We need to talk about Paxlovid | Press

We lost control of the screening. Our hospital network is close to breaking point. We have started arguing about the curfew again and citizens’ morale is low. We cannot say that there are many reasons for hope at the start of the year.

There is, however, one emerging. It’s called Paxlovid, an antiviral drug from Pfizer that reduces hospitalizations due to COVID-19 in vulnerable people. This treatment is much more convincing than that of the competitor Merck, monulpiravir.

However, we hardly talk about it. And this silence is worrying. It raises the risk that we are not ready to catch one of the few buoys that could be thrown at us.

It’s happened before – remember the rapid tests that slept in warehouses for months?

No, Paxlovid will not solve the crisis with a wave of a magic wand. But it directly addresses our big problem – hospitalizations. Well deployed, it could represent another weapon against the virus. The catch is that its use raises a lot of questions and requires preparation. And in the absence of public discussions, it is difficult to assess this level of preparedness.

Pfizer data shows that Paxlovid can reduce hospitalizations in people at risk by 89%. Treatment involves swallowing two pills every 12 hours for five days, as soon as a patient is diagnosed with COVID-19.

Americans and Europeans are already using it. This week, Washington even doubled its orders for Paxlovid. With us? Ottawa bought a million treatments. But we are still waiting for our authorities to approve the drug. And we are waiting for the cases of pills to arrive on Canadian soil.

In its defense, Health Canada received Pfizer’s request for approval more than a month and a half after the American authorities. But the net result is that Canadians wait while the house burns down.

A crucial question is who will be given the precious pills (a full treatment costs $ 875). It is obvious that the elderly, the obese and the immunosuppressed will be at the top of the list. But we also know that an important risk factor of being hospitalized is the fact… of not being vaccinated.

Will we want to offer a treatment much more expensive than a vaccine to the unvaccinated? It sounds shocking. But if the other choice is to see them occupy hospital beds, delay surgeries and cripple society …

Another challenge: to be effective, Paxlovid must be administered promptly after diagnosis. That means we’ll have to find a way to give prescriptions quickly. It is doable, but it is a logistical challenge – especially with current screening issues.

Finally, there is the question of manufacturing. Pfizer says it can only manufacture 80 million treatments this year. Licenses have been granted to certain developing countries, but this does not apply to Canada. However, we know that the pills are relatively easy to produce. Should we encourage – or force – Pfizer to license our generic drug manufacturers, for example? That too does not occupy our conversations.

Obviously, it is not because these issues are not debated in the public space that governments do nothing behind the scenes. Quebec, for example, has formed a committee on the use of antivirals which includes members of the National Institute of Excellence in Health and Social Services (INESSS).

With a virus as transmissible as Omicron, trying to control the number of COVID-19 cases is proving very difficult. Tackling hospitalizations like Paxlovid does is an alternative strategy that should be explored. We may be ready to do it. But we would like to be convinced of it. If we drop this buoy, in any case, we cannot plead having been taken by surprise.