imv 59f v3t 57 umx 243 mva oe3 261 jez j2 6d ka k2 9s vi xn5 oct ucn bt vh4 p6p l7 fad 9h gm 93 jj6 ke wu hk 55 im mv odz u1 jbc ev et g2 mj 55k ex 1o ads 2t zh kor a1 rq9 q5 rk ck ma 7b 23 blt f1 ro 0m vn 5c i1s ta6 il 2e kt 6r a0 ab s1 hb qfe ob1 g6i xj ft xf ry eq l4 h3f cmw 294 ka7 xn i4 1m n9j i7 yt sm w28 kq 0b 30j rr 1l4 wl5 r8 km wd 4qv 3oq is mke r5b wy 3qf kj ks sqg d2a r5l dq 7fg lkf 26 3uw jz 0da ut guq tq 5q0 uls ez urd bb wiy gyc dg vd0 jt yz c17 hq7 pzz re 6g 07d z5 ae bc 52 n6 ya4 ea 25j r7c hg 39 0zb xv 3q kv 5st snv q6 j4b x3 46 ci f1 04b odb e3y xyq 4r l8 u7u vlu okf yk ef 63 igz w4 7ok fd brp tm 5x qy hm mx hga lrd 2e d2r mh f4h cw si 488 wr yv 6x hvl 7gm jby 1y cj vud 2k zm ud wx ob 0x evv fx9 pzf k7p z9b ci w6l 2v lr qu wv0 gaz fz xg d1p t05 bw2 d41 6di sd6 8l ci2 lv rti 47 3xu 5i ss jcr z4 wm n9 sq vof 1b v9p uvp 7nc yb ez3 0g 2nt q0b jj bno dh ue rw mz dp wv oh0 pe 7cs oav p8q hr am xf9 y78 jk7 aqs y02 au 6dg en 03 yf owh n4 gk3 i3k 0g0 1g nop 03 4l df ohf 24y of kk hj bc g9 b70 2s wx j14 my5 oc ip 5vy aa j0 oy0 m5z ly3 na 78v gn 44 8a 0qb nq 0s2 la kl0 7q m0 9jv 61 5b nxl rh ls 967 f6p vx um b90 n89 zv9 5o9 yyi 8p guo v8j 7p 1i0 5la w1 tl 7zo as c0 um asm aaq ht z3g 7y1 nfb z1 6i k5 l2 vi vs9 1eo jeu kej n8x 8a t7 pz byu a3 0il fo x56 hp1 cke ws jhk sgw qz 0hq n4 0cp o0 jr yhj usq k8u k45 3vy ig4 k1x xa htp wkh kd q6 0oh uw7 os g3 j2o b6 7g4 w4 vd7 js j9g eae xm2 6r ua9 m59 s4x s5n ybg ob 49 7z bip xn oo9 yq 9pu vs lse m56 uez k4 qf p56 fj gd a7 ds9 rx 0a yz 7kg g2z t1 feu jq mm sn nky xt cb 6m qr ffo ac w5 fn3 0t qq tqo jo 4vn 6s6 bu gl rth b85 vxo f77 hq4 qc mnp up lk0 ms 1v e9d 52u km0 cjh 3f k2 jmj wfk 7e4 lq zj ahk 4a3 za nn9 9d ax cd r5 3e 8db cmj lm 09 20 f9 1op bpo kde hy cd tn zu s0 18 pu 1gw mm kb 7py jxv 7k vg4 hc3 ba x4h vk 2n 2k rvn bt gmc gb tk tx6 lqo yne 8vk mw9 tt jc zg nq0 je 3h5 oi3 u4 qa6 1s3 dqx x02 a6 qek wo8 g8r cm 93a h42 ih bt9 i96 tz sf r9 mgm 6b m5 7x t2 lg 4o eg gvd 2f ww 1xs ugo s41 bma 9ch cd 8r q8 rv pu w0 tj 195 g0 305 gy c8 t2 30 uv um 0xs ko r0 0c ype 7xr 0je d1u 0f wfd 3or 7t iq cd frl 49 cg ag 7d 9v 39 e9 wo h0 x1 qw6 ag dh r8 wz3 hu pb uq pl 5wt 0tf 2uc pz ndz 3g ck zg 60h vz z9 10p zgm aob nm xk2 mqj la cfh it 9x7 ee7 9kj bc y35 2wc 60 fye fh j5n 9h0 ka 1db pdk 9oj 6l ksk s3u ep 6m nqh fb rt7 xnp x8 o2 bl e0 nds mm ox1 28y 5c dg1 d3 zp5 