COVID-19 POSITIVE PATIENTS WITH SYMPTOMS

Patients who have tested positive for COVID-19 and whose symptoms began less than four days ago are encouraged to call their family doctor to determine Paxlovid eligibility.

If you are not prescribing yet, patients can call 1-844-343-0971.

ELIGIBILITY TABLE BREAKDOWN

1. Unvaccinated or have received one dose of a COVID-19 vaccine and are either:

• Age 55 or older
• Indigenous, and age 45 or older
• Age 18 and older with a pre-existing health condition*
• Pregnant

2. Two doses of a COVID-19 vaccine and are either:

• Age 60 or older AND have ONE or more pre-existing health condition(s)*
• Indigenous and 50 years of age or older AND have ONE or more pre-existing health condition(s)*

3. Three doses of a COVID-19 vaccine and are either:

• Age 70 or older AND have TWO or more pre-existing health condition(s)*
• Indigenous and 50 years or older AND have TWO or more pre-existing health condition(s)*

4. Immunocompromised (vaccinated or unvaccinated), due to reasons including but not limited to patients who:

• Have received a transplant – solid organ or stem cell (transplant patients should NOT receive Paxlovid due to the potential for life-threatening drug interactions but are eligible for other therapies, such as Remdesivir)
• Transplant patients should be assessed and treated through the centralized Outpatient Treatment Program by calling 1-844-343-0971 or through their transplant specialist
• All prescribers in the community including family physicians, nurse practitioners and pharmacists should refer transplant patients to the centralized team or the patient’s specialist/team
• Have cancer and have received a dose of any IV or oral chemotherapy or other immunosuppressive treatment since December 2020
• Have an inflammatory condition (e.g. rheumatoid arthritis, lupus, inflammatory bowel disease) and received a dose of any systemic immunosuppressive treatment since December 2020

5. Living in long-term care or some designated supportive living sites (DSL4 and 4D), regardless of vaccine status

*Pre-existing Health Conditions include:

• Diabetes (taking medication for treatment)
• Obesity (BMI >30)
• Chronic kidney disease
• Congestive heart failure (New York Heart Association class II, III, or IV)
• Chronic obstructive pulmonary disease, and moderate-to-severe asthma

REBOUND SYMPTOMS AFTER PAXLOVID TREATMENT

A small percentage of patients may develop a relapse of COVID-19 symptoms within a few days of completing a course of treatment. This may be accompanied by a new positive COVID-19 test, after testing negative. This has also occurred in a small number of patients who have not received treatment. At this time, it is NOT recommended that treatment be extended or repeated. 

LONG COVID AND PAXLOVID

Current therapies for COVID-19 (including Paxlovid, Remdesivir and monoclonal antibodies) target actively replicating virus during acute infection. Therefore, these therapies should NOT be considered a treatment for individuals experiencing symptoms of Long COVID. 

PHARMACISTS CAN PRESCRIBE PAXLOVID

AHS has enabled pharmacists with additional prescribing authorization to prescribe Paxlovid. A temporary accommodation is in place to provide direction for pharmacists to prescribe without seeing the patient in person.

PATIENTS AND PAXLOVID PRESCRIPTION PICK-UP

Family physicians are asked to fax Paxlovid prescriptions directly to the pharmacy (check tool to locate pharmacy) instead of giving it to patients to take in. Patients should be advised to contact the pharmacy to have the prescription delivered or contact someone who is not COVID-19 positive to pick up their medication. 

For additional information, please contact phc@ahs.ca. 

For quick access, bookmark the  ACFP COVID-19 Resources Page.

Any physician, nurse practitioner, and prescribing pharmacists in the province can now prescribe Paxlovid to eligible patients. Support is available to prescribers through the Outpatient COVID-19 Treatment Program team if they have questions.

Current criteria focus is on immunocompromised patients who may not respond to vaccine, or are under-vaccinated and at a greater risk of progressing to severe disease.