COVID-19 treatments at home or in the community

Rack of vials in research laboratory

Some people with Crohn’s or Colitis will now be eligible for new COVID-19 treatments to have at home or in special clinics called CMDUs. People at highest risk of developing serious complications of COVID-19 will be able to quickly access either an injection into a vein (infusion) or tablets to help fight off the infection. This applies to all parts of the UK.

We are aware that there are some delays and problems in people getting access to these treatments. The NHS is communicating with hospitals, GPs and other healthcare providers to make sure that they know about these new treatments and that eligible people are identified.

Rack of vials in research laboratory
Last reviewed June 2022

Latest updates:

13/06/2022-

Updated eligibility criteria for Direct access to treatments

12/04/2022 -

Paxlovid has now been added to the PANORAMIC study as a second antiviral treatment option.

09/02/2022-

Updates to direct access programme from February 10 in England:

  • Along with the two treatments already being used in the direct access programme, molnupiravir and sotrovimab, the NHS is offering two additional new medicines to some people with COVID-19:
    • Paxlovid is an antiviral tablet made up of two medicines called nirmatrelvir and ritonavir. Your doctor will check what other medicines you are taking before deciding if Paxlovid is the right treatment for you. Paxlovid can be taken at home and works best if you start taking it within five days of getting COVID-19 symptoms.
    • Remdesivir is an antiviral treatment given by a drip into a vein, usually in your arm (intravenous infusion). Remdesivir works best if you start taking it within seven days of getting COVID-19 symptoms.
  • If you have COVID-19 symptoms, you can now take a lateral flow test if you don’t have a PCR test at home or are waiting for a PCR test result. You must report your lateral flow test result to www.gov.uk/report-covid19-result or by calling 119.

23/12/21 -

  • Updated 'Direct access to treatment' section, including eligibility criteria.

What is a CMDU?

Direct access to treatment for people at highest risk

How does monoclonal antibody treatment work?

How does antiviral treatment work?

Does it matter if I’ve had the vaccine?

What happens if I get COVID-19 and need to go to hospital?

The PANORAMIC trial


What is a CMDU?

A CMDU is a COVID-19 Medicine Delivery Unit. These are centres set up to organise and deliver the new COVID-19 treatments in the community.


Direct access to treatment for people at highest risk

This information currently only applies to England. Click here for more information on COVID-19 treatments in other UK nations.

Four new medicines are now available for people at highest risk of complications if they get COVID-19. The aim of early treatment with these medicines is to prevent you from becoming seriously ill with COVID-19 or having to go to hospital.

The medicines are:

If you are in the highest risk group, you should get a letter or email from the NHS with further information.  This will tell you how you may be able to get treatment if you develop COVID-19.

You should keep some lateral flow tests at home so you can test as soon as you have symptoms of COVID-19. If you are eligible to receive COVID-19 treatments, you can Order free coronavirus (COVID-19) rapid lateral flow tests online on GOV.UK. 

What do I do if I have COVID-19 symptoms?

Take a lateral flow test as soon as you have any symptoms of COVID-19 (such as a high temperature or a new, continuous cough). You must report your lateral flow test result to www.gov.uk/report-covid19-result or by calling 119.

Your local CMDU should then contact and assess you. If they think that one of the new medicines is suitable for you, they will organise for you to have one of the medicines if it is safe to do so.

You can find further information on direct access to treatment on the NHS website here.

For more information on COVID-19 treatments in other UK nations, visit their websites:
 
Northern Ireland: Treatments for coronavirus (COVID-19) | nidirect

Scotland: Coronavirus (COVID-19): Treatments | NHS inform

Wales: COVID-19 treatments | GOV.WALES

How are the treatments given?

Sotorovimab and remdesivir infusions will be given at one of the CMDUs, usually at a hospital.

Paxlovid and molnupivravir tablets will be delivered to you to take at home.

Who will be eligible for treatment?

It is important to note that being in the list below or getting a letter does not mean that you will definitely receive the treatment. A clinician at a CMDU will assess you first and make the final decision.

