Support and advice for patients in the UK

England

Free Lateral Flow tests can now only be obtained free of charge from most Boots Pharmacies. You must take a copy of your letter received from NHS England instructing you to shield or a letter from the NHS England confirming you are clinically extremely vulnerable and eligible for the COVID-19 vaccines.

Scotland

NHS portal for ordering coronavirus (Covid-19) lateral flow tests and reporting results

Wales

Free Lateral Flow tests can be obtained via a community pharmacy. Proof of medical condition must be taken.

Ireland

Free Lateral Flow tests can be obtained via local pharmacies  Proof of medical condition must be taken.

England

Use this NHS service to book a vaccination appointment in England

Scotland

Use this NHS service to book a vaccination appointment in Scotland

Wales

Use this NHS service to book a vaccination appointment in Wales

Ireland

Use this service to book a vaccination appointmentin Ireland

Who can have COVID-19 treatment?

You’re eligible for a COVID-19 treatment assessment, without being admitted to hospital, if all the following apply:

• you’re at highest risk of getting seriously ill from COVID-19
• you’re aged 12 or over
• you have symptoms of COVID-19
• you have tested positive for COVID-19

Some treatments are also available through a national study to a wider group of people, including those aged 50 years old and over (or 18 years old and over with a health condition that puts them at increased risk of COVID-19).

Treatments for COVID-19

The treatments available for people at the highest risk of becoming seriously ill from COVID-19 are:

• nirmatrelvir plus ritonavir (Paxlovid)
• sotrovimab (Xevudy)
• molnupiravir (Lagevrio)
• remdesivir (Veklury)

Nirmatrelvir plus ritonavir, molnupiravir and remdesivir are antiviral medicines.

When being assessed for treatment, a doctor will advise which treatment is most suitable for you.

Some treatments come as capsules or tablets that you swallow. Others are given to you through a drip in your arm (infusion), usually in a hospital or local health centre.

These treatments can help some people manage their COVID-19 symptoms and reduce the risk of becoming seriously ill.

How to get COVID-19 treatment

Local NHS organisations are responsible for arranging COVID-19 treatments. The way you get treatment will depend on where you live. Your local integrated care board (ICB) can give you more information.

If you think you’re in the highest risk group and need to access COVID-19 treatment, follow these steps to be considered for a referral:

1. Keep rapid lateral flow tests at home

If you’re eligible for COVID-19 treatment, you should keep rapid lateral flow tests at home.

You may be able to pick up free rapid lateral flow test kits from your local pharmacy if you’re eligible for COVID-19 treatment.

Your local integrated care board (ICB) may be able to give you more information on where you can collect free tests. Find your local ICB here.

The pharmacy may ask you questions about your medical history to confirm you are eligible for free tests. If you have a copy of a letter or email sent to you by the NHS that says you are eligible for COVID-19 treatment, take this with you. A letter or email is not essential, but it will help the pharmacy to confirm you are eligible for free tests more easily.

Someone else can collect free tests on your behalf, for example, a friend, relative, or carer. If you do not have a friend, relative, or carer who can collect your tests for you, you may be able to book a volunteer responder by calling 0808 196 3646. Anyone collecting free tests on your behalf needs to give the pharmacy your details, including your

• full name
• address
• date of birth
• NHS number (if available)
• medical condition(s) to confirm your eligibility

They should also bring any copies of letters or emails that have been sent to you by the NHS about COVID-19 treatments.

2. Take a rapid lateral flow test if you get symptoms

If you have any symptoms of COVID-19, take a rapid lateral flow test as soon as possible, even if your symptoms are mild. Only take a test if you have symptoms. You can also use tests you have paid for, for example, a test you have bought from a supermarket or pharmacy.

3. If your test is positive, call your GP surgery, NHS 111 or hospital specialist

Call your GP surgery, NHS 111 or hospital specialist as soon as possible if your test result is positive. They’ll decide if you need a referral for an assessment for COVID-19 treatment or may carry out the assessment themselves.

As part of the assessment, you may be asked what other medicines you take or receive, including any vitamins and minerals, so it is important to have a list of these ready.

If you are eligible for treatment, it is important to start the treatment as soon as you can. Treatments for COVID-19 need to be given quickly after your symptoms start to be effective.

If you are prescribed capsules or tablets, the medicine can be collected on your behalf by someone else, such as a friend or relative. You’ll be advised where the medicine can be collected from. Alternatively, the NHS may be able to arrange for the medicine to be delivered to you.

If the treatment needs to be given as a drip in your arm (infusion), you’ll usually get it at your local hospital or in a local health centre.

You’ll get instructions on where to get the treatment and how to get there and back safely.

4. If your test is negative, do a total of 3 tests over 3 days

If your test result is negative, but you still have symptoms of COVID-19, you need to do a total of 3 rapid lateral flow tests over 3 days. For example, if you did your first test today, you should do a 2nd test tomorrow and a 3rd test the day after.

If any test result is positive, you can stop testing and call your GP surgery, NHS 111 or hospital specialist as soon as possible.

