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Ontario expanding access to COVID-19 PCR testing, Paxlovid amid sixth wave

Access to Paxlovid has largely been limited

By Allison Jones and Paola Loriggio, The Canadian Press

Ontario is expanding eligibility for COVID-19 PCR testing and antiviral treatments amid a sixth wave, but the province’s top doctor says a broad mask mandate won’t be reinstated at this time.

The province says anyone 70 and older, people 60 and older with fewer than three doses of a COVID-19, and people 18 and older with fewer than three vaccine doses and at least one risk factor such as a chronic medical condition can now be tested and assessed for treatment.

Since January, the guidelines for access to the antiviral treatment Paxlovid, and as a result PCR testing, has been limited to immunocompromised adults, unvaccinated people aged 60 and over, and unvaccinated people aged 50 and over if they are First Nation, Inuit or Metis individuals or have one or more risk factors.

Chief medical officer of health Dr. Kieran Moore says COVID-19 trends are rising and it’s clear Ontario is in a sixth wave driven by the BA.2 variant, and he says that will likely continue for several more weeks.

Moore says he will not be bringing back mandatory masking right now, though Ontarians should be prepared for that to return if a new variant of concern emerges, if the health-care system is threatened due to rising cases, and potentially during the winter months.

Moore says he strongly recommends people continue to wear masks in indoor public spaces.

Access to Paxlovid has largely been limited to clinical assessment centres and primary care providers, but the province says participating pharmacies will start dispensing Paxlovid this week.

A positive result for COVID-19 on a PCR or rapid test is required to be assessed for antiviral treatment, and it must be started within five days of symptom onset.

Moore held his first press conference in more than four weeks on Monday. It comes on the heels of a report by Public Health Ontario that shows COVID-19 cases, test positivity rates and hospitalizations have gone up since March 21, when the province ended mandatory masking in most indoor spaces.

“The full impact of lifting masking and other measures may not yet be observable, given limited PCR testing eligibility and lagging hospitalization data,” the report says.

It proposes bringing back indoor masking and extending masking mandates in high-risk settings as possible elements of a “layered” strategy to mitigate a surge in cases.

The report also warns that the number of Ontario children experiencing severe illness from COVID-19 is likely to increase given the increased transmissibility of the BA.2 subvariant of the virus, the removal of public health measures and the limited vaccine eligibility and two-dose coverage in those under the age of 12.

The BA.2 subvariant is now the dominant strain in the latest wave of the pandemic, the document says. The proportion of samples identified as BA.2 rose from 12.3 per cent the week of Feb. 13 to 54 per cent the week of March 13, it says.

Dr. Thomas Piggott, the medical officer of health for Peterborough, Ont., said the province should consider reinstating mask mandates and rethink its plan to lift remaining public health measures later this month.

“There are many concerns right now, both with the lack of masking in the current context and also the potential for increased removal of measures into the next few weeks, and I hope that there will be reconsideration to all of that given that the sixth wave is way worse than even the worst modelling scenarios from the Ontario science table,” he said in an interview.

“I think now’s the time to reconsider.”

Public health officials in the region have been strongly recommending that people continue to wear masks indoors, but even so, “we’re not seeing that the compliance is nearly what it was when masking requirements were in place,” Piggott said.

“The situation is not all that different from region to region, we’re in this sixth wave across the province. And I think that ideally, the response would be at a provincial level as well,” he added.

Mask mandates were lifted in most public settings and schools on March 21, and the province has set April 27 as the date it plans to eliminate masking requirements in remaining places, including long-term care homes, hospitals and on public transit.

Health Minister Christine Elliott said Ontario is “constantly assessing” that date with Moore’s guidance.

Wastewater surveillance suggests cases have been on the rise since mid-to-late March.

The scientific director of Ontario’s panel of COVID-19 advisers has said the latest wastewater data suggest daily cases are around 100,000 to 120,000.

Dr. Peter Juni said last week it’s unclear how long this wave of the pandemic will last since limits on testing make it difficult to know how many people have been infected and have some immunity.

COVID-19 hospitalizations were up 40 per cent last week from the previous one.

Last week, the province expanded eligibility for fourth doses of a COVID-19 vaccine to those 60 and older, as well as Indigenous residents and adult members of their households. Moore said he got his fourth dose on Sunday.

Fourth doses were already available to long-term care and retirement home residents and immunocompromised people in Ontario.

Banner image: Dr. Kieran Moore, Ontario’s chief medical officer of health reads his notes as he holds a news conference regarding the lifting of most mask mandates for indoor settings in Ontario at Queen’s Park in Toronto on Wednesday, March 9, 2022. THE CANADIAN PRESS/Nathan Denette

This report by The Canadian Press was first published April 11, 2022.