Paxlovid if testing positive for Covid?

Are you speaking about getting this while traveling overseas or here in the US from your own doctor?

My understanding (from my dh doctor who prescribes this) is that you have to be in a high-risk category (which you are) and your doctor has to agree to write you a prophylactic prescription, and it has to be available, and this latter point is iffy. Because availability is low, your doc may be reluctant to write you a script when you dont have Covid, ykwim. But you can ask :)

And as for getting it when you are abroad: no idea

Sorry! I meant to specify when I am in France. I don't even know if they have paxlovid in France. We're really hoping to not contract Covid while in France and expect to mask most of the time except when eating (outside). Being cautious, we are double vaxed and double boosted. That said, I seem to remember reading that in France one out of three people has or has had Covid. But then, I believe here in the US it's one out of four. The thing is I'm pretty sure how to deal with the situation here but in France, not so much. We've got the binax proctored tests (thanks again, Carol) to take with us and a few "at home" tests and figure we will start testing say 10 days or so prior to our return (unless, of course we have symptoms, in which case of course we would test!). We really do not want to have to purchase new last-minute expensive tickets for our return, so trying to figure out as much as possible in advance.

If you don't want to get stuck buying expensive last-minute tickets, you should be looking for travel insurance to cover that.

Regarding Paxlovid, according to press reporting, you can get a prescription for it here if you are within the first five days of symptoms, at high risk, etc etc. Your trick of course would be finding a doctor to examine you and prescribe it.

You could google "English speaking doctors in (whatever city/town you are in)" and have that list handy in case of need so you could call if you end up needing an appointment (which hopefully you won't need!).

Le Monde, earlier this month, published an article saying that the French government ordered substantially more Paxlovid than has been used, so there is no shortage to worry about. It is available.

Anyway if you do test positive, even if it is on one of the self-tests you brought with you, you would need to go to a pharmacy to get an "official" positive test in order to request the doctor, so maybe the pharmacy where you go could also provide help finding a doctor's appointment.

Thanks, Kim! Good to know that there is no shortage of Paxlovid iin France as there appears to be here in the US. Excellent idea about googling English speaking doctors. I will certainly do so. I understand about getting the results officially verified by an pharmacy should I test positive using my "at home" tests. We also bringing proctored tests, where someone watches you do the entire process online and then sends verification of your results to your phone or email which the CDC says are acceptable. I just thought we should use the home tests may be 10 days before our return so that if we were to test positive we would have time to recover before our flight. My understanding is that if I've officially tested positive for Covid I would need to wait 5 days and then test again, at a pharmacy, officially. Assuming I'm negative I would then be able to board a plane. If I should test positive after 5 days I would need to find a doctor to certify that I have recovered. Which is a little confusing to me but does this sound correct to you? My husband and I did look into travel insurance and they indicated they would reimburse us for our nonrefundable return flight but would not buy a new ticket. Since the return flight is fully refundable insurance would not cover it. We could get coverage for accommodations for a few days but I don't think that would cost much less than paying for the accommodations ourselves. Anyway, thanks again for your help.

There may not be a shortage of the drug, but there could be a shortage of doctors willing to prescribe it. LeMonde says that the paperwork for French doctors is very onerous (20-30 min to complete) and that it may therefore be difficult to find someone willing to prescribe.

My husband tested positive yesterday and the ER doc would not prescribe anything except Tylenol equivalent. She kept saying come back if he gets worse. We are in Lyon. We have a call with our American Dr 11:30 their time today. I went to nearby pharmacy and they do not have and have never heard of paxlovid. But they found and ordered it and should have it tomorrow and if I have an rx from American doc tomorrow they will be ready to fill. Fingers crossed they get it! Pharmacy folks were very helpful.

From LeMonde... (explains why Carolyn's husband is not getting Paxlovid even if indicated)

Out of the 500,000 doses that the French government ordered, only about 4,400 doses have been prescribed so far. ...
"We have to go to a Pfizer online platform, identify ourselves and fill out a questionnaire on the characteristics [symptoms, age, other diseases, etc.] of the patients," explained Dr. Battistoni. "It is a very unusual procedure for us." It takes "20 to 30 minutes for general practitioners to fill out this online form," agreed Olivier Saint-Lary, President of the National College of Teaching Generalists. The simplification of the procedure proposed by HAS should remove this constraint, and thus encourage prescriptions.
Conscious of the significantly lower than expected use of this treatment, HAS was forced to start a process to modify the status of Paxlovid... [but not being a LeMonde subscriber I couldn't read the rest of the article to see how long it'll be before the French bureaucracy makes it simpler for French doctors to rx the drug]

Sounds as if it could be a scramble to get your PCR, get your televisit with your American doc and locate a French pharmacy with the drug before the 5th day after you test positive and before you get sick enough to be hospitalized (in which case the drug is contraindicated). Too bad the drug is not in wider supply in the US, b/c it would open the possibility to getting pills preemptively before you travel - same as for traveler's diarrhea.

There is an additional wrinkle if you live in CA, which is that virtually all prescribing in CA now needs to be electronic (thank you so much, state legislature, for passing this law over the objections of the CA Medical Society). In theory, a paper prescription is OK for people/pharmacies residing outside of CA or when "patient's health would be adversely affected" by not having a paper rx, but now you have to hope that your doc still has a paper prescription pad (we don't think ours do).

and here is the patient package insert for Paxlovid (note the list of drugs you aren't supposed to take it with)
https://www.covid19oralrx-hcp.com/files/Fact_Sheet_Patient.pdf

C of David and C.

My doctor prescribed it for me to fill and take to Paris with me just in case I needed it. It is actually not in that short of supply in the US.

Just to update my earlier post...
The primary care provider was not available, but another doctor talked to my husband and sent an email that he tried to make look like a real rx. I took this to the pharmacy and they told me the drug company would not release it to them until a French Doctor completed the database.

We went to the ER where he tested positive, showed them the rx we had, and asked them to complete the database. After much discussion they agreed. While we were waiting we got an email from the primary care doc very concerned about my husband taking pavlovid because of some of his other medication, and because little is known about it. The other doc had told him to stop 2medications while on paxlovid. As we are digesting this, the French doc comes out with a similar story. She listens to his lungs and says they sound good and she recommends he not take it. We decide not to take the paxlovid.

He is feeling much improved today, now we just need to focus on the details of when we can get home, and hope I don't get it in the meantime!