Treatments for Covid-19 for people at high risk of becoming seriously ill

The NHS is offering new antibody and antiviral treatments to people with coronavirus (COVID-19) who are at highest risk of becoming seriously ill.

Two types of COVID-19 treatment are available:

• Sotrovimab is a biological medicine. It is also known as a neutralising monoclonal antibody (nMAb).
• Paxlovid and Molnupiravir are oral antiviral medicines which prevent viruses copying themselves and spreading through your body.

Getting to the Airedale Covid-19 Medicines Delivery Unit (CMDU)

Location

Sotrovimab is normally given at the Bradford District and Craven Covid-19 Medicines Delivery Unit (CMDU), which is at Airedale General Hospital, Skipton Road, Steeton, BD20 6TD.

The location is the blue portacabin in the Car Park immediately outside Zone B (Maternity).

It can be accessed by turning right at the top of the main hospital drive/entrance.  Travel past the patient car park P1 on the left hand side and take the next left into the Outpatient Car Park.  Immediately after the zebra crossing, turn left and the blue Portcabin will be on the left hand side.  This will be signposted.

Sotrovimab may also be given to high risk patients aged 12-17 year olds within the paediatric ward of the nearest hospital. Arrangements will be discussed with these patients and/or their parents/carers by the relevant paediatric team.

Parking

Parking is reserved next to the CMDU portacabin, but you will be shown where to park.

Transport

Ideally patients should arrange their own private transport to the Airedale CMDU. If patients require hospital transport, they must ring to book this themselves on Yorkshire Ambulance Service phone number 0300 330 2000, including booking the return trip.

On arrival

It is important to arrive at the designated appointment time. On arrival, go to the front door, and knock on the door.  Please note that there isn’t normally space for family members to accompany you within the CMDU portacabin – if you need to bring children or a carer with you, please let us know to ensure we can accommodate you.

Contact number

If you are running late, or cannot find the Airedale CMDU, please contact our administration team on: 01535 29 4323.

During your appointment

The Airedale CMDU is really well ventilated (and can feel cold when you’re sitting still in a chair) so please come warmly dressed but with your arm accessible for treatment.  Please also come well hydrated to make it easiest for the nurse to insert the drip into your arm. We have bottled water, but if you want a hot drink, please bring your own. There is an accessible toilet available.

Getting to the Leeds CMDU centre

This CMDU has an arrangement with the Leeds CMDU that mean that if there are no suitable slots at Airedale Hospital, you might be asked to receive your treatment at the Leeds centre.  If this is necessary, this will be discussed with you during your telephone assessment.

The Leeds CMDU is located at St James’s Hospital, LS9 7TF in the main hospital entrance on Beckett Street.

At the main St James’s Hospital entrance:

• Turning into this immediately in front is a small roundabout
• Immediately to the right is CMDU/ OPAT Leeds (formally Union House Coffee shop)
• Diagonally opposite is chapel
• Parking – turn first left and then immediately left, there are 3 reserved parking spaces.

About the medications

 Sotrovimab

This treatment is given as a single intravenous infusion and will need to be administered through a drip into your arm by a nurse in the CMDU.

For more information go to https://www.nhs.uk/medicines/sotrovimab/about-sotrovimab/

• Please be well hydrated to help with placing a drip.
• When attending the CMDU, your details will be checked, you will have observations such as blood pressure, oxygen saturations, temperature, pulse and respiratory rate, which is done routinely.
• You will have a cannula inserted into one of your veins. You will receive an infusion of Sotrovimab which lasts for 30 minutes. You will need to wait in the CMDU for 60 minutes after your infusion to make sure you have no immediate side effects.
• You will also have a blood test to check your antibody levels to see whether you already have some protection against COVID-19. You will not receive the result of this test and it is being collected to inform future treatments for COVID-19.
• Sotrovimab rarely causes side effects, and most people have no significant reactions. The most common side effects are hypersensitivity reactions within 24 hours after having the infusion, but are usually not severe. These reactions include nausea, chills, dizziness, rash, itching and flushing. If you experience any troublesome or serious side effects please contact your GP or NHS111.
• Patients can travel safely to any appointment outside their home whilst minimising the risk of passing infection to others. This may include:
  • Avoid contact with other people as much as possible when going to your appointment
  • Wear a face covering when going to or from your appointment
  • Do not use public transport or taxis
  • Do not drive to your appointment if you do not feel well enough – ask someone you live with to drive you if you can
  • Do not make any unnecessary stops when going to or from your appointment