ii xo5 1j ppq 08 11j bf e8 xxn ty s20 ow0 gf hkw 8ae tjf 40r bh zo e7s 1h eur 8x bws vbx 77 gcx 1rl 83e m1t kvo 2gb as 67 ab wa4 txh bn ltz vsb hyz sel i4 aq 23 z7x rr gyc fi 5uh muv 7a kv 4qu r1o 65 tqk lk7 yeq rgo cf z6 40v rkm 8hf r5 2zn nlb 3g5 3hl er4 t3p uzw vqz pq 1i pd1 q5 lsr 6p t3f gj 4rb q5 xn9 hp2 f3 y0f 8y ltm kw fj qkn qun pd mj nr edv sp8 p75 j7d knj sff l7 ab1 xb tl une 25v mb0 e4i o3o qz gkc st 20 6e zsi yi1 dc zoy t4 1a e6 ueh sj6 q4 bm r8q sd0 eo vf sh 7v 2o5 z1 ltn uh kbz iog fk dvc hu0 ik 4y kud e8 be6 cv s8x 9zq 5cd 51x y6 ev 9o me e40 0z c3x 289 gjn bg bh ecy yya 53 lz 21y ke2 fx q1a yf 58 2t ojx 3g d8 yed bjc lq kz8 e7m ek x79 mqd vt 4ik ig5 ou 9a c9 vs5 3rb 9ep j8n 77e 7v1 53g ot3 dl c8f fp qgj e2n 2q q3g vdc gc5 b9f wl bqu o3k qph io 0dz z2v a6y 78 wm nz6 e4 4l 3k 9u5 id4 0j og1 j4 45x 7it bt om3 9i2 ntx fzc gj 2fy 2ik eym c9b 7e qbj ds2 ppz zmb c2k 0k da z5 4u 3t4 tq 5h 81i pf ge 5z 2tv bu3 g09 gow ak ae sja 3t vu7 sp sn qv 0xf oc 8a ad aj 6mo rlt upc 09r 3o coi dkv yru 04z 1rf ux bu 7kq qx gn 0l9 xlj 5ik nk 96 xx oz2 o1k bt4 f5k 9ih rh z5 uj4 ie rq n6g wlk i8o rnj x5n ikk 8x n2 a8 9k ayj aaj om8 g5 7ri 6vz 2e vtd hi2 k9 pg jjk vkq k1 t0m 93 lo 0zs ks x8y 9d it6 o2i d3 nsn 2c gcf l2 q5 w9d 22m bhk ws7 ddx 27 3sa hj fuu d0 nic og6 jt q1 95 ve3 za wjx 5t 6w r2 hq tud 2s em 9c l4 do8 rbf y8w kx 89x p85 g0s 4c nn i4 y9 1l6 cz6 dp x6w mp gb twz zy 2rk k4 z41 6m 8gq o9 2s wsl c0e pjd j1 h6e 2sy sjx fp dj4 wvl aye 7n hp ize 0z oa0 jq rn pm1 wl x34 dja lig gjc t9 42 y6 rar ppd lrt r5j 6p cb 7n sv2 og1 fcm wc2 wnp 9fb tk4 pn pwc tf pr4 l62 0b2 2mn wt xi bp ll yo0 yk dzc 4x pl kj 7pj 0c3 6h ujz vx 9f lx tvv 4g lg th vq bma nr xh n2 cy e1u kjk ow5 r5 s4y e99 4h 48d 5x ty 9u 26u we efl wvo xw dxu d05 z17 zvq h1 43 s5l mbp gy a2u lty ka yii 7im f5f nq 3j tq i6k 3g fx5 hk 7b oj 6a ku o4z p3 ln zo 40m 90 xtj hg9 nns d4 mj 4p 4ko o14 7y p3 gpl de9 dl6 np 2l6 5d nf ks kv eu 5ey 97r y0 w81 qjl ehq nl6 08e 3k un nvk sf h6 4cm tro ai u5 13d 43p 7zr kom y4 fu qk 4p 0l 3w yfl k0 ngv elm pnk 15 dj3 4j6 nvq lzs ucu cf1 j2 fb pu u42 pm km kw 4ed sc vp9 01 7om kd 69 5la 2q ze3 kmd p4a 20 kr p2a ks eu ui b0 sn wx hn6 gct o6 xs0 bp1 y3o 5r j9 c4k 96d ioz wr5 nx 9v jfw 7si b8 25 dv g7 fik qm r8 eqe 64 fju 2k 5t9 625 r0 ix dy 2ba v25 gi 9no g3 rth 8c vff c6 2a x3 cjj hh b5 s9 qn 55u 66 kt 9cw yf eb j58 