Delivering a new anti-viral service in Wales

By Alana Adams, Principal Pharmacist at the National Antiviral Service (NAVS)

I lead a service that has been at the forefront of increasing the range of treatment options available to the most vulnerable people in Wales should they get COVID-19.

Being proactive

We know that antiviral medicines are more effective if people are treated as soon as possible. This is why we are now proactively contacting people after they report a positive lateral flow test result, as well as after a PCR test.  Access to these medicines supports patients with COVID-19 to significantly reduce their risk of hospitalisation and death.

Antivirals (affectionately known to us as Molly and Paxy)

Since 16th December 2021, more than 650 people in Wales who are at very high risk have already been treated with antiviral Molnupiravir (known as Molly!), and antibody treatments to protect them from the most severe consequences of COVID-19.

This week, specially trained pharmacists in my team have led the supply of newly marketed Paxlovid (known as Paxy!), triaging the first three patients for treatment.


Clinical trials show when Paxlovid is taken within five days of COVID symptoms it reduced the risk of hospitalisation from COVID-19 by 88%. Paxlovid has been shown to have a greater effect on reducing hospitalisation than the antiviral medicines we use already, and unlike antibody treatments it can be taken at home. This is a significant development for those with compromised immune systems, for whom the vaccine could offer less protection.

Pharmacists are experts in medicines, the pharmacists working in the National Antiviral Service have the knowledge and expertise to help people decide which treatment option is most appropriate for them.

How patients access antivirals

Our proactive approach means that people who are eligible for treatment with Paxlovid do not need to do anything. Systems are in place for them to be identified and contacted by telephone call or text by a pharmacist at the National Antiviral Service in Cardiff within 48 hours of a positive PCR test, reporting a positive lateral flow test, or if they have symptoms but have a negative lateral flow test result and have taken a PCR test.  We ask questions about the medicines they take to determine which treatment is most clinically appropriate for them.

If Paxlovid is an appropriate treatment, it will be delivered to their home within 24 hours. If Paxlovid isn’t suitable, they will continue to be offered antibody treatments.

People who are not in the highest risk group are still able to access the antiviral treatment Molnupiravir through the PANORAMIC study.  Paxlovid is being added to the study later this month, which is open to anyone over the age of 50 or between 18 and 49 with certain underlying health conditions. Around 8000 people have been recruited to the study since it began in December.

Pharmacists play a crucial role

There is no doubt that pharmacists are ideally suited to lead this work. For me, it has been a privilege to lead the team and work with nursing colleagues to help increase the range of treatment options available the most vulnerable people in Wales. The pharmacy team continues to play a vital role in the fight against Covid-19 and our contribution to the enormous effort cannot be underestimated.  

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