Health Board: Once the meds reach pharmacies, we can reclassify COVID

Ragnar Vaiknemets.
Ragnar Vaiknemets. Source: Priit Mürk/ERR

One of the criteria for reclassifying COVID-19, currently classified as a dangerous novel communicable disease, as a regular communicable disease, is the arrival of COVID drugs that can be administered at home at Estonian pharmacies, said Ragnar Vaiknemets, chief of the Health Board's Crisis Headquarters.

"Yes, I do believe that's one of the criteria," Vaiknemets told ERR on Friday. "If we have an effective treatment like this that prevents severe illness, then an individual [with COVID] won't end up hospitalized and become a burden on the healthcare system."

Another criterion for reclassifying COVID is ensuring the capacity of Estonia's healthcare system.

"If we still end up seeing this fall that hospitalization needs exceed the 400 or 500 patient mark, that the need for intensive care inevitably rises as well along with that and this starts to impact emergency care, then we can't speak of [reclassifying COVID]," he said.

The Health Board is currently eagerly awaiting the arrival in the country of Paxlovid, which received market authorization for home use in the EU. Estonia is party to the EU's joint procurement tender for the drug, but the procurement process has stalled.

"The contract is being signed by the European Commission and the manufacturer; the expected delivery time is this fall," Vaiknemets said. "Unfortunately this joint procurement has stalled, as there are some kind of criteria involved over which an agreement has not yet been reached. For example, Pfizer doesn't want to guarantee quantities, and the EU doesn't want precarious contracts for [participating] countries."

He was unable to anticipate when the procurement contract may be complete. "That could mean September, October," he said. "We're hoping it'll still be completed in a matter of weeks. But it's coming and it's effective — that much is clear."

The Health Board official explained that under the Communicable Diseases Prevention and Control Act (NETS), a dangerous novel communicable disease is defined as a communicable disease that has no effective treatment or for which no effective treatment is available or the spread of which may exceed the hospital treatment capacity.

"[COVID] will likely still meet these conditions this fall, granting the right to implement measures authorized for the prevention of the spread of extremely dangerous communicable diseases," he noted.

According to Vaiknemets, long COVID-19 needs to be considered in the context of COVID as a dangerous novel communicable disease as well.

"This is the additional concern involving a dangerous novel communicable disease — that we are unable to assess to what extent long COVID has an impact in terms of harm to health," he admitted.

University of Tartu (TÜ) virology professor Irja Lutsar has repeatedly previously expressed the opinion that prior to implementing any possible new COVID-related restrictions, COVID needs to be reclassified in Estonia as not a dangerous novel communicable disease but a seasonal viral disease.

A disease's classification has an impact on which restrictions that restrict people's fundamental rights can be implemented in response to an outbreak in the country, such as whether schools can be closed or businesses' activities restricted.

The Health Board has previously stated that three COVID risk scenarios are likely in Estonia this fall: a mild scenario, a serious scenario and a new pandemic.

According to Vaiknemets, the Health Board's latest assessment is predicting a mild new wave of COVID this fall, with the reproduction number, R, continuing to fall; as of Friday, R stood at 0.85.

"We believe that, in view of the Omicron BA.5 variant, we won't be seeing this fall what we did last year," the official said. "We can, however, expect an increase in light of September 1 and the start of the new school year, for example, as well as at the start of the viral season."

Paxlovid is indicated for the treatment of COVID-19 in adults who don't require supplemental oxygen and are at increased risk for progressing to severe COVID, the European Medicines Agency (EMA) said.

Click here for more information from the EMA about Paxlovid.


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Editor: Aili Vahtla

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