30,000 COVID treatment courses unused amid B.C. doctor shortage

There are 30,000 rounds of the COVID-19 treatment Paxlovid in pharmacies and storage locations in British Columbia, with only 2,500 ever dispensed in the province, CTV News has learned. The situation has been blamed in part on the shortage of doctors.

The anti-viral tablets, which must be taken for five days, are only approved for certain people considered to be at higher risk of serious illness from the virus: those deemed extremely clinically vulnerable, Indigenous people over 50, the unvaccinated over 50, and those 70 or older with chronic conditions.

• Take the province's online self-assessment for Paxlovid eligibility here.

The medication must begin within five days of the onset of mild-to-moderate symptoms, and also requires a positive COVID-19 test, either via lab-based PCR methods or the at-home rapid tests available for free at many pharmacies. 

“A large supply-to-dispense ratio does not necessarily reflect underutilization or lack of access to the treatment,” the Ministry of Health wrote in an email outlining the statistics.

“There are reasons why Paxlovid may not be a good choice for some people, such as some pre-existing conditions and multiple interactions with other medications.”

But CTV News has spoken to several frontline doctors expressing concern that due to massive demand and fewer physicians, they aren’t able to see patients within the five-day window; something they find particularly worrisome at a time the number of people hospitalized with COVID-19 has been growing and British Columbians continue to die after becoming infected.

In addition to issues around timely access to an assessment, the doctors also expressed frustrations that a special form required to authorize a prescription of Paxlovid is needlessly complex and involved, taking up to 20 minutes to research, complete and fax to a pharmacy.

CTV News has made repeated requests to speak with the provincial health officer or other Health Ministry representative on the matter since Monday, but no one has been made available. 

DOCTORS’ ASSOCIATION SUPPORTS ELIGIBILITY CRITERIA

Doctors of B.C., the association that speaks on behalf of physicians in the province, wants to remind the public that while studies show Paxlovid reduces the chance of someone ending up in hospital with a serious case of COVID-19, vaccination is still the best prevention, because the drug is only intended for those at high risk.

“Any time there's a new medication, from a safety profile we need to be sure that the right people are getting it in the right time frame in the right place,” said the organization’s president-elect Dr. Josh Greggain.

“As with anything in medicine, we continue to wrestle with, 'Should everyone get it? Some people get it? Some people get it for little bit of time? If you're getting better, is it too late?'"

He added certain medications clash with Paxlovid and could prompt a doctor to reject it as a treatment option.

Greggain suggested those sick with COVID who believe they’re eligible for Paxlovid but are having trouble reaching a doctor should call the province’s 811 HealthLink line to see if they can get the drug, which is free throughout B.C.

LONG DELAYS THROUGH PROVINCIAL SYSTEM

The Ministry of Health also suggested that those without timely access to a doctor call Services BC, but that phone line has been plagued with long delays as well.

A president-elect nominee for the Canadian Medical Association is among the growing number of people taking to social media describing days-long waits to hear if and when they can access Paxlovid treatment.

My frail elderly relative COVID+ve-Called COVID hotline to access treatment 2 days ago - now into day#6 of symptoms at home with no assessment and no phone call, thankfully mild-mod symptoms so far. Not good @adriandix @DrBonnieHenry @DoctorsOfBC @frasernorthwest @Fraserhealth https://t.co/B9Hq9SYQZ2

— Dr. Kathleen Ross (@DrKathleenRoss1) April 24, 2022

A former nurse contacted CTV News on the ninth day of waiting for a call back from the helpline, where staff had told her not to attempt any follow-up calls herself.

“I’m livid,” said Carrie Mae Garber, who lives with her elderly mother and is extremely clinically vulnerable herself. “If someone like me, with my experience in the health-care system, with my privilege and education and being White, didn’t get returned – what about those people who don’t have a family doctor and can’t do all this?”

She was able to work with her family doctor to determine she was eligible for Paxlovid despite being on a medication that could conflict with the anti-viral and is now feeling better.

Roughly one million British Columbians are without a family doctor and walk-in clinics in the province hit their patient limit early in the day, so the issue of accessing Paxlovid within the five day treatment window is likely to continue unless the province changes its policy.

Meanwhile, pharmacists in Quebec have been authorized to prescribe the tablets for eligible patients for the past month.