Who in B.C. will get the COVID-19 anti-viral pill first?
Posted January 19, 2022 1:20 pm.
With batches of Pfizer’s anti-viral COVID-19 treatment already arriving in Canada, B.C.’s top doctor notes those who contract the virus and are at greatest risk of serious illness or hospitalization will be top of the priority list.
“We’ve been looking at them again with an ethical lens here in British Columbia, and what we’ve put together is what we call a heat map of who’s most at risk based on things like underlying illness, one or two conditions, vaccination status, and age,” Provincial Health Officer Dr. Bonnie Henry said Tuesday.
The Paxlovid treatment, which is in pill form and the first approved for use for COVID-19 in Canada so far, is a combination of two anti-viral medications — Ritonavir and Nirmatrelvir — which prevents the virus from replicating once it has infected a person.
Pfizer says its trials have shown the drug can cut the chance of hospitalizations or death by 89 per cent in adults when taken shortly after initial symptoms.
However, B.C. has run into testing challenges in the past several weeks due to overwhelming demand amid the Omicron wave. Henry says the province is working to bring in measures to get tests to those who are most at risk.
“What we have in British Columbia through our clinically extremely vulnerable group is we have identified a group of people who are most at risk, regardless of vaccination status. So we are working through all of these issues, with this limited supply, particularly, how to ensure that those people who are most at risk are able to access testing and the drug, if needed, in the shortest period of time,” she explained.
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Older people, particularly those over 80, but also anyone over 70, as well as British Columbians with immunocompromising conditions, regardless of vaccination status and age, have been identified as those at the front of the line.
Henry says another consideration when deciding who to give the Paxlovid treatment to is how it can be used to prevent people from needing hospital or critical care in remote and other, similar communities.
“We’ve had some really terrible outbreaks in some First Nations communities and remote communities in the province. So we are working with the First Nations health authority and others to look at how we can have rapid access in those communities where we know there’s a higher risk of people needing care,” she added.
Clinical trials for both Ritonavir and Nirmatrelvir were all conducted in non-vaccinated people, Henry notes, adding they are still the most likely to end up in hospital with COVID-19 complications.
“But there is a whole spectrum of people and we’re focusing on how do we identify them earliest.”
Henry stresses the treatment is not a substitute for getting the vaccine, and should only be used in people who test positive for COVID-19.
Pfizer says laboratory testing has also shown the drug retains its potency against the Omicron variant.
Health Canada has approved the drug for use in adults with mild or moderate COIVD-19 who are also at high risk of becoming more seriously ill. The treatment is not approved for use in teenagers or people who are already hospitalized because of the virus.
The drug must prescribed within five days of the onset of symptoms.
On Monday, Canada Chief Public Health Officer Dr. Theresa Tam said people who are not vaccinated against COVID-19 should be on the priority list for Paxlovid, saying, “this is a scientific and rational use of a drug that is in short supply.”
“We know that the unvaccinated are at higher risk of getting severe outcomes and getting hospitalized and ending up in the ICU. So, this is the evidence, and we’re following that evidence,” she said on Jan. 18.
“I think that as healthcare providers, you don’t pick and choose which patients you have coming into the hospital and getting treated. I think this approach shows that we are prioritizing treatments to those most in need.”
