COVID-19 treatments

NHS patients who are at greater risk from COVID-19 are eligible for COVID-19 treatment at home.

Vaccinations remain the most effective way to protect those most vulnerable. Vaccination protects people from illness from COVID-19. This means most people are now at a much lower risk of severe disease and do not benefit from antiviral treatments.

Some people can receive antiviral treatments as part of their care if they remain at high risk of severe COVID-19.

COVID-19 treatment for people at high risk of severe COVID-19

People who are at high risk of becoming severely ill due to COVID-19 may be able to receive treatment at home.

The highest risk group includes people who have: 

• chromosomal disorders that affect the immune system, including Down’s syndrome
• certain types of cancer, or have had a cancer removed in the last 12 months
• had either radiotherapy or chemotherapy in the last 12 months
• sickle cell disease
• certain conditions affecting the blood or have received a haematological stem cell transplant
• chronic kidney disease (CKD) stage 4 or 5
• severe liver disease
• had an organ transplant 
• some autoimmune or inflammatory conditions needing certain medications like:
  • rheumatoid arthritis
  • inflammatory bowel disease
• HIV or AIDS
• a rare neurological condition such as:
  • multiple sclerosis
  • Huntington’s disease
  • motor neurone disease
  • myasthenia gravis
• an impaired immune system due to either a condition or certain medications 

The highest risk group has also been extended to include all people aged 70 and over who live in a care home or who are in hospital.

If you are in the groups listed above, and you test positive for COVID-19, you may be eligible for treatments. Treatments help manage your symptoms and reduce the risk of you becoming unwell due to COVID-19.

If you have a positive test result for COVID-19, you will be screened to see if you are eligible for treatment. 

What you need to do to access treatment

If you are in one of the groups listed above you should keep rapid lateral flow tests (LFTs) at home. Find out how to get Covid-19 lateral flow tests.

Take a test as soon as you get symptoms of COVID-19. If your test is negative but your symptoms persist, you should take another test on the next day (day 2). If it’s still negative, test again on day 3. If your tests on day 2 and day 3 are negative, it’s unlikely you have COVID-19.

What to do if you test positive for COVID-19

If you are in one of the groups above and eligible for treatment, you will need to fill out the COVID-19 Antiviral Self-Referral Form (NHS 111 Wales). If you cannot access the self referral form you can ask your GP or hospital specialist to refer you for assessment or you can call NHS 111 and state

• you have symptoms of COVID-19
• you have tested positive for COVID-19
• you believe you are in the highest risk group and are eligible for treatment 

The call handler will offer a nurse assessment for your symptoms. They may refer you to your local health board’s antiviral service for an assessment to ensure you receive the most suitable treatment for you.

How you will be contacted if you are eligible for treatment

If you are eligible for treatment, you will usually be contacted within 48 hours of you completing the self-referral form or contacting NHS111. You may be offered treatment via text message or telephone call. It is important to respond to the text message. 

Either reply the word: “ADVICE” - to speak to a member of staff to receive further information on potential treatment options available to you or “DECLINE” - to decline treatment. Once you reply, you will be contacted and asked more information to assess if treatment is right for you and which treatment is most appropriate.

What to do if you have not been contacted, but believe you are eligible for treatment

If you have symptoms, have completed a self-referral form and aren’t contacted within 48 hours of reporting a positive LFT result:

Call NHS 111 and state: 

• you have symptoms of COVID-19
• you have tested positive for COVID-19
• you believe you are in the highest risk group and are eligible for treatment 

The call handler will offer a nurse assessment for your symptoms. They may refer you to your local health board's antiviral service for an assessment to ensure you receive the most suitable treatment for you.

Which treatments are available? 

Antiviral treatments

• Paxlovid (nirmatrelvir and ritonavir) 3 tablets twice daily for 5 days. This dose may vary for certain individuals, so always check with a health care professional if you are unsure. 
• Some people for whom Paxlovid isn’t suitable may be offered treatment with Xevudy (sotrovimab). A drip that is given through your arm (infusion) in a single appointment usually in a hospital.

Further information 

Further information regarding COVID-19 treatments:

Antiviral Services across Wales - Welsh Medicines Advice Service

Get help or advice whilst receiving treatment

Contact your GP surgery, specialist clinic or NHS111 if during your treatment you:

• continue to feel unwell
• feel like your symptoms are worsening 

What you should do if you have declined treatment, but now wish to be treated for COVID-19? 

If you now require COVID-19 treatment, call NHS 111 and they will be able to guide you appropriately.

If you live in a care home

If you live in a care home and have symptoms of COVID-19, staff should arrange for your health board to do a different type of test. This will determine if you have COVID-19 or another respiratory illness such as flu, the health board staff who carry out the test will then arrange for you to be assessed for treatment if you test positive.