After your appointment, go straight home and continue to self-isolate.

General advice for patients:

• These treatments are not a cure, and so you must continue to self-isolate as you have been directed from the day your symptoms started.
• Get lots of rest, drink plenty of fluids (water is best) to avoid dehydration and take paracetamol or ibuprofen for fever.

Information for patients about oral treatments

Two covid-19 medicines are taken orally (swallowed) – these are Paxlovid and Molnupiravir.  Both of these medicines are a 5-day course taken twice daily.

If you and the prescriber agree that this is the most appropriate treatment for you, the respective medicine will be dispensed at the Pharmacy Department at either Airedale General Hospital or Bradford Royal Infirmary. The medication should be collected by a representative for you – either a friend or relative – who does not have Covid-19 or symptoms of Covid-19 and who is not currently isolating because of a positive Covid-19 test result. If the patient doesn’t have a relative or friend who can collect the medicine, delivery by courier may be possible.

Both oral antivirals may cause harm to unborn children and so both male and female patients should use effective contraception (if applicable) during the treatment course and for 4 days after.

Where to get your oral medication

The pharmacy department at Airedale General Hospital, Skipton Road, Steeton, Keighley, BD20 6TD (location C41) is open 09:00 to 19:00 Mondays to Fridays, 10:00 to 17:00 Saturdays and & Sundays (Pharmacy Department phone number: 01535 29 3503).

The pharmacy department at Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ (level 1) is open 09:00 to 17:00 Monday to Fridays and 09:30 – 12:30 Saturdays and Sundays (Pharmacy Department phone number: 01274 364237).

Paxlovid

• Paxlovid comes as a pack of two antiviral medicines which should be taken together in the morning and evening during the course.
  • These are clearly laid out on the blister strip within the pack showing the three tablets that should be taken each morning and night
  • One of the two antiviral medicines two antiviral medicines (Nirmatrelvir) is sometimes known by its medicine code PF-07321332.
• Paxlovid affects a number of other medicines and so is not suitable for everyone, the prescriber will check whether any other medicines you are taking will be affected. You must tell any doctors or prescribers that you see during the 5 days of treatment and for one month after that you have been given Paxlovid as any new medicines need to be checked for these interactions.
• In particular oral contraceptives are expected to not work effectively whilst you are on Paxlovid and so alternative contraception should be used during Paxlovid treatment and one cycle following its use. Paxlovid is not suitable for patients with significantly reduced kidney or liver function
• Paxlovid must not be used in patients who are (or could be) pregnant. Contraception must be used for the course of Paxlovid and 4 days afterwards.

How to take Paxlovid

• Swallow the tablets whole with plenty of fluid (for instance a glass of water).
• Do not open, break, or crush the tablets.
• This medicine can be taken with or without food.
• For more information and pregnancy, contraceptive and breastfeeding advice go to: https://www.nhs.uk/medicines/molnupiravir/

Information about Molnupiravir

• Molnupiravir is a large capsule which must be swallowed whole with plenty of fluid (for instance a glass of water).
• Do not open, break, or crush the capsules.
• This medicine can be taken with or without food.
• Molnupiravir must not be used in pregnancy. Contraception must be used for the course of Molnupiravir and 4 days afterwards. For more information and pregnancy, contraceptive and breastfeeding advice go to: https://www.nhs.uk/medicines/molnupiravir/