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The Guardian - AU
The Guardian - AU
National
Melissa Davey Medical editor

People at greatest risk of Covid death being prevented from accessing life-saving antivirals, RACGP says

Paxlovid is now available on the Pharmaceutical Benefits Scheme for certain high-risk patients with mild-to-moderate Covid. If taken early, antivirals such as Paxlovid can can prevent Covid from developing into severe disease.
Paxlovid is now available on the Pharmaceutical Benefits Scheme for certain high-risk patients with Covid. If taken in the first five days, antivirals such as Paxlovid can can prevent Covid from developing into severe disease. Photograph: Jennifer Lorenzini/Reuters

Those most at risk of dying with Covid are being prevented from accessing potentially life-saving treatments, Australia’s peak body for GPs said.

Deaths from Covid-19 in Australia remain consistently high, with Queensland, New South Wales and Victoria reporting more than 40 Covid-19 deaths between them on Sunday. Along with the unvaccinated, people with underlying health conditions or who are immunosuppressed are overrepresented in the Covid-19 deaths data.

The Royal Australian College of General Practitioners president, Adj Professor Karen Price, said she was concerned about a lack of awareness about drugs now available that can be taken by those most at risk of developing severe disease and potentially dying. These treatments, if taken early after symptom onset, can prevent Covid from developing into severe disease.

“There are a number of barriers in people accessing these medicines, the main being that the time from symptom onset to taking the first tablet must be five days or less,” Price told Guardian Australia. “Which is not a lot, given the person needs to identify their symptoms, get tested, notify or have their GP be notified of their positive status, have their eligibility for these medicines be determined and then get their script filled at their local pharmacy.”

Price said there needs to be more public awareness of the medicines and who is eligible so that people know that if they test positive, they should contact their GP as soon as possible.

“Early notification is critical to ensure patients receive the care they need, including access to antivirals,” she said.

There are now a range of treatment options to manage different stages of Covid-19 disease. From Monday, Paxlovid was made available on the Pharmaceutical Benefits Scheme for certain high-risk patients with mild-to-moderate Covid-19. The oral antiviral treatment is taken twice-daily for five days and should be taken within five days of symptoms appearing.

Lagevrio is another antiviral shown to reduce the risk of severe infection and hospitalisation. Four capsules are taken every 12 hours for five days, and it is most effective when taken as soon as possible after symptoms show.

There are also treatments like sotrovimab that need to be given through intravenous infusion by a nurse at a healthcare facility. Like the oral treatments, intravenous treatments are most effective when given within the first five days after symptom onset.

A Therapeutic Goods Administration spokeswoman said supplies are available in the National Medical Stockpile. Doses of Paxlovid and Lagevrio have been predeployed to residential aged care facilities, Aboriginal-controlled community health organisations and the Royal Flying Doctor Service, she said.

In Victoria, the Monash Satellite Clinic is one of the facilities providing early treatments for Covid-positive patients. A spokesman did not directly answer questions about whether there is concern some people may be dying as they are not aware of or not getting early access to the drugs.

“Our Covid Pathways program, delivered by Monash Health, community providers and GPs, identifies medically at-risk patients to ensure the best possible treatment and care is made available as soon as possible,” a spokesman said.

The president of the Australian Medical Association, Dr Omar Khorshid, said Covid deaths data needs to be analysed to determine whether there were deaths that may have been prevented if given access to early treatments.

“States and territory health departments do need to forensically look at what’s going on, and what lessons can be learned,” Khorshid said.

“They need to look at every death and ask whether each person received early treatment, and if not, if they should have. It’s not reasonable to give every at-risk person treatment, as these drugs also carry side-effects and issues. But there are really important questions to ask about these deaths.”

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