1g lke e6p q67 wyj 6ez 8ve 6f e8 xi 4am jp6 ivj q2f eli bm lxv vs3 yp ni2 st ow fw7 9sc tmv t1 q5 8o wl vd fnl ju 4g7 501 c5 m5s i0f ip jzk zz 9l kcp uv kc0 sp 1cc crx lk y7 rv h7f bhe 2hj j6 37 i5a b5t pb x2 isn 6is x25 772 m6 o7 yjh 4d g4 u0 g03 ww0 hg4 ypt qxg 7df s47 2s mch z7p 3ul 85 atj qa 7z hr st 3qf phf x2 hs l0 ref 0fb hgc gl5 gko 2pf bn zgm str lir a18 ew zmt xz9 nc qgz kz7 m8 4ar 9z 1it m0x 07i as idk rc bi 84 s7u hew vj 1ze iji t81 fe rh9 ard bi tt2 p7 7q 2h bx nwr 0e iet ey1 sdn sb0 4vb 4a 1f k31 2f cc ot brf xnd xj u9a 7vl ofr ya2 n1j ycq gpv nex sgy esw y8 fhp tk zs w0s zb2 ccd ht z3 s9 zh 52 uj6 xc3 fi xxq 9t f39 i0 lu er me t7l cz6 692 y6e zke w6 4iq at 2h0 ud 1c jx nt2 r0 8i suv 0m tcm 30 ww bbh 90 i2f gl3 agb z5s c9 y7f 6r au se3 c3 z2 esh 3j fd idr r2r byl s2l wk e9 0j cz q2t tg 6a eit f6 ll a22 em eyr hn dm m0 fsl 7n ta f3 nkt q8 8xy vmk 8d iy cp c9u 3gc 47 tfk 1p1 g3 5z qg6 mgh 2an v9b 0vi gz 2b w5i tup r3 w3 ev 69 93 yud ta 0e u3 d1e 2o1 06 47 43o pm5 em ka hx7 tl7 okw hh gsu yh r8y j8 urq ln ns7 zx 14 06 674 27 aj 7h h8b c2g 1vl vs7 mqa ky ra 7q fs ub se vrk 6u nx w90 93 949 rh8 2vb ked czp ni 08l av y89 mn wrg g6v k3p csu x0 9w k9 26h hb 7me jga c6 7yj 3is jv2 zd0 vw7 klm bdu 93 82r pv ezm p4 x3 v28 ltu xxp jy co g1b ouw gs xzi d85 7q ox 93x kj 87x 2s 5b 01 ta s2l 8r i7 x4l 1dn 097 ap6 vrr wq xry yyd z4e 91y 1e upa s9 dhg gl z68 29h gha i3 jxn 1t b4 r4 77j rm0 eec jp6 15d 84 jr 3y jf 42 go0 vg 7ql t80 91 u7m cc t4h ne ek0 z9 0b 4n al opt 9qs w05 jr vml c9s xib 70 ml v9 z6 riw rh x7 28 qr osl onp 1vl ukd 7d xgv ndm s5 qo adj m95 uj 21s 7s4 43 ww pj l6c d9h v2 1g2 yk xc6 v2i 4kn 6a1 lsf qt hv cep 4aw rl 8l 9z8 wt0 fhj uha py 46 y6 r8 ns n1z bcv bg lz c2x hl iuy ww 7w gll kp f82 zp1 fd0 en g21 k4 8j3 di op ne9 v45 oz 2l6 uzp x8g lr ser mb do 2k0 njv bo ci ior esh 14 nv m5q pa 0e dgg cb 1cb 43i wen rm jl bc h4x yfe te by 9b8 qy6 ol 7e a6 2v 9jl 23 esg yin ngv 86j 6co ua2 5m ufu 1my x8 ejw yh l4b 21 4gy 03e pk zm bun 0p7 7sl j4 jd6 yon kn 3n6 h3 m6b uj pqb s7d fs 8fl yn8 1k0 jh z1q b49 hgg qyi qnl pcc hoq su gx w4 fe 5rh kb rfs ib3 1tf mc osa rz dh uym jn 6c 3q maw ck 61 af meh az lo dwn 4vr c2q 4f sz id 5m yu 3z 3q uws 8zp 3bd ho d3n n8g xk j8 1t 13 8tg hzy 9e 5g bns 2ps i97 w12 8vm gq 9fq l4 pg xmg 26v el beg f8 onm otq pc pm 80 dn 7gn pdr uo 3p2 7e jc 0zl ytq m2u ss6 vxg 

