Pfizer's COVID-19 pill could have real impact in Canada — if we can roll it out fast enough

After Canada approved a new treatment for COVID-19, Pfizer's highly effective oral therapeutic Paxlovid, experts are  hopeful the highly sought after pill can help control a devastating Omicron-driven surge — if it's rolled out fast enough.

"I think it will be an effective tool in high-risk individuals if they can get tested quick enough to be able to be in the window for therapeutic benefit," said Dr. Amesh Adalja, an infectious diseases physician and senior scholar at the Johns Hopkins Center for Health Security in Baltimore. 

"If you can get it to people fast enough to keep them from needing hospitalizations, then that basically solves the major problem that we're facing."

But questions remain as to whether the provinces and territories will be able to get the drug out to sick, vulnerable Canadians within the recommended five-day window, helping to ease the pressure on hospitals until current COVID-19 levels subside.

"Obviously this is a very promising development, but there's still some work that lies ahead," Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario's COVID-19 vaccine task force, told CBC News Network on Monday.

"That's fantastic we've crossed that first step. We also now, of course, need to distribute it to the provinces and to have the provinces work out how it's actually going to be administered."

WATCH | Paxlovid shows great promise despite logistical hurdles, says Dr. Isaac Bogoch:

Canada's Chief Public Health Officer Dr. Theresa Tam said Monday the antiviral treatment — made up of nirmatrelvir and ritonavir — will be in "high demand" and that officials anticipate initial supply "will not be great anywhere" as they work with provinces and territories to determine how best to roll it out.

Dr. David Naylor, who led the federal inquiry into Canada's national response to the 2003 SARS epidemic and co-chair of the federal government's COVID-19 immunity task force, said recently he's been "very frustrated" with the pace of approval.

Canada needs a Paxlovid rollout plan involving both virtual and ambulatory care, he said — one that can confirm the presence of the virus in a patient, assess the severity of their illness, prescribe the pill quickly and to ensure that available doses reach those who need it most.

"So far as I can tell, we're also dragging our feet on that front," he told CBC News. "Countless thousands of Canadians are seriously ill at home with COVID-19 and, from what I see and hear, many are feeling abandoned." 

Naylor said Canada can also develop helplines for those eligible for the treatment, provide clear information on its benefits and co-ordinate outpatient care to support patients at home — instead of assuming their situation is "irrelevant" unless they're hospitalized.

After several months of clinical trials, Pfizer had reported in November that Paxlovid reduced the risk of hospitalization or death by an impressive 89 per cent compared with a placebo in non-hospitalized high-risk adults with COVID-19.

Canada has pre-purchased one million doses of the drug, with the first batch of 30,000 to be distributed on a per-capita basis and more arriving in the coming days. It will no doubt spark a rapid push to disperse the treatment to those at highest risk as soon as possible.