UPDATE | Amy Ferguson received her Paxlovid treatment on Friday afternoon.
An immunocompromised Ottawa woman says she has been waiting since Tuesday to fill her prescription for the COVID-19 antiviral drug Paxlovid – a treatment that must begin within three to five days of the onset of symptoms to be effective.
Amy Ferguson has rheumatoid arthritis, an autoimmune disease that puts her in the high-risk category of COVID-19 patients.
She found out on Monday that a friend she had been in contact with had COVID, she said. Ferguson was experiencing mild symptoms, similar to those caused by rheumatoid arthritis, took a rapid test and said he came back as a “mild positive”.
The medicine is there, I just don’t understand the barrier.—Amy Ferguson
She woke up Tuesday morning with worsening symptoms, took another rapid test which also came back positive, and called Ottawa Public Health for information on isolation for her and her family.
Then she called her family doctor’s clinic and spoke to a doctor, who prescribed her Paxlovid.
Since then, she and this doctor have been trying to figure out how to get their hands on the treatment.
“The doctor called me back twice to let me know the status of his learning, his research, and making those connections,” she said.
“The medicine is there, I just don’t understand the barrier.”
Dr Zain Chagla, an infectious disease specialist and associate professor at McMaster University, said he believed there were plans to expand the use of Paxlovid, but that has been slow.
“That’s really what could be the consequence, that people just don’t know how to navigate the system and the system doesn’t help them navigate it,” he said.
Ferguson said the doctor at his clinic coordinates with the public pharmacy and the inpatient pharmacy at the Civic Campus of the Ottawa Hospital.
Tuesday, it looked like she would have her prescription by Wednesday at the latest. But when she called the public hospital pharmacy, the pharmacist told her they could see her prescription there but could not fill it for her.
Currently, Ontario residents cannot access antivirals – drugs designed to help the body fight off the SARS-CoV-2 virus, reduce the symptoms of an infection and shorten the period of illness – which to a provincial testing center after confirmation of a positive molecular test.
Ferguson said when she spoke with the doctor at her family doctor’s clinic, they didn’t think she would be able to get the results of a PCR test quickly enough for her eligibility window. Paxlovid (three to five days after onset of symptoms).
Clinic staff, who had also contacted the pharmacy on his behalf, managed to refer him to the hospital’s clinical assessment center.
Thursday was Ferguson’s fourth day since the onset of symptoms, although it’s hard to say exactly when his COVID symptoms started due to their similarity to rheumatoid arthritis symptoms.
Maybe tonight I can’t breathe, I have to go to the emergency room and then I have to take a bed and then I have to take resources.—Amy Ferguson
“This medicine is for us and it’s weird that I can’t access it and my window to do it effectively is closing,” she said.
At this point, the best-case scenario for Ferguson is seen at the clinical assessment center on Friday – five days since the onset of symptoms.
Chagla said the system needed to be more decentralized and plans were underway to achieve this.
“Put this in test pharmacies outside of hospitals so people in the community can prescribe it,” he said.
“I saw four very similar patients [Thursday] and prescribed this Paxlovid myself,” Chagla said. “These are the ones who have to go to these treatment centers and … should not be lost in the cracks in all of this.
One of Ferguson’s concerns, beyond his short- and long-term health, is becoming added pressure on an already strained health care system.
“Maybe tonight I can’t breathe, I have to go to the ER and then I have to get a bed and then I have to get some resources,” she said.
According to a Ministry of Health spokesperson, Ontario received 40,000 treatments for Paxlovid and distributed 400 through clinical assessment centers and 755 to hospitalized patients.
Ferguson said she doesn’t think she’s alone in her confusion and frustration over this situation.
“If it’s that hard for me – confirmed sick, has a prescription, can’t access it. … They have hundreds of patients, and if this hiccup happens to me, it definitely happens to others.”
“It’s no use being angry”
But she also wanted to make it clear that she doesn’t blame the hard-working medical professionals during the pandemic.
“There’s no point in being angry. Just imagine how our health officials feel,” she said. “I feel so intensely for all of our healthcare workers.”
Around 8 p.m. Thursday, an infectious disease doctor who had read Ferguson’s blog about the situation contacted her, she said. The doctor works at an assessment clinic like the one where she is to be seen and told her they would report her referral.
Ferguson said the doctor told him someone would call him when the clinic opened Friday morning.