As the UK phases out covid-19 restrictions 鈥� with England dropping nearly all such measures 鈥� people who are extremely vulnerable have a new weapon against the virus: antiviral drugs and antibodies designed to lower the risk of people getting severely ill.
The medicines should be taken within five days of a positive PCR test and symptoms beginning, and ideally as soon as possible. Getting the drugs to people who are at home, not in hospital, has meant setting up a new system of rapid testing and access to medicines through special clinics.
People who are eligible include those with cancer, genetic immune deficiencies and some autoimmune conditions. They should by now have received letters and a prioritised PCR test to keep at home in case they start having coronavirus symptoms.
Advertisement
The antibody treatment, called sotrovimab, which seems to be most effective, is given as one infusion that takes up to an hour to deliver. If people with covid-19 were to mix with others in hospitals, it would risk spreading the virus, so some new clinics have been set up away from other wards.
鈥淲e kicked some finance people out of their offices, and that鈥檚 a separate building with its own parking, so that works quite well,鈥� says , who heads the covid-19 medicines delivery unit at Nottingham University Hospitals.
People who aren鈥檛 suitable for the antibody infusion can take an oral antiviral treatment called molnupiravir at home. They get a phone call from the clinic, then a packet of tablets is couriered to them the same or the next day, as well as a pregnancy test if applicable, because the drug could cause birth defects.
鈥淚t鈥檚 really impressive,鈥� says at the charity Blood Cancer UK. 鈥淭he clinicians that we鈥檝e spoken to are highly motivated to make sure that the people at highest risk are as protected as possible.鈥�
That is not to say that everything has gone smoothly, especially in the early days. The treatments were supposed to have been available from 16 December. Roseanna McMahon, a software engineer in London, who has multiple sclerosis, got a positive PCR result on 24 December.
A packet of molnupiravir was delivered to her on Christmas Day, but that was on day four of her infection, barely in time. There were delays in McMahon getting her PCR results, because at the time, neither her primary care doctors nor the call handlers on the 111 National Health Service helpline knew about the new system. 鈥淚 was barely able to talk. One doctor said there aren鈥檛 any treatments; you have to keep taking paracetamol,鈥� she says.
Lewis says: 鈥淥ver the Christmas period there were delays with people getting their PCR back and we did have the occasional patient that was out of time. But I鈥檝e not had any patients that have been out of time in the past two or three weeks.鈥�
Not all people with blood cancers have yet received instructions and a priority PCR test in the post as they should, says Rowntree. But when everything works as intended, she believes it is a great help for people who know their medical conditions would leave them highly vulnerable.
Some people have had three or four vaccine doses and still have low antibody levels. 鈥淪ome people are genuinely terrified about what it would mean for them to catch covid-19,鈥� says Rowntree. 鈥淭here鈥檚 a psychological dimension to it. We still speak to people who are taking really intense precautions 鈥� they haven鈥檛 seen anybody else in two years. That has a huge impact on people鈥檚 mental well-being.鈥�
Soon a new oral antiviral called Paxlovid will be added to the medicines available from the clinics, because it has been approved for use in the UK. Trials suggest this has higher effectiveness than molnupiravir, although there hasn鈥檛 yet been a head-to-head comparison of the two drugs, which is the only way to know for sure.
In the next few months, the medicines may also become available for people who are at slightly higher risk from covid-19, but not so extremely vulnerable as those currently eligible. The wider group includes anyone 50 or over, or 18 or over with certain medical conditions.
To test their effectiveness in these groups, the UK is running a of molnupiravir, which may soon also include Paxlovid. This study is to find their effectiveness against the omicron variant in vaccinated people, because the manufacturers鈥� trials were in unvaccinated people when different variants were circulating.
Sign up to our free Health Check newsletter for a round-up of all the health and fitness news you need to know, every Saturday
