B.C. will receive a limited supply of COVID-19 antiviral pills. Here's who will get priority access

B.C.'s top health officer notes that there are limited supplies of Canada's first oral antiviral COVID-19 treatment and priority will be given to individuals who are at high risk of developing severe illness. 

On Monday (Jan. 17), Health Canada authorized the combination of two antiviral drugs, nirmatrelvir and ritonavir (brand name PAXLOVID^TM), to treat adults with mild to moderate COVID-19 who are at high risk of progressing to serious disease, including hospitalization or death. 

The treatment is the first approved antiviral treatment for a coronavirus infection that may be administered at home instead of in a hospital. The antiviral treatment is intended for use within five days of symptom onset. Taken early, the drug prevents a more serious illness. 

Provincial Health Officer Dr. Bonnie Henry told reporters in a press briefing Tuesday (Jan. 18) that the treatment is meant for people over the age of 70, clinically extremely vulnerable, immune-compromised, and for younger people who have additional medical conditions and don't have the protection of vaccines.

'For now, though, we will be receiving a very limited supply," she explained. "We expect that in the next few a week or so we'll get about 4000 treatment courses.

"It's not going to change the trajectory of our pandemic right now. But it is something that we have another tool to help those people who do get sick, who are more at risk of ending up in hospital."

Ethical discussions regarding who should have priority access to the new treatment are crucial, Henry emphasized, adding that the province is putting together a "heat map" of people who are most at risk based on things like underlying illness, one or two conditions, vaccination status and age.

"The risk is greatest in older people, no matter what age they are," she stressed. "But [people] over age 70 and people who have immunocompromising condition— regardless of vaccination status and regardless of age."

The treatment will also offer a vital alternative to people in communities where hospitals are not very accessible. Henry noted that the province is working closely with First Nations and remote communities where there's a higher risk of people needing care.

Paxlovid is an oral antiviral treatment for COVID-19, consisting of a combination of two medications that must be taken together. The first drug, nirmatrelvir, blocks an enzyme that the SARS-CoV-2 virus needs to reproduce. The second, ritonavir, is a commonly used HIV treatment, which in the Paxlovid combination, slows down how fast nirmatrelvir breaks down so it can do its job for longer.

In clinical trials, Paxlovid was so successful at reducing hospitalizations and deaths among high-risk people not yet seriously ill with COVID-19 that Pfizer ended the trial early so it could start giving the treatment to a wider number of people. When given within three to five days of symptoms, it was 85 to 89 per cent effective at reducing hospitalizations. No Paxlovid patients died, while seven people in the study died after receiving a placebo.

With files from the Canadian Press.