Outpatient Treatment for COVID-19

COVID-19

Paxlovid™ / Remdesivir|Evusheld

Alberta Health Services and Alberta Health are administering several outpatient treatments, which include:

To prevent high risk patients with mild to moderate COVID-19 symptoms from progressing to severe disease if taken within five days of symptom onset (seven days for Remdesivir).

For the prevention of COVID-19 for people who are immunocompromised.

All outpatient treatments will be available following an assessment by a healthcare professional.

Paxlovid™ / Remdesivir

How is Paxlovid™ Administered?

Paxlovid™ is taken orally in pill form. One dose is a combination of two nirmatrelvir (pink) tablets and one ritonavir (white) tablet, taken twice a day for five days. Patients with a reduced kidney function may have their dose reduced to two pills twice a day for five days.

How is Remdesivir Administered?

Remdesivir is given intravenously (through a vein) by a qualified health professional. The medicine is given over 30 minutes. You will be watched closely for another 15 to 30 minutes after getting the treatment. You can expect the appointment to last about 1.5 hours, including setup time.

Who is Eligible for Paxlovid™ and Remdesivir?

If you test positive for COVID-19 and one or more of the following scenarios apply to you, you may be eligible for treatment to prevent your symptoms from getting worse.

Criteria: Immunocompromised*
Vaccination Status: Unvaccinated or vaccinated (any number of doses)

OR

Criteria: Living in long-term care or designated supportive living
Vaccination Status: Unvaccinated or vaccinated (any number of doses)

OR

Criteria: Age 18 or older with one or more pre-existing health conditions** or pregnant
Vaccination Status: Unvaccinated or one dose

OR

Criteria: Age 55 or older, or First Nations, Métis or Inuit and age 45 or older
Vaccination Status: Unvaccinated or one dose

OR

Criteria: Age 60 or older, or First Nations, Métis or Inuit and age 50 or older; with one or more pre-existing health conditions**
Vaccination Status: Unvaccinated or one or two doses

OR

Criteria: Age 70 or older, or First Nations, Métis or Inuit and age 60 or older; with 2 or more pre-existing health conditions** AND
Vaccination Status: Unvaccinated or one or two or three doses

*Immunocompromised patients under 18 years of age should consult with their specialist for consideration of treatment. Transplant patients should NOT be offered Paxlovid™ due to the potential for life-threatening drug interactions.

**Pre-existing health conditions include:

  • diabetes (taking medication for treatment)
  • obesity (BMI >30)
  • chronic kidney disease
  • congestive heart failure
  • chronic obstructive pulmonary disease, and moderate-to-severe asthma

If you have any questions about your eligibility status, more information can be found in the FAQs:

How do I Access Paxlovid™ or Remdesivir?

If you have tested positive for COVID-19 and your symptoms began less than five days ago and you believe you meet the eligibility criteria (above), please call your primary care practitioner. If you don’t have one, or your primary care practitioner isn’t prescribing Paxlovid yet, call the dedicated line at 1-844-343-0971 to find out if you qualify to receive treatment. Do not call 811.

When you call, you will be asked to leave a message. Staff will call you back and ask you some questions before referring you to a health professional who will determine if you are eligible, get your consent and write you a prescription for Paxlovid™ or book an appointment for you to receive Remdesivir at either a third-party site, in your home or at an AHS site.

If you will be receiving Paxlovid™, the prescribing physician will direct you to pick up your prescription at the closest community pharmacy that is stocking Paxlovid™. Patients who cannot have their prescription picked up by someone else are advised to have it delivered or arrange for curb-side pickup to mitigate the risk of spreading the infection.

Please make sure you have the following information prepared before calling:

  • Date That Your Symptoms Started
  • COVID-19 Vaccination Status
  • Current Medication List (including over-the-counter and health products)

Can I Choose Whether I Receive Paxlovid™ or Remdesivir?

During your assessment, a physician will recommend which treatment is best for you, but you won’t be able to choose which medication you receive.

Why is Sotrovimab Treatment Being Suspended?

Recent evidence suggests Sotrovimab may not be effective in treating the BA.2 variant which is the dominant COVID-19 variant in Alberta at this time. Remdesivir is being offered as an alternative to Sotrovimab. Physicians may prescribe Sotrovimab to patients when it is confirmed they do not have the BA.2 variant. For more information, please visit the Health Care Provider FAQ.

Future Access

AHS is making every effort to ensure timely and fair access for all Albertans who qualify to receive these treatments.

Evusheld

How is Evusheld Administered?

Evusheld is given as two intramuscular injections. The shots go into the side of each of the upper buttocks.

Treatment is provided mainly through a third-party provider:

  • In Calgary and Edmonton, the provider will have dedicated infusion sites.
  • For Grande Prairie, Fort McMurray, Red Deer, Lethbridge and Medicine Hat, a third party provider will travel to these communities on a regular basis to administer Evusheld.
  • Other communities may be added based on demand

Who is Eligible for Evusheld?

Evusheld is not a replacement for COVID-19 vaccination. Albertans are strongly encouraged to get fully vaccinated against COVID-19.

Evusheld is initially being offered to those who are immunocompromised, are unlikely to mount an adequate immune response to vaccination and have the highest demonstrated risk of severe outcomes from infection with COVID-19. At this time, Evusheld will be offered to the following groups, regardless of vaccination status:

  • Solid organ transplant patients that meet one of the following criteria:
    • Lung transplant
    • Received B cell depleting therapy (Rituximab), T- cell depletion (ATG, Alemtuzumab), or Belatecept within the past 6 months
    • Solid organ transplant in first 6 months post- transplant
    • 60 years of age or older
  • Stem Cell Transplant or CAR-T therapy within the past 12 months
  • Hematologic malignancy on B cell depleting agent within 12 months
  • Moderate or Severe Immunodeficiency i.e. patients who have primary immune defects known to be associated with impaired antibody production and function. Examples of such conditions include CVID, SADs, XLA, Job's Syndrome; DiGeorge Syndrome
  • Secondary immunodeficiency due to treatment with a B-cell depleting therapy
  • Secondary hypogammaglobulinemia (IgG less than 5g/L) with a history of recurrent infections
  • Unable to take vaccination due to a documented allergy or anaphylactic reaction to the COVID-19 vaccination

To be eligible for treatment, you must:

  • Weigh at least 40 kg
  • Not have a current COVID-19 infection
  • Not have a recent COVID-19 exposure (within eight days)
  • Be more than 14 days since:
    • your last COVID-19 vaccination
    • recovery from a COVID-19 infection

If you have any questions about your eligibility status, more information can be found in the FAQ:

How Do I Access Evusheld?

If you think you meet the eligibility criteria for Evusheld, call the dedicated the centralized Outpatient Treatment Program at 1-844-343-0971 and leave a message. A Health Link professional will call you back to discuss eligibility with you. You may also speak with your specialist (transplant, hematology/oncology) to discuss this potential option with you.

If you are eligible, an order will be sent to the third-party provider and this provider will contact you to book an appointment for treatment. The provider will follow up with your specialist once Evusheld has been administered.