How to get Paxlovid in Ontario for COVID-19 treatment: Your questions answered

Multiple rapid tests better at detecting COVID-19 Dr. Isaac Bogoch explains the benefit of taking two rapid antigen tests 24 hours apart to determine whether or not someone has COVID-19.

More people are now eligible to receive antiviral treatments for COVID-19—treatments that may be able to reduce severe symptoms and prevent hospitalization.

There are four treatments currently available for the novel coronavirus, however the most accessible and versatile is Paxlovid, a medication that can now be prescribed to certain at-risk patients by a doctor.

"It's great to have this option," Dr. Tara Kiran, a family physician and Fidani Chair of Improvement and Innovation at the University of Toronto, told CTV News Toronto this week.

"I think, in the last couple of weeks when I've had people who've had COVID, I've been referring them to our local COVID Assessment Centre, and now we're getting all materials and processes in place in our own setting to feel comfortable being able to do this in a safe way for the right people."

WHAT IS THIS TREATMENT?

Paxlovid is an oral medication that must be taken within five days of symptoms developing. Those taking the medication must take three pills, twice a day, for five consecutive days.

Kiran said that Paxlovid was originally studied in "unvaccinated patients in the Delta era" but there has been some research that suggests it's also effective with the Omicron variant.

"Scientific experts have said that if people are at high risk of progressing to serious illness, then this is a medication where the benefits likely outweigh the risks and should be considered," Kiran said. "And they've made it clear kind of based on age and chronic conditions and the number of vaccination doses you have, whether you would be considered high risk or not."

WHO CAN GET IT?

The treatment is recommended for people who are at higher risk of severe symptoms or hospitalizations and not for the general public.

Earlier this week the province released a list of groups that are now eligible both for the antiviral treatment as well as PCR tests:

• Individuals aged 18 and up who are immunocompromised

• Individuals aged 70 and up

• Individuals aged 60 and up with fewer than three vaccine doses

• Individuals aged 18 and up with fewer than three vaccine doses and at least one risk condition (for example, a chronic illness, heart disease, obesity, diabetes, ect.)

Individuals experiencing symptoms of COVID-19 can also take an online assessment on the province's website to determine if they should seek treatment.

The province has also said that a health-care provider may prescribe Paxlovid to those outside of these groups based on individual circumstances.

WILL MY DOCTOR PRESCRIBE IT TO ME?

Eligible individuals are being urged to contact their family doctor to discuss whether this antiviral treatment is right for them prior to potentially contracting the virus.

Kiran said that eligible individuals should come prepared with a list of medications they are currently taking.

"(Paxlovid) does have some potentially very serious drug interactions," she said. "And so we need to be careful about weighing the risks and benefits."

Prior to asking a doctor to prescribe the medications, patients should also confirm they actually have COVID-19 by taking either a rapid antigen test or going to a clinical assessment centre for a PCR test.

However, Kiran urged people experiencing symptoms of COVID-19 who test negative on a rapid test to also get a PCR test, as they are far more accurate.

WHERE CAN I GET THE DRUGS?

Paxlovid can be obtained at a clinical assessment centre or one of more than 2,000 pharmacies across Ontario with a prescription from a doctor. The provincial government says that it anticipates additional pharmacies to take part in the program.

A full list of pharmacies dispensing the antiviral treatment can be found here.

ARE THERE OTHER ANTIVIRAL OPTIONS AVAILABLE?

There are two other medications that can be prescribed by a doctor to help alleviate the symptoms of COVID-19. The first is budesonide, an inhaled medication the COVID-19 Science Advisory Table said had the potential to reduce recovery time by a median of three days.

The other medication is Fluvoxamine, an oral pill primarily used as an antidepressant but studies suggest it could reduce risk of severe symptoms and hospitalization.

"Both of these medications have been found to be helpful to treat COVID," Kiran said, adding that " they're not as helpful as Paxlovid."

A fourth treatment option is Remdesivir, a medication that must be taken intravenously at a COVID-19 clinical assessment centre or hospital once daily for three days.

DO I STILL NEED TO GET A COVID-19 VACCINE?

Health experts have said that while Paxlovid can help in reducing symptoms of COVID-19 and lessen the likelihood of hospitalization and death, it does not provide the same level of protection as multiple doses of a vaccine, especially when paired with public health measures such as masking and physical distancing.

"What we want to do more than anything is prevent you from having COVID in the first place," Kiran said. "So get the vaccines that are recommended for you. That's so important."

"There's a lot of buzz about Paxlovid, but I think it should always be in context of like, prevention is better than cure."