If the Omicron death count falls short of the 6,000 a day envisaged by the gloomier Sage scenarios, it could be for many reasons. It might be because the variant is milder or because the vaccines offer strong protection — but there’s something else that seldom gets much notice. Britain has placed the world’s biggest per person order for new antiviral drugs that can be given to help those who have Covid and vastly reduce the scope for hospitalisation and death.
The scheme will target the 1.3 million people who are regarded as especially vulnerable to Covid for a whole bunch of reasons (and who tend to account for most of the death toll). They may be healthy but very old. They may be young but have had a kidney transplant, and are therefore taking immune-suppressing drugs which make them vulnerable to the virus. Everyone on this list has been sent an at-home PCR test, ready to use if they feel ill. If they test positive, then the idea is to send around antiviral pills — Merck’s molnupiravir or Pfizer’s Paxlovid — as quickly as possible.
This is the work of the little-known antivirals taskforce run by Eddie Gray, a former senior executive at GlaxoSmithKline. The project aims to ensure that more Covid patients can be handled by their GPs instead of being admitted to hospital. This can be done, runs the argument, if those who are most likely to get seriously ill are identified and put first in line for new drugs intended to stop them needing hospital help.
‘Antivirals are very much a part of living with Covid,’ says Gray. ‘The likelihood is that living with Covid is an understanding that some people are going to be infected in winter periods. For a significant number of those people, the route that they will follow will be to say: OK, I’ve got Covid, there are Covid medicines — in the same way as if I had an infection of any other kind.’
The new drugs won’t stop healthcare workers from having to take time off when they are infected. But what the drugs could do is stop hospitals from filling up with more Covid patients who would otherwise be most likely to become seriously ill.
Sending out the antiviral drugs might be expensive (the scheme triggered a row with the Treasury, who were unnerved at the cost) but it will be cheaper than higher hospitalisation rates and the costs are very small in comparison with the vast vaccination programme.
The NHS system has its faults, but having a unified health service makes it easier to identify all vulnerable people, send out testing kits and prepare delivery. Gray is also overseeing a study to measure the efficacy of the pills. ‘The NHS is an unusual structure,’ says Gray. ‘It has connections between primary and secondary care. Its data collection — the way in which it holds all of the data somewhere within its system — is increasingly adept and clever, managing that data and bringing it together. If it’s not actually unique, it’s close to unique.’
Gray’s antiviral taskforce is modelled on Kate Bingham’s vaccine taskforce and, like hers, had to choose from a range of products, knowing some would turn out more effective than others. It’s a gamble. Bingham was fêted for getting it right. But to date the antiviral programme has not been rigorously tested, because the virus is not (yet) infecting the most vulnerable in serious numbers.
Gray hopes it stays that way and that his team remains low-profile. ‘If we end up the stars of the show,’ he says, ‘then the reality is the country’s in deep trouble.’