New treatment options available for those at greater risk from COVID-19

By Alfred Gin
Winnipeg Regional Health Authority
Published Tuesday, February 22, 2022

Throughout the COVID-19 pandemic, Manitoba's health care professionals have been clear that vaccination remains your best defense against the virus.

That's still the case.

It's reassuring to know, however, that new treatments for COVID-19 are now available, by referral, for adult patients who meet the required criteria. As a clinical pharmacist, I see this as particularly good news for patients with underlying health issues that place them at higher risk for hospitalization or severe illness.

There are currently two forms of treatment for COVID-19 approved in Canada: monoclonal antibody treatment (MAB) and antiviral medication.

Monoclonal antibodies are laboratory-made proteins that that act like human antibodies in the immune system. Given intravenously in hospitals or infusion clinics, they work to fight off the harmful virus that causes COVID-19. In simple terms, they make the COVID-19 virus visible to the immune system. This allows our immune system to both prevent the spread of the virus to healthy cells and to attack it where it already exists.

MAB treatment is expected to reduce the severity of illness and hospitalization rate for some patients by promoting an initial immune response in those with no prior antibodies to COVID-19. This response is also expected to help prevent severe COVID-19 illness in people with weakened immune systems who may not generate a robust response to the COVID-19 vaccines.

In Manitoba, Sotrovimab is a one-time intravenous MAB treatment that can be offered to people who are at risk of severe disease, including those with chronic illness or who are immunocompromised as well as unvaccinated or vaccinated people. While Sotrovimab is currently only available for adults, there are plans for it to be made available for adolescents between the ages of 12-17 years of age who are at risk. 

In addition to monoclonal antibodies, two new antiviral treatments are available, including one in pill form that allows eligible patients to receive treatment at home rather than in a hospital or infusion centre. Paxlovid®, is an oral antiviral (pill) prescribed as two doses per day over a period of five days.  Remdesivir is given intravenously once a day for three consecutive days at an infusion centre or hospital. Both are expected to reduce the hospitalization rate and severity of illness for some patients by blocking or inhibiting the replication of the COVID-19 virus.  

As with most medical treatments, timely intervention is key, and with these treatments time is limited. From the start of your symptoms to the start of your treatment you have less than 5 to 7 days depending on the treatment. If you develop symptoms, even if they are mild, and you are at a higher risk related to COVID-19, get tested as soon as possible. If you test positive for COVID-19, and your symptoms began less than 5 to 7 days ago, contact your doctor or health care provider to see if  you quality for treatment or call Health Links – Info Santé at 204-788-8200 or 1-888-315-9257. Treatment information and eligibility information is also available online at gov.mb.ca/covid19/treatment.

If you have a health condition, you can also discuss with your primary health care provider whether COVID-19 treatment is right for you.

I can tell you that pharmacists like myself, along with all other health care professionals who have been on the front lines of the pandemic battle since its outset, are pleased to have these new treatment options in our toolbox. They are playing an important role in reducing the ongoing impact of COVID-19 on patients who are most at risk. By helping to reduce the severity and duration of COVID-19 symptoms, they are also helping to reduce the burden on our health care system.

While treatment helps reduce serious outcomes caused by COVID-19, it is definitely not a substitute for vaccination. As I mentioned earlier, vaccination remains your best defense against the virus.

As public health restrictions begin to loosen, the arrival of treatment options will remain an important tool along with vaccines and making choices about the activities you choose to participate on. Knowing your risk, following the recommendations of health care professionals, seeking early testing if you are at high risk of severe COVID-19 illness, and accessing treatment if you are eligible, all remain important.  After two years, we are all ready to move on from COVID-19 but we need to recognize that the virus is still out there, and that for some Manitobans it will remain a serious risk to their health.  People with underlying health issues - our friends, family and strangers in our communities – are counting on all of us to do what we can to protect ourselves and each other.

Thanks to pharmaceutical advances, we have new treatments for COVID-19 that are safe and effective. That's certainly welcome news. But when it comes to achieving the goal of protecting your health and the health of others, common sense dictates that prevention outweighs treatment.

I encourage you to stay vigilant, stay informed, and stay healthy.

Alfred Gin is Clinical Pharmacist – Infectious Diseases at Winnipeg Health Sciences Centre.