Many at-risk Manitobans with COVID-19 not getting tested soon enough to benefit from treatment: top doctor

Manitoba's chief public health officer is encouraging people at increased risk of severe COVID-19 outcomes to get tested as soon as any symptoms emerge so they can access available pharmaceutical treatments before symptoms worsen.

Manitoba now has monoclonal antibodies and Paxlovid, which can help stem the progression of symptoms, but they are most effective when taken in the first days of symptoms, Dr. Brent Roussin said during a Friday morning news conference.

"What we're finding now is many people [who] would be eligible for treatment … are testing positive and have underlying health conditions, [but] they're testing too late," he said.

If patients present more than the five days after symptom onset, the medication isn't going to be useful, said Roussin.

"If you're at increased risk of severe outcomes, get tested as soon as even the mildest symptoms start because we do have treatment options available now."

The rules about who does and doesn't qualify for a PCR test at provincial testing sites have changed in recent months, which has raised questions about the province's pandemic response.

Manitoba's testing capacity was overrun in December when thousands of people experiencing symptoms during the COVID-19 wave driven by the Omicron coronavirus variant sought PCR tests at public sites.

That resulted in Manitoba switching to providing take-home rapid tests — which are not considered as accurate as the more sensitive PCR tests — for most symptomatic people.

Only certain groups are currently eligible for a PCR test, including people having surgery, symptomatic hospital patients, residents of First Nations communities, symptomatic kids who can't take a rapid test, and some symptomatic immunocromprised people.

Monoclonal antibody treatment, also known as Sotrovimab, uses laboratory-made antibodies to give people with no prior COVID-19 infection an initial immune response that may prevent serious illness, according to the province.

The province started offering the treatment to some Manitoba patients in December. As of early last month, the treatment was being touted by public health officials as an important new tool, though at the time it remained in short supply in the province.

Since it became available on Dec. 20, a total 467 Sotrovimab doses have been administered, a Shared Health spokesperson told CBC. As of Feb. 8, there were 109 doses remaining.

The province also has 972 treatment courses of remdesivir, another anti-viral treatment manufactured by Gilead Sciences, Shared Health said.

Paxlovid, made by Pfizer, is an anti-viral treatment taken in pill form that can be prescribed by doctors. It consists of two anti-viral drugs — nirmatrelvir and ritonavir — that are taken orally over the course of five days.

Manitoba received a shipment of Paxlovid on Jan. 19, with 83 doses being given since, Shared Health said. On Feb. 8, the province still had 978 treatment courses available.

Pfizer's clinical trial data suggests that when a Paxlovid treatment course is started within five days of infection, the risk of hospitalization dropped by 85 per cent.