What’s Up Doc? What you should know about outpatient treatment for COVID-19 infection
By Dr. Noorali Bharwani on April 27, 2022.
According to Reuters, global COVID-19 cases have surpassed 500 million, as the highly contagious BA.2 sub-variant of Omicron surges in many countries in Europe and Asia and North America. Recent surge across Canada has been driven by the Omicron variant and its BA.2 subvariant. In Alberta and rest of Canada, COVID-19 numbers are going up as we relax on our need to wear a mask, avoid crowded gatherings and get fully vaccinated. Wearing a mask is strongly recommended by Canada’s Chief Medical Officer of Health. In order to prevent hospital overcrowding with COVID-19 infected patients, Health Canada has approved out-patient use of medications for certain group of venerable individuals who are infected. Since these medications are currently in short supply, Health Canada has advised provinces to prioritize patients as follows: 1. Individuals who have the highest likelihood of severe illness including those who are immunocompromised regardless of vaccination status; 2. Individuals over the age of 80 whose vaccinations are not up to date; and 3. Canadians aged 60 or older who live in underserved rural or remote communities, long-term care homes, who are from First Nations, Inuit, and Metis communities, or whose vaccinations are not up to date. Alberta Health Services and Alberta Health are rolling out the administration of outpatient treatments like Paxlovidâ„¢ and Remdesivir, COVID-19 medications recently approved by Health Canada that are shown to prevent COVID-19 from progressing in high-risk patients with mild to moderate symptoms if taken within five days of symptom onset (seven days for Remdesivir), says Alberta Health website. Patient will be first assessed by a healthcare professional before Paxlovidâ„¢ or Remdesivir will be available to the patient. Paxlovidâ„¢ is taken orally in pill form. One dose is a combination of two nirmatrelvir (pink) tablets and one ritonavir (white) tablet, taken twice a day for five days. Patients with a reduced kidney function may have their dose reduced to two pills twice a day for five days. Remdesivir is given intravenously by a qualified health professional. The medicine is given over 30 minutes. You will be watched closely for another 15 to 30 minutes after getting the treatment. You can expect the appointment to last about 1.5 hours, including setup time. In Alberta, Who Is Eligible for Paxlovidâ„¢ and Remdesivir? Treatments are available for patients who have a lab-confirmed COVID-19 infection if they can receive the treatment within five days of symptom onset for Paxlovidâ„¢ or seven days for Remdesivir and they are: 1. Unvaccinated or have received one dose of a COVID-19 vaccine and are: age 55 and older or Indigenous, and age 45 or older or age 18 and older with a pre-existing health condition including diabetes (taking medication for treatment), obesity (BMI >30), chronic kidney disease (estimated glomerular filtration rate, <60 ml per minute per 1.73 m2 of body-surface area), congestive heart failure (New York Heart Association class II, III, or IV), chronic obstructive pulmonary disease, and moderate-to-severe asthma, pregnant OR 2. Immunocompromised (vaccinated or unvaccinated), due to reasons including but not limited to: have received a transplant, is an oncology patient who has received a dose of any intravenous or oral chemotherapy or other immunosuppressive treatment since December 2020, has an inflammatory condition (e.g., rheumatoid arthritis, lupus, inflammatory bowel disease) receiving a dose of any systemic immunosuppressive treatment since December 2020 OR 3. Living in long-term care or designated supportive living, regardless of age or vaccine status. How do you access Paxlovidâ„¢ or Remdesivir? If you have tested positive for COVID-19 and your symptoms began less than four days ago and you believe you meet the eligibility criteria (above), please call the dedicated Health Link line at 1-844-343-0971 to find out if you qualify to receive treatment. Do not call 811, says Alberta Health website (Outpatient Treatment for COVID-19). The website also has more information. Remember 10 words: Wear a mask, avoid crowded gatherings and get fully vaccinated. Dr. Bharwani is a general surgeon, freelance writer, photographer and author of A Doctor’s Journey and Doctor B’s Eight Steps to Wellness. His books are available at http://www.nbharwani.com. You can discuss this article and other articles on his website: nbharwani.com and sign up for RSS feed, Twitter or get on the email list 21-20
