Doctors fear scores of patients who qualify for antiviral treatments for COVID-19 are missing out.
They say patients could be missed because rapid antigen tests (RATs) are not picking up infections early enough or because people are not registering their positive results.
"I'm horrified by the number of people that may be missing out on these medications," outgoing vice-president of the Australian Medical Association (AMA) Chris Moy said.
"Partly because of a lack of awareness but partly because we only have a five-day window from when the symptoms start to be able to give them these medications."
Antivirals are medicines that help prevent a virus infecting healthy cells or reproducing in the body.
They work best when taken as early as possible following an infection, preferably within five days from the onset of symptoms.
Two antiviral drugs, Lagevrio and Paxlovid, were approved for use in Australia earlier this year.
They're available to people aged over 70, those who are immunocompromised, over-50s with two risk factors or Aboriginal or Torres Strait Islander people aged over 30.
Khalil Kazan from Granville in Western Sydney credits early intervention with antivirals with saving his life.
"I felt an aching body and didn't feel so good, I thought I had the flu," he said.
After testing positive, he was linked up with a team from Western Sydney Health, who prescribed antiviral medication.
"Every day the nurses delivered the medication. They offered to get me food. I just can't find how to thank them."
Patients 'missing the boat'
Dr Moy is particularly concerned about a reliance on rapid antigen tests that are done at home.
He said they did not pick up infections as early as PCR tests carried out at testing centres.
It means by the time patients seek medical help, it's often too late to prescribe antivirals.
"For people that have actually relied on a rapid antigen test and they haven't bothered to go out and get a PCR test, when they've got symptoms and they only turn positive on day four or five, they've missed the boat," Dr Moy said.
Doctors say the two types of oral antivirals available can dramatically reduce the risk of severe illness.
"Although vaccination is the most important form of preventing severe disease, these medications can make up to an 80-per-cent reduction in chances you end up in hospital, end up in an ICU department or die," he said.
Positive results not registered
Benson Riddle, who runs the Western Sydney Health team that helped Mr Kazan, said he feared some people were not registering their results.
He said notifying NSW Health of a positive test was critical to getting access to care and antiviral medications.
"It opens up this gateway, which enables you to get all that information that you require," he said.
"It gives you access to this questionnaire that you then fill out and people who potentially are high risk and could really benefit from the tablets, it gets them on the right path."
Dr Riddle works in Western Sydney, which was subject to some of the harshest lockdown measures in 2021 and strict policing.
"I think people are still concerned about, you know, what it might mean if they register," he said.
"It's really all about making sure that they're getting all the information that they need and the people who are going to benefit from the tablets can get it."
