opinion: lack of access to paxlovid could cost elderly ontarians their lives
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in newfoundland and labrador, quebec, saskatchewan and alberta, where pharmacists were allowed this spring to prescribe paxlovid, there was a big pick-up in use. (photo by handout/pfizer/afp via getty images)
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as ontarians return to offices in droves and kids head back to school newly mask-less, it’s easy to forget that wave eight of covid-19 is just around the corner. and that thousands of seniors in this province are still extremely vulnerable.
that’s because although boosters are available, with a new crop of omicron-specific ones soon on offer, ontario’s covid-19 prevention strategies in the most vulnerable groups need to be changed — and changed quickly — to avoid thousands of more deaths.
just under 42,000 canadians over 60 have died of covid as of sept. 9, according to statista. many of these deaths occurred before pfizer’s paxlovid — an antiviral drug that reduces the risk of hospitalization or death by 89 per cent in people at higher risk of serious illness from covid-19 — became available this year. in april, family doctors and nurse practitioners were given the green light to prescribe these drugs, as long as patients are over 70, are aged 60 with less than three booster doses, are immunocompromised, or are over 18 with significant health issues. those on certain medications and with kidney issues may not be candidates.
yet, despite its efficacy, paxlovid is often not reaching those who need it most. and that’s a reflection of how it’s being prescribed.
take my parents’ experience, for example. this past july, both of them over 80 and each with significant health issues, came down with covid-19. with multiple positive at-home tests and rapidly worsening symptoms, they reached out immediately to their long-term gps to obtain prescriptions for paxlovid. paxlovid needs to be prescribed in the first five days after the onset of symptoms to be most effective, so time is of the essence.
paxlovid is not reaching those who need it most
yet they were both turned away and told that if they wanted the antiviral, they needed to drive to covid-19 assessment centres that were, at a minimum, 45 minutes away by car. doctors at three walk-ins also declined prescribing the drug. they could book appointments online, my parents were informed, and hours at the centres were limited. “one just closed,” a doctor’s assistant cheerfully informed my mother.
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with his strength waning — due to covid-related pneumonia, as it later turned out — my 81-year-old father had me book him an appointment and insisted on driving across toronto to an assessment centre at michael garron hospital. there, he and my mother received prescriptions for paxlovid and obtained great care. the whole process took six hours and left him exhausted and in bed for two days. but it was not lost on him that the ability to drive, advocate for himself and have family assistance was a privilege.
curious about who was actually prescribing paxlovid, i reached out to a toronto pharmacist that same week. his answer: the bulk of prescriptions were from a canadian private virtual health platform that offers access to online doctors for $50 a visit.
but what about the non-english speaking seniors who don’t own computers and can’t book online appointments? and those who don’t have the strength, money, family support or wherewithal to get themselves to an assessment centre? it’s a tall order having the very ill and elderly transport themselves to assessment centres in order to obtain medications which can keep them out of hospitals and reduce their risk of death.
given its current health-care crisis of understaffed hospitals and a lack of available beds, ontario should be doing everything it can to get paxlovid to these vulnerable individuals, ensuring that family doctors or nurse practitioners are prescribing the medication as they have been urged to do. this should not be relegated to the physicians who staff covid-19 assessment centres, leaving the elderly scrambling to obtain the medication — or simply giving up and experiencing potentially dire outcomes.
notably, in newfoundland and labrador, quebec, saskatchewan and alberta, where pharmacists were allowed this spring to prescribe paxlovid, there was a big pick-up in the use of the antiviral.
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ontario has the tools to protect its seniors. it needs to change how it delivers paxlovid and save lives this fall.
anna sharratt is a toronto-based award-winning health and business reporter.
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