Covid pill to be rolled out before Christmas

The first at-home treatment for Covid is to be offered to patients by Christmas as ministers roll out the antiviral pill to help protect the most vulnerable from the omicron variant.

Sajid Javid, the Health Secretary, is preparing to announce the start of a national pilot of Lagevrio, also known as Molnupiravir – the "game-changing" pill that Britain became the first country to license last month.

Under the plans, the NHS is expected to deliver courses of the tablet to clinically vulnerable and immunosuppressed patients within as little as 48 hours of them testing positive for Covid.

Hospital and GP leaders have been told the health service will be setting up a series of Covid medicines delivery units to help get the drug to patients as quickly as possible once they test positive. Last week, local health chiefs received a letter setting out health service plans to facilitate the rollout.

Whitehall sources said the deployment of antiviral treatments had become "even more important" in the face of the omicron variant, which has prompted the Government to extend the booster vaccine campaign to all adults.

On Saturday, the Cabinet's Covid operations sub-committee decided to reinstate a requirement for fully-vaccinated travellers to take pre-departure Covid tests before coming to the UK from 4am on Tuesday in a bid to slow down the spread of the variant.

The move came despite Grant Shapps, the Transport Secretary, warning that such a move could "kill off the travel sector again".

Ministers were shown an analysis by the UK Health and Security Agency indicating that patients with omicron may become infectious more quickly than those with delta, increasing the likelihood of pre-departure testing identifying positive cases before they travel. The test requirement will also apply to children aged 12 and above.

On Saturday night, Mr Javid said: "We knew this winter would be challenging, but the arrival of a new variant means we must further strengthen our defences. As our world-leading scientists continue to understand more about the omicron variant, we are taking decisive action to protect public health and the progress of our Covid-19 vaccination programme."

Ministers also added Nigeria to the travel red list after it emerged that omicron was in the country in October.

Under the plans to roll out Lagevrio, when patients deemed high-risk test positive their local Covid medicines delivery unit will telephone to offer them the drug. Most are expected to be offered a course of tablets to take at home, although some will be given the drug intravenously in hospital.

The rollout is intended to help prevent vulnerable patients becoming severely ill with Covid, avoiding hospital admissions. Britain has secured 480,000 courses of the drug, and ministers hope the national pilot will precede the routine rollout of antivirals to vulnerable patients.

Last month, the Medicines and Healthcare products Regulatory Agency (MHRA) said Lagevrio was "safe and effective" at reducing the risk of hospitalisation and death among those with mild to moderate Covid who were at increased risk of it becoming severe. Mr Javid hailed it as "a game-changer for the most vulnerable and the immunosuppressed".

It had previously been expected that the drug would be given to patients from next year, but Boris Johnson and Mr Javid have come under pressure over the speed of the rollout of antivirals, with David Davis, the former Cabinet minister, challenging the Prime Minister about it in the Commons last week.

A Whitehall source described the rollout as "even more important now as we face this variant", adding: "Vaccines are our first and best line of defence and will continue to be – particularly the booster programme – but this is another line of defence that we've got and we have got to work out how best to make use of it."

As well as the 480,000 courses of Lagevrio, the UK has ordered 250,000 courses of Ritonavir, a drug produced by Pfizer that is usually used to treat HIV/Aids. However, ritonavir has yet to receive MHRA approval.

Lagevrio, produced by Ridgeback Biotherapeutics and Merck Sharp & Dohme, works by preventing the Covid virus from multiplying, keeping levels low in the body and reducing the severity of the disease. The MHRA said the drug should be taken as soon as possible following a positive Covid test and within the first five days of symptoms.

Patients who will be eligible for it under the MHRA's ruling will have at least one risk factor for developing severe Covid including obesity, diabetes, heart disease or being over 60.

An outline of the study issued by the Antivirals Taskforce in the summer said it would examine the impact of treatments on clinically vulnerable patients who test positive for Covid, as well as some non-vulnerable household contacts of those who test positive. It is not clear whether non-vulnerable people will still be included in the pilot.

The Government appears to have downgraded the original ambition of the UK Antivirals Taskforce, set up by Mr Javid's predecessor, Matt Hancock, in April, from potentially offering treatments to all Covid patients to instead getting drugs to those deemed clinically vulnerable, including people with pre-existing medical conditions who cannot have a vaccine.

As the omicron variant continued to spread in the UK, government advisers suggested an extension of the current requirement to wear masks in shops and on public transport until the new year may now be inevitable.

"I suspect it may be [extended]," said one member of the Sage committee of scientific advisers. "We do know that those restrictions work, and they can be used in a mass setting."

Several Cabinet ministers said they considered the current restrictions "proportionate" while ministers await the first data on the link between omicron, hospitalisations and deaths.

One senior minister warned that while they "can cope" with the mask-wearing requirement being extended beyond the initial three-week review mark later this month, continuing the new self-isolation requirement for vaccinated contacts of people with omicron would meet "some pushback" in the absence of data justifying the decision.