This piece has been written and donated by a clinical psychologist who is also clinically extremely vulnerable. We present this information in the hope that it is helpful. However, if you are depressed or feel suicidal, this is not a substitute for medical advice and you should seek professional help. If you need help urgently, please contact your GP, call 111 for advice or in an emergency visit A&E. 

The Wren Project also provides listening support for people with autoimmune conditions.

Managing the wait – how to look after ourselves during shielding

Shielding and being CEV is hard. There is nothing about it that you don’t already know. Our mood can fluctuate; we can be hopeful at one moment and experience crashing lows at another. Stress, mood, anxiety, pain, fatigue, health problems, financial worries… These can all interact and at times feel overwhelming. However, there are small things that we can do. In fact, it’s probably the small things that have got you through so far.

Externalising the stressors

Write a list or draw a diagram of everything that you are having to manage at the moment. In psychology this is known as ‘externalising’. Putting the stressors on paper, outside your head is not just to allow you to see how much you really are doing or facing. It also allows you to reduce the cognitive effort of trying to hold everything in your working memory at the same time.

Juggling the demands

Three things – the Post-It game. I have found this particularly helpful when the level of being busy becomes overwhelming and inescapable, especially as my normal ways of breaking up the day are not available to me because I can’t go where other people are. I write the three most important things of the day (or hour) onto three separate notes and clear everything else to one side. Suddenly that’s my focus for the hour. The other tasks are still there – I just don’t need to try to do them all at once.

Meaningful distraction

Anything repetitive, absorbing or enjoyable can be very helpful in managing stress, low mood or pain. This is no accident. The repetitive nature of work involving creative skills can produce a similar effect to mindfulness or meditation. It allows us to disengage slightly with the content of our anxious thoughts and provides a level of distraction. Distraction provides a competing stimulus to the unpleasant stimuli – the effectiveness of distraction is well established in pain management and in mood where techniques involved in ‘behavioural activation’ are often helpful.

Mindfulness and meditation

You might be a long-standing fan, a die-hard sceptic or perhaps curious. There are mindfulness and meditative practices to suit everyone. Mindsprings combines gentle movement with mindfulness thinking and explains the physiology of the process if that appeals to you. Alastair Appleton is both a TV presenter and a very experienced psychotherapist and mindfulness practitioner with a down to earth approach:

Other resources recommended by psychologists and their clients/patients include:

• The Mindful Movement
• The Mindfulness Association
• Calm app
• Balanced Minds

Downtime is important

It can be harder to allow ourselves time to switch off and indulge in apparently trivial treats when so much that is difficult is happening in our health and social worlds. We need to look after ourselves and our stress levels even more at the moment, and have a separation where possible between work and home life. This is harder when we may not be leaving our homes much, so we probably need to pay it more attention than we would when not in COVID-19 times. This is not me just admitting a fondness for Netflix and chocolate, but paying attention to the fact that psychologically the more we can train ourselves to relax the lower our autonomic stress responses become and the more slowly they become activated.

Perceived control

This is a concept that is very useful in physical health psychology. When we have health problems that involve complex medical treatment and reliance on multiple clinical teams it’s easy to feel that we do not have many choices or control over many areas in our lives. That’s enhanced during this pandemic where we by necessity have our choices restricted for us. However, we do have choices, even if they are small or feel inconsequential. Have a think about all the choices you make in a day and consider whether there are any others you would like to identify. Making a cup of tea or speaking to a friend on the phone are all choices.

Social interaction

Maintaining social contact is so important – and also hard at the moment at times. We may be exhausted trying to stand more than two metres away and shouting pleasantries at people on the pavement – I know I am – but human contact is really important in managing mood and mitigating loneliness. Despite my disappointment in people not understanding my shielding situation, this pandemic period has also brought some extraordinary surprises: new contacts, new colleagues, new friends – all over the country and the world. It’s a good time to reach out in new ways. I know one person who took up calligraphy to help with pain management (distraction technique) and has ended up joining an international calligraphy exchange group. Beautifully decorated envelopes containing exquisitely penned personal messages arrive most weeks from around the world.

Waiting well, with hope

It feels superfluous to suggest remaining hopeful when that’s what you’ve been doing since March 2020. However, we don’t know what is out there. A year ago we didn’t know about Evusheld, and two years before that there were no vaccines. We can’t know what the pharmaceutical companies are working on – they have to protect their formulae until the time comes to take them to trials. We don’t know what the next government might bring – and look at what this group has achieved already. From zero members to a thousand in a week is pretty amazing – and there are others in important and influential positions in the medical and political world who of necessity need to remain anonymous, but are no less involved and determined that something will change and help will be available. In the meantime, we have each other. That’s a real gift.

Reaching out

The most important thing is to ask for help if you need it. Everyone’s different – some people just need someone to hear them, others need more specialist support. Speak to:

• Your GP
• The relevant medical charity for your condition; many have excellent helplines who can link you in with counselling support
• Local IAPT (primary care mental health) services usually take self referrals
• The Samaritans – who help with more than feeling suicidal
• Mind
• Saneline
• Clinical and other HCPC-registered practitioner psychologists working independently.