Some people with Crohn’s or Colitis may be eligible for treatment. This includes:

People aged 18 years and over:
  • If you are currently taking steroids equivalent to 10mg or more of prednisolone, every day for at least 28 days before your positive COVID-19 test.
  • If you are currently taking, or have taken in the six months before your positive COVID-19 test, a biologic medicine, tofacitinib or filgotinib.
  • If you currently have, or have had in the three months before your positive COVID-19 test, active or unstable disease which required any of the following:
    • An increase in dosage of immunosuppressive treatment such as azathioprine and mercaptopurine
    • A new immunosuppressive treatment
    • A steroid injection
    • Oral steroids
  • If you are currently taking ciclosporin.
Children and young people aged 12 to 18 years:

The criteria above applies to people aged over 18. In children and young people aged less than 18 years, the risk of hospitalisation from COVID-19 is very low. If you are aged 12 to 18 years and your doctor thinks you might be eligible for COVID-19 treatments, they will discuss your case with a group of specialists called a multi-disciplinary team (MDT) before deciding to offer you treatment.

Why am I in this highest risk group?

There is now reassuring evidence that most people with Crohn’s or Colitis are not at higher risk of getting COVID-19 or having more severe COVID-19 because of their disease or treatment. However, your risk may be higher if you are in a flare-up or you are taking oral steroids, which is why they are included in the list above. Other medicines are included in the list because people who take them may have responded differently to COVID-19 vaccines. The COVID-19 treatments can prevent you from becoming seriously ill with COVID-19 or having to go to hospital. Read more in our information on COVID-19 risk.

What should I do if I think I’m eligible but have not had a letter or email?

If you have recently started medicines that would make you eligible for treatment, you may not be automatically contacted. 

If you think you are eligible but you have not had a letter or email, contact your GP or specialist to discuss whether you are in one of the highest risk groups.

If you have had a positive lateral flow test and think you are eligible for treatment but have not had a letter or email, call your GP, 111 or your consultant for referral to a CMDU. 

What should I do if I have had a letter or email, but don't have any lateral flow tests at home?

If you are eligible to receive COVID-19 treatments, you can Order free coronavirus (COVID-19) rapid lateral flow tests online on GOV.UK. 

What if my lateral flow test is positive but no-one has contacted me about treatment?

Make sure you have reported your test result to www.gov.uk/report-covid19-result or by calling 119.

If you think you are eligible for treatment and no-one has contacted you within 24 hours of a positive test result, call your GP or 111.


What it is a monoclonal antibody treatment?

Antibodies are proteins made by your body to fight infection. Monoclonal antibodies are similar to the antibodies that your body makes, but they are made by scientists in a lab.

Monoclonal antibodies work by attaching themselves to coronavirus. This stops the virus making more of itself. It also stops the virus causing further damage to the body.


What is an antiviral treatment?

Antiviral treatments work by interfering with the DNA of the virus, which means the virus can’t make more of itself. This reduces your risk of becoming unwell as the virus can’t grow as quickly.  


Does it matter if I’ve had the vaccine?

Your vaccination status will not affect your eligibility for either programme. However, it's advised to get your vaccine (and boosters).


What happens if I get COVID-19 and need to go to hospital?

If you have COVID-19 and are seriously unwell (whether you have received treatment or not) call 111 or 999. Visit the NHS website for more information on the symptoms to watch out for.


The PANORAMIC trial

The PANORAMIC trial will study how well the antiviral tablets molnupiravir (brand name Lagevrio) and Paxlovid work for people who are unwell with COVID-19 at home. It is for people with mild to moderate COVID-19 but at high risk of developing severe illness.

To sign up for the PANORAMIC trial you must:

  • Currently have symptoms of COVID-19, and these symptoms started in the last 5 days AND
  • Have had a positive PCR test for COVID-19 in the last 7 days AND
  • Be aged 50 years or over OR
  • Be aged 18 or over with a condition that puts you at higher risk of COVID-19 complications OR
  • Be aged 18 or over and taking a treatment that puts you at higher risk of COVID-19 complications

This would mean that many people with Crohn’s or Colitis will be eligible to sign up. If you take part in the trial you will be given either the new medicine to take, or usual NHS care. The treatment you receive will be chosen at random. You will then be asked to keep a diary of your symptoms. You will also be given emergency contact details in case you become more unwell.

Visit the PANORAMIC trial website to find out if you're eligible to take part in this trial and to sign up.

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