In normal times, our health system already lives permanently on the edge of the abyss, at the mercy of the slightest flu epidemic or summer vacation period. It is therefore not surprising to see it collapse completely in the face of the tsunami created by the coronavirus causing COVID-19.
Paxlovid is a new antiviral that may reduce post-COVID-19 hospitalizations. Its imminent arrival in Canada (this drug is already available in the United States) constitutes an interesting scenario: would our health system be able to take advantage of the arrival of this new therapeutic tool?
To be effective, Paxlovid should be administered at the onset of symptoms. To benefit from it, it is therefore necessary to be able to quickly receive a diagnosis and obtain a prescription. This simple mechanism demonstrates the flaws in our system. Our PCR testing system was swamped by the wave, and rapid tests, after sleeping in warehouses for months, were ordered in short supply anyway. And even with a diagnosis in hand, how can you imagine getting a prescription quickly if the time to access a general practitioner is typically around two weeks?
Assuming that we could solve the diagnostic problems (the federal government woke up late by promising the distribution of millions of tests in the near future), we could imagine a system allowing pharmacists (or other health professionals) to distribute the drug to those with a positive diagnosis. The recent example of naloxone has already shown that it is possible to broaden the methods of distributing a drug. However, it is easier to imagine that months of painstaking discussions would be required to grant a similar exemption to Paxlovid, which defeats the need for a swift and forceful response.
While it is possible that Paxlovid may still prove useful if it is given only to already hospitalized patients, the above scenarios demonstrate how much of our capacity to care depends on the hospital system. However, the latter is already extremely fragile: the number of hospital beds per segment of the population is already twice lower than in France, and three times lower than in Germany. We therefore depend on a hospital capacity which, in addition to its intrinsic shortcomings, is overtaxed by a deficient organization of first-line services. Should we therefore invest more in health systems? However, Canada is already characterized by a system that costs more than that of most other industrialized countries.
For some strange reason, the Canadian health care system is a source of pride for many citizens. Despite everything, he seems a prisoner of his dogmas, which prevent him from taking a frank look at the situation and respecting certain minimum standards of efficiency. Once the COVID-19 tsunami has passed, this pandemic should at the very least be used as a pretext for radical changes in our ways of doing things. It is more likely, however, that our centralized, rigid, bureaucratic and aging system will continue to purr in the same way. Who will be able to sound the alarm and prevent the perpetuation of a system that is destined to fail?