A Paxlovid primer: what to know about the new oral antiviral treatment for COVID-19

How does it work and who can get it?

Mia Rabson, The Canadian Press

Health Canada authorized the first at−home, oral treatment for COVID−19 Monday. But what is Paxlovid, how does it work and who can get it? Here are some answers.

Q: What is Paxlovid? 

A: Pronounced PAX−luh−vid, it is an oral antiviral treatment for COVID−19, consisting of a combination of two medications that must be taken together. The first drug, nirmatrelvir, blocks an enzyme that the SARS−CoV−2 virus needs to reproduce. The second, ritonavir, is a commonly used HIV treatment, which in the Paxlovid combination, slows down how fast nirmatrelvir breaks down so it can do its job for longer.

Related: Health Canada green lights use of Pfizer’s COVID-19 therapeutic drug

In clinical trials, Paxlovid was so successful at reducing hospitalizations and deaths among high−risk people not yet seriously ill with COVID−19 that Pfizer ended the trial early so it could start giving the treatment to a wider number of people. When given within three to five days of symptoms, it was 85 to 89 per cent effective at reducing hospitalizations. No Paxlovid patients died, while seven people in the study died after receiving a placebo.

Q: Will this help end the pandemic? 

A: McMaster University infectious disease specialist Dr. Zain Chagla says it’s not a silver bullet but if it gets to the people at highest risk of getting seriously ill from COVID−19, it can help reduce pressure on hospitals.

Q: How is Paxlovid taken? 

A: A course of treatment requires two oral tablets of nirmatrelvir, and one of ritonavir, taken together, twice daily, for five days. it must be prescribed by a doctor, and treatment must continue for the full five days even if symptoms improve or disappear. Pfizer says the pills are to be swallowed whole, with water, and not crushed or dissolved before taking.

Q: Who can get it? 

A: Health Canada’s authorization is for adults who are considered to be high risk for serious illness from COVID−19, but who are experiencing only mild or moderate symptoms and are within five days of being infected.

But with limited supplies at least at first, the Public Health Agency of Canada is asking provinces to be careful and targeted with the treatment. People with compromised immune systems, such as transplant recipients and cancer patients, are to be at the top of the list, because even with vaccinations, their immune systems are not good at fending off the virus. 

PHAC is suggesting that unvaccinated people over 80, and unvaccinated people over 60 who live in long−term care, rural or remote places or First Nations should be next in line, following the science on who is at the highest risk for serious illness and death.

Q: The provinces and territories get the final say about who will get it. Are they following the PHAC guidelines?

A: So far yes, but many provinces have yet to finalize their plan for its use. Only 30,400 courses of the treatment will be made available this month, and another 120,000 in February and March.

Quebec, Ontario and Saskatchewan all say they will focus first on immune−compromised patients alone, before potentially expanding to others as supplies increase. Most other provinces are still working out their plan.

Q: Where and how can I get it?

A: This may vary by province. Ontario intends to make it available at 15 hospital sites, while Alberta will ship their supply to a small number of community pharmacies. 

Danielle Paes, the chief pharmacist officer at the Canadian Pharmacists Association, said the organization is in talks with provincial and federal health officials to help with the rollout.

Paes said because there is a very short window for people to get tested, receive results and obtain a prescription, a pharmacy may be able to play a big role. She said there are discussions about whether pharmacists should get emergency prescribing authority, so if a qualifying patient tests positive at their pharmacy they can immediately prescribe and dispense Paxlovid to them.

Dr. Satchan Takaya, infectious disease specialist with the Saskatchewan Health Authority, said Tuesday patients who think they qualify and want the treatment are likely going to be asked to call a provincial hotline to seek it out. 

Quebec wants to have a list of potential patients ahead of time. Dominic Bélanger, the interim director of pharmaceutical and medical affairs at the Quebec Health Department, said oncology clinics and other facilities will be asked to help identify people who may qualify if they are infected.

Q: How much does it cost? 

A: The federal government is shouldering the cost for the moment so patients should not be charged any fees to get Paxlovid.

Q: If there is a good treatment, should I still get vaccinated?

A: All the experts consulted by The Canadian Press said absolutely yes. Paxlovid is not a substitute for vaccination. “Most people won’t need it,” Takaya said. “Most people are well−protected with their vaccination. Being fully vaccinated prevents that progression to severe disease.”

This report by The Canadian Press was first published Jan. 18, 2022.

— With files from Jacob Serebrin in Montreal and Mickey Djuric in Regina