Hospital CEO calls on Health Canada to approve Pfizer's antiviral pill amid health system strain

Toronto -

A Toronto hospital executive is calling on Health Canada to approve Pfizer's COVID-19 antiviral pill amid increasing hospitalizations across the country.

Dr. Kevin Smith, who is president and CEO of the University Health Network (UHN), told CTV News Channel on Sunday that the surge in COVID-19 cases is affecting capacity at the UHN's hospitals.

"We also have to remember that we don't only have Omicron or COVID patients to look after, but many, many, many other delayed patients, not to mention the urgent and emergent patients who present because of motor vehicle accidents, heart attacks, strokes, all sorts of other emergency events," he said.

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On top of that, Smith said, between 50 and 100 health-care workers at UHN's hospitals are calling in sick every day.

"Obviously, when those people aren't caring for patients, that makes it all the more difficult for us to ensure continuity of care," he said.

Data from Pfizer's 2,250-person clinical trial shows that the company's oral medication was around 89 per cent effective at preventing hospitalizations or deaths due to COVID-19 when compared against a placebo. There were also no deaths among the participants that took the Pfizer treatment.

"When we think about that, out of every 10 people who might be admitted (to hospital), almost nine of them could be avoided," said Smith.

"Our big challenge right now is capacity and staffing. So, if we can turn that back to 80 or 90 per cent of avoided admissions, we really can manage the system."

Pfizer's antiviral pill -- called Paxlovid -- works by preventing the SARS-CoV-2 virus from replicating itself in the patient's body.

"(It's) very, very different than a flu remedy that one would see over the counter, which basically tries to address your symptoms. This prevents the disease from replicating and making you sicker and sicker," Smith explained.

The company submitted its treatment to Health Canada for approval on Dec. 1, 2021. But while Pfizer's antiviral pill has already been authorized in the U.S. and the U.K., Health Canada has yet to make a decision.

Merck's antiviral pill, which was submitted on Aug. 13, is also awaiting approval from Health Canada. The U.S. authorized Merck's treatment in late December.

The federal government has already signed deals to procure one million of Pfizer's antiviral pills and 500,000 of Merck's pills, which will be distributed as soon as Health Canada gives the green light. Merck even announced last month that it would be producing its pills in Ontario.

Health Canada told CTVNews.ca in an email statement that the agency is still waiting for additional data from the companies. The agency also said it could not give a timeline on when a decision will be made.

"Timing for the completion of Health Canada’s review depends on many factors, including but not limited to a need for additional data, discussions with the sponsor, and requirements for updates to safety information," Health Canada spokesperson Mark Johnson said.

"Health Canada will only authorize the use of anti-viral treatments if the independent and thorough scientific review of all the data included in the submissions show that the benefits of the treatments outweigh the potential risks."

Smith believes there already is enough data to warrant approval now, citing the authorization of Pfizer's pill in the U.S. and U.K. as well as the "risk for us to not be able to continue comprehensive hospital care."

"I totally respect my colleagues at Health Canada, but my personal view is we now have enough data from those two approvals," he said. "It really is time for us to use this at an emergency basis."

Ottawa-based ICU and palliative care physician Dr. Kwadwo Kyeremanteng agrees that treatments like COVID-19 antivirals are being underused.

"I think there's a lot of room for therapeutics within our treatment of COVID-19," he told CTV News Channel on Sunday.

"If you have a tool at your disposal that can prevent people from landing in hospital, which is our ultimate goal. It would be great to have that available."

However, Kyeremanteng also stressed the importance of access to PCR testing, which many provinces have limited due to lack of testing capacity.

"One of the challenges is that you need to know that you're positive to be able to have access (to antivirals)," he said. 

I know how hard EVERYONE has been working. Thank you. We’re seeing very rapid snd concerning growth in the need for General Internal Medicine hospital admissions. @GovCanHealth how can we help get Paxlovid (Pfizer antiviral) immediately be approved for emergency use? #needitnow

— Dr. Kevin Smith (@KevinSmithUHN) January 1, 2022