tried to get an appointment with his or her primary care physician within that five-day window, but was unsuccessful.

Dr. Deena Hinshaw, chief medical officer of health, said the current eligibility criteria balance the benefits with the risks of taking Paxlovid.

“It’s important to remember that determining who can benefit most from this medication depends on who is most at risk for serious outcomes at this time,” Hinshaw said Wednesday.

“With any medication, including Paxlovid, it is important to consider what benefit a medication can provide and also what the potential side effects are.

“Paxlovid is an additional line of defense that may help some people with their COVID-19 infection.”

Lindsey considers himself fortunate that he was able to start the five-day treatment with Paxlovid on the last day when it would have been most effective.

“I didn’t end up in the hospital. The way I look at it is whether it did its job in preventing progression of worsening, because I didn’t get worse from the day I started it,” he said, adding that the AHS process went “smoothly.”

And he gave some simple advice to those who may opt for antivirals.

“Don’t wait. Just contact them.”

– with files from Lauren Pullen, Global News