Covid-19: Watertight communication required to ensure safe antiviral dispensation – doctor


Three antiviral medicines used for treating Covid-19 early in an infection will be rolled out to about 400,000 more people, should they catch the virus.


Photo: AFP

Pharmac yesterday announced that the antiviral drugs branded as Paxlovid, Lagevrio, and Veklury would be made available to anyone 75 or older, and a larger number of people with pre-existing conditions, from Monday, 18 July.

Royal New Zealand College of General Practitioners medical director Dr Bryan Betty was in favor of the medications’ wider availability, but told Morning Report Clear communication between general practitioners, laboratories and pharmacists would be key to ensuring patient safety.

“These medications are reasonably effective, so we’re all for more access to the medications, however there are issues around interactions with the medications and certain medical conditions where you can’t prescribe them, so we need to make sure that the system we have in place is safe.”

Making the antivirals available ‘over-the-counter’ to patients was the area Betty and his colleagues were most concerned about, he said.

“The government is proposing a gazetting, which means that pharmacists would be able to just give [the medications] across the counter without interactions with a doctor.”

Betty said it was vital pharmacists knew whether patients seeking the antiviral drugs had any other medical conditions or comorbities, or whether they were taking any other medications.

“Ensuring there’s clear communication, that those boxes are all ticked off across the country so this can occur safely, is our main concern.”

Announcing the wider eligibility for the medications yesterday, Covid-19 Response Minister Dr Ayesha Verrall said the antiviral medicine Paxlovid reduced the chance of an at-risk person going to hospital by almost 90 percent.

“To realise the benefit of these medicines in this outbreak, we have to make sure they reach the people who need it, when they need it.”

Verrall said making the antivirals available as pharmacy-only medications would require changes to regulation, which was why that change would be phased in over a fortnight.

Training modules would also be offered before any changes were made as the drugs could have side-effects for patients, she said.

Betty said it was important the antiviral medications were started within five days of a person contracting Covid-19.

“Early intervention is really important. The medications are taken several days – twice a day – and yes, they are effective and they are targeted to those who are at risk of going to hospital or from a bad outcome from Covid.”

Call for wider access to second booster

The National Party said the government’s move to make masks and rapid antigen tests (RATs) free]was sensible, but questioned why more people weren’t eligible for a fourth dose of the Covid-19 vaccine.

Verrall and Director-General of Health Ashley Bloomfield made the announcements yesterday afternoon.

National Party Covid-19 spokesperson Chris Bishop said his party had been calling for increased access to both masks and RATs for “quite some time”.

“I’d like to see the government widely disseminate the really high-quality N95 – or equivalent – masks as well. As I understand it they’re planning on handing out a lot of the blue, the medical-grade masks I think most people are familiar with, but the N95s really make a difference.”

He said National would also have liked to see New Zealand come into line with countries like Australia and the United States in offering those aged 30 and older a second booster.

“We’d like to see that second booster/fourth dose more widely available… I think that’s the missing part of the government announcement.”

People aged 50 and over are currently available for a fourth dose of the vaccine in New Zealand.

Both Verrall and Bloomfield declined interviews with RNZ today because they were on leave. Te Whatu Ora’s interim chief executive Margie Apa also declined to be interviewed.

Bishop told Morning Report National would also like to see a “test to work” policy introduced for household contacts who were negative.

“So if you have a rapid antigen test and you’re a household contact and you’re asymptomatic, you can go to work with a rapid antigen test.”

Critical workers are currently allowed back to work with a negative RAT but Bishop said the scheme should be more widely implemented.

“Our preference would be for everyone to be able to do that at this time of workforce shortages across the economy… every worker is critical.”

He said he agreed with the existing mask rules, saying he didn’t think it would be pragmatic to require them to be worn “everywhere, all the time” as he believed epidemiologist Michael Baker was advocating.

“I just think that is unrealistic; there’s a social license issue here in relation to mask-wearing.”

Bishop said the pressure on the country’s hospital system needed to be addressed and unvaccinated nurses should be permitted to return to work.

“At the moment we’ve got this ridiculous situation where unvaccinated nurses can’t go to work – our preference would be to allow those to go back to work.”

National was also campaigning the government to add nurses to the “fast-track greenlist for immigration”, he said.

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