Province urges patience amid high demand for COVID-19 pill Paxlovid

Officials with Health P.E.I. are asking Islanders for patience when trying to access Paxlovid — and say physicians have now prescribed more than 1,200 courses of the highly effective COVID-19 antiviral.

The five-day oral treatment is available to those classified as high risk, including those 50 and older and anyone who is immunocompromised. It needs to be taken within five days of symptom onset.

Dr. Laura O'Connor, physician lead for COVID-19 response for community and seniors, says Health P.E.I. is doing the best it can to meet the demand for the antiviral medication, but added Islanders need to keep in mind that Paxlovid isn't for everyone.

"Even if we had 150,000 doses, we wouldn't give it to everybody in the province," said O'Connor, explaining it may interfere with other medications.

To manage supply and streamline distribution, only 10 Island pharmacies are currently equipped to dispense Paxlovid. A small group of Island doctors who have received additional training can prescribe it. 

"I'd ask the public to be understanding," said Dr. O'Connor. 

"We have an incredibly hard working team of clinicians, pharmacists and physicians and their support staff making this happen in the cracks of their day and after hours. And, you know, it isn't perfect, but I think we've made a real difference. And I think we're doing the best we can for the circumstances."

Treatment likely led to fewer hospitalizations

After several months of clinical trials, Pfizer reported in November that Paxlovid reduced the risk of hospitalization or death by an impressive 89 per cent compared with a placebo in non-hospitalized high-risk adults with COVID-19.

The medication is most effective in those at highest risk of severe illness, whether due to age, underlying health conditions, comorbidities or those who are unvaccinated.

O'Connor said approximately 50 to 60 people are being prescribed Paxlovid daily. And as of Monday, only two people who started Paxlovid have needed hospital care for COVID-19.

O'Connor said that without Paxlovid the Island would have likely seen significantly more hospitalizations.

COVID-19 cases rose in mid-to-late March, but hospitalizations didn't subsequently rise in the same fashion, she said.

"So we did not see a hospitalization bump despite the massive case bump. And you know, in a truly scientific way, can I tell you it was because of Paxlovid? No. But a lot of us in the system have our hunches that that was a big player because it's been shown to be very effective in trials," said O'Connor.  

Another barrier to Paxlovid for some is the need for a positive molecular COVID-19 test — something other provinces don't require. 

O'Connor says that's because other provinces don't have P.E.I.'s testing capacity and must rely mainly on rapid tests. 

"We put all our eggs in the testing and screening basket," O'Connor said. "This province is flush with molecular screening tools. And we have the capacity for that. So we haven't needed to go to rapid testing. I think when other provinces are doing that, it's not for convenience, it's because they have no way to mobilize Paxlovid because they don't have access to those molecular tests in the same way P.E.I. does." 

Getting training materials out

O'Connor says work is underway now to train more physicians to prescribe the drug. 

And the province is collaborating with the P.E.I. Pharmacists Association to offer it more widely, something she expects in the coming weeks.

"We now have to deal with the logistics of getting it out to pharmacies and getting it into their workflow and getting some more training materials out to physicians," said O'Connor. 

She says supply has always been a concern, but the province had about 1,200 treatments of Paxlovid available as of Monday.

In terms of how the drug is accessed on P.E.I., O'Connor doesn't foresee any changes at this time.   

"With any treatment, it comes down to risk versus benefit," said O'Connor. "How much is this drug going to help you versus any harms that might come of it? And if it's not going to help you, why would we take any chances in giving it to you?"