NHS offering three Covid drugs as 'more infectious' Nimbus strain spreads

The NHS is offering three Covid treatments as the "more infectious" Nimbus variant continues to spread across the UK. The latest data shows a worrying increase in the number of Covid cases and hospital admissions, particularly as we're only just entering autumn.

In the week leading up to September 15, the overall weekly hospital admission rate for Covid was 2.73 per 100 000 people, according to the most recent surveillance report from the UK Health Security Agency (UKHSA). This represents a 60% increase from a month earlier, when the rate was 1.71 per 100 000 in the week beginning August 18.

Lawrence Young, a virologist at Warwick University, told the BMJ: "A combination of return to work and school after the summer holidays, cooler weather-more indoor mixing in poorly ventilated spaces-and waning immunity are contributing to the increased spread of the virus. The increased trend in cases of infection and hospitalisations, although still low, are worrying so early in the autumn period."

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Amanda Doyle, NHS England's primary care director, expressed her concern and said: "It's concerning to hear flu and Covid-19 cases are already creeping up ahead of winter," before urging those who are eligible to get their vaccinations as soon as possible.

Young also warns that the UK's reduced data collection on the virus could leave health officials in the dark as we head into winter. He said: "The lack of routine [Covid] testing means we have no idea about the spread of SARS-CoV-2 in the general population, making it difficult to predict any future waves of infection."

He pointed out that current testing is primarily focused on hospital patients rather than community or primary care, which could make it "difficult to identify and monitor outbreaks", and added: "Relying on hospitalisations as a measure of surges in infection is not a sensible approach to managing the spread of infection and planning for pressures on the NHS."

When asked to comment on the current Covid situation and concerns over the lack of surveillance, a Department of Health and Social Care spokesperson told the BMJ: "The government is committed to protecting those most vulnerable to Covid-19 from serious disease and death, in line with the expert advice from the independent Joint Committee on Vaccination and Immunisation.

"This includes older adults-those aged 75 years and over and residents in a care home for older adults-and individuals who are immunosuppressed. The UK Health Security Agency continually monitors the prevalence of Covid-19, with the most recent data suggesting circulation is currently low."

According to Young, the Nimbus variant is more infectious than Stratus, but genetic changes in the Stratus bug help it dodge immunity from past Covid jabs and infections. "Both these features contribute to the increased spread of these variants," he added.

The UKHSA says current data does not suggest that these variants cause more serious illness than earlier Covid strains. The NHS website outlines several ways those with Covid can relieve their symptoms:

• take paracetamol or ibuprofen if you feel uncomfortable
• get lots of rest
• drink plenty of water to avoid dehydration (your pee should be light yellow or clear)
• try turning the heating down or opening a window to help with breathlessness
• try having a teaspoon of honey if you have a cough – do not give honey to babies under 12 months
• breathe slowly in through your nose and out through your mouth, with your lips together like you're gently blowing out a candle
• sit upright in a chair to help with breathlessness
• relax your shoulders, so you're not hunched to help with breathlessness
• lean forward slightly – support yourself by putting your hands on your knees or on something stable like a chair to help with breathlessness

You should, NHS guidance continues, avoid clear of lying on your back if you have a cough, and using a fan to cool the room - as this may spread the virus. Panicking when feeling breathless can also make it worse.

Those at the highest risk of severe illness from Covid can access treatments on the NHS, including nirmatrelvir plus ritonavir (Paxlovid), sotrovimab (Xevudy), and molnupiravir (Lagevrio). Some of these treatments are taken orally as capsules or tablets, while others are administered via an intravenous drip, typically in a hospital or local health centre. These treatments can help manage Covid-19 symptoms and reduce the risk of serious illness.

The NHS has outlined that you may be at the highest risk of severe illness from Covid-19 if you:

• have chronic kidney disease (CKD) stage 4 or 5, including those on dialysis
• have Down's syndrome, or another chromosomal condition affecting your immune system
• have certain types of cancer, or have undergone treatment for certain types of cancer
• have conditions affecting your blood, including some types of blood cancer
• have sickle cell disease
• have severe liver disease
• have certain autoimmune or inflammatory conditions, such as rheumatoid arthritis or inflammatory bowel disease
• have had an organ transplant
• have a condition affecting your immune system
• have HIV or AIDS with a weakened immune system
• have a condition affecting the brain or nervous system, such as multiple sclerosis, muscular dystrophy, motor neurone disease, myasthenia gravis, Huntington's disease, Parkinson's disease or certain types of dementia
• have certain lung conditions or treatments for lung conditions

If you're hospitalised due to Covid-19, you may receive additional treatments.