Professor Robert Booy .

Carmel Sparke A LEADING infectious diseases specialist has urged GPs to prescribe nirmatrelvir – ritonavir more readily for patients in aged care facilities , who are still dying of COVID-19 in unnecessarily high numbers .

Professor Robert Booy says , while COVID-19 deaths in the community have come down considerably , the graph is stuck for those living in nursing homes .

In the three months between May and the end of July this year ,

some 443 aged care residents died of COVID-19 — higher than the number of influenza deaths .

“ These are unnecessary deaths ,” he added , stressing that , in one week in July , there were some 400 active outbreaks in aged care homes , with around 2000 residents infected with SARS‐CoV‐2 .

He argued that more could be done , starting with increasing vaccination booster rates from 44 % to 90 % among the over-75s .

But the other statistic that was

alarming him was the “ sparing ” use of nirmatrelvir – ritonavir ( Paxlovid ).

He said molnupiravir ( Lagevrio ) had been prescribed 10 times more often than Paxlovid : 128,000 versus 12,000 scripts .

“ For more than 18 months , Paxlovid has been the recommended treatment . And yes , there are some patients who cannot have it , but there are so many more who can who have not ,” said Professor Booy , of the University of Sydney .

He acknowledged that the drug

was difficult to prescribe because of the numerous medication interactions .

But he encouraged GPs not already doing so to use online guides , such as the University of Liverpool ’ s COVID-19 drug interaction checker .

“ I want to be clear that I am not criticising GPs .

“ I am just concerned that , if only they could take time with , say , five consecutive patients , they would see they could do it more quickly and easily than they think .”

PAGE 3 college guidelines : “ As these tools gain popularity and their use increases , there is potential for GPs to become over-reliant on their use and pay less attention to critical clinical details or forgo the vital process of checking the output generated by the AI scribe , resulting in errors that could affect patient safety .”

Is there a risk the doctor forgets the importance of active listening and active questioning ?

This relates to the key section in the college guidelines , the section that should apply to any medical intervention promising big things .

It is that the marketing claims being made for these products in most instances are yet to be “ backed by substantial research evidence ”.

That is important because it is not totally clear how many consults are being done with AI scribes in Australia .

Lyrebird Health on its website says its AI is used in more than 10,000 consults a day .

Dr Franklin ’ s view is that it is important for GPs to be involved .

“ I think that if we as doctors aren ’ t willing to even engage , or even if you [ don ’ t ] use the products , there is a larger risk ,” she says .

“ Someone will just go ahead and use these tools anyway , and then we won ’ t have been involved in making it safe or protecting our patients from inadvertent harm .”

Australian Doctor asked both doctors if they had any conflicts of interest . Dr Franklin said she had no conflict of interest . Dr Audehm said that he worked at a pilot practice for Lyrebird Scribe , but did not receive financial compensation for it .