Getting Covid antivirals when traveling

[LilyMistri2]

Firstly thanks to everyone who responded to my last question about Covid. You really helped me get through the week, whilst I worried that I had Covid. I’m still not feeling 100%, but I’m negative.

I really want to travel abroad this year to see relatives and to go sightseeing again. But I’m afraid to get Covid abroad in case I can’t get an antiviral, which my immunosupressed Lupus body won’t be able to cope with, if that happens.

Does anyone have any experience of getting antivirals abroad when they got sick abroad? Can the GP give an emergency prescription before you go?

Please let me know. I fear I’ll never travel again.

[Sara_A]

The gps have nothing to do with covid and covid medication etc there is a specific centre that deals with this. So I doubt very much you would be able to get a 'just in case' prescription. Depending on your lupus it might be that you could very well be able to fight off the infection as it's not always as bad as we fear. Tho I had antivirals both times for mine I feel that I probably could have done without them as my symptoms were mild.

I feel that you have a huge amount of fear which is understandable. I am on mtx 25mgs, prednisolone 25mgs daily hydroxychloroquine 400mgs daily, I have slept, antiphospholipid syndrome and inflammatory arthritis and the 1st time I hot covid all I had was a bitter taste in my mouth the 2nd time more symptoms but still not massively unwell but was in bed a day or 2 but was ok just had a bit of a fever and was tired but that's all.

There must be some way of finding out about treatment when travelling either by the gov websites or ringing 119 maybe for advice?

Try not to be so scared you need to live ur life have u been vaccinated??

[LilyMistri2 in reply to Sara_A]

thanks so much Sara. Your reply is very helpful. Yes my fear is really huge. I don’t keep well with so many lupus, hormonal, blood sugar and infection problems that I fear all of these will get out of control as well as the lupus if I get sick, so I keep a very small social life. Hearing how you got on gives me I hope. I’ve had 5 vaccines. X

[bertie203 in reply to Sara_A]

> Tho I had antivirals both times for mine I feel that I probably could have done without them as my symptoms were mild

This is a risky assumption - your infection might have stayed mild only thanks to the antiviral.

For us immunosuppresssed it's best to follow the medical advice of taking the antiviral even if a past case was mild, there's just no way to know what it might've been like or what it might be like this time round even.

[Sara_A in reply to bertie203]

This is true but I was a few days in with the 1st infection and was absolutely fine. The 2nd time they actually just 'offered' it to me, asked if I wanted to go ahead and take it.I obviously did as like you say we just don't know.

I was due my mtx on the wed and I think I finished my antivirals on the tues so I thought it's fine I'll take my 25mg mtx injection as I'm day 6 or something now and tested negative had no fever etc

Only to then get what we assume must have been this 'rebound' covid which u can get with or without (it seems from reading evidence) after taking antivirals. So I became symptomatic and tested positive again and remained positive until day 19. I therefore followed the rebound advice and isolated for a further 5 days from my positive tests. And reported it on the yellow card drug scheme.

So it appears I probably didn't actually shift the original infection??

I've had 6 vaccines now and covid twice!

[Ncut]

Hi LilyMistri,

I would think firstly it would depend upon which country your visiting. I do know when I had covid in October last year within 4 hrs of my result the hospital had rung me and the antiviral drugs were prescribed and taken. It was explained to me that the drugs supplied were designed for your prescribed medication you take.

I’m currently in Spain on holiday for five weeks and I must admit it didn’t cross my mind about catching covid and the antiviral, perhaps I’ve let my guard down.

I will let you know if my situation changes and what the provision is over here ( hopefully I won’t need to find out ).

[LilyMistri2 in reply to Ncut]

yes I hope you don’t have the need to find out too! A doctor frustratingly told me ‘in other countries you can get antivirals but not in Britain’. But he didn’t elaborate on how. It’s good to know from you that antivirals are tailored to your meds. But this means that when abroad you’d have to make sure of that too if you had to go and buy some. Maybe going through the nhs hotline would be the right thing to do in the first instance when abroad to ask. X

[AgedCrone]

I doubt you will be able to get antivirals abroad…..it will depend on the rules in the country you visit…..why don’t you ask whoever you intend to visit what rules apply?

However I do know GPs will not give precautionary drugs just in case you get sick when on holiday abroad. You should make very sure your travel insurance covers all aspects of Covid. In fact GPs can’t prescribe the antivirals…they have to refer you to the CMDU for assessment.

But don’t worry too much, I had a nasty bout of Covid over Christmas & nothing was working here….GP was shut,& 111 & 119 were impossible to contact. When I did get in contact I spoke to a Clinician who decided which antiviral would be suitable for me…,but then he called back to say it was too late & wanted me to go in to hospital….but I preferred to stay home rather than end up rubbing shoulders with Covid,Flu & StrepA patients.

Being on Rituximab & elderly I was quite worried, but although I had a miserable time,I got through it.

Enjoy your holiday…….unless you are going to a third world country …in the unlikely event you do catch Covid….you will get the treatment you need.

[LilyMistri2 in reply to AgedCrone]

I’m sorry to hear you had Covid at Xmas and had such a difficult contacting anyone and then going through it. It feels so wrong that you couldn’t get the help you needed. I’m glad to hear you actually got through it. Maybe these vaccines are better than I think they are. Thanks for your support. X

[AgedCrone in reply to LilyMistri2]

In fact I had no antibodies from the vaccinations…because of my age & being on Rtx I was tested. I was quite ill with the first two, & only had two more very reluctantly….in fact I thought I had managed to get away with it….so didn’t test when I first felt off kilter ….hence I missed out…but from people I know who did get the anti virals …they say they felt worse after taking them, so in a way I was very lucky.

It must have been sheer good luck I pulled through so well. I think my saving grace was I have never had any sort of lung infection & have never picked up any infection due to Rituximab.

[LilyMistri2 in reply to AgedCrone]

it’s such a conundrum this whole business isn’t it! I’m sorry you had Covid but thankfully it was better than those had it worse because of the antivirals. Food for thought. X

[Guatmom]

In the USA it’s easy. Any physician can prescribe antivirals, and at this time the oral medication is free.

[bertie203]

What I'd do is:

- Make sure to have a list of all of your medications prepared in advance, along with the reasons for getting them. Paxlovid is the main antiviral, but it has a lot of interactions, and doctors will need to check all your medications and potentially pause them before prescribing it. Even better is to discuss these interactions in advance with your GP - because then a foreign doctor might feel more comfortable pausing a medication if you've already OK'd it with your GP. (In my case there's one medication that might block Paxlovid use, and I haven't discussed this with my doctor yet...)

- Make sure you've got insurance coverage. I'm not sure what the post-Brexit situation is in Europe anymore.

- Ideally get a letter from one of your doctors confirming your medications and summarising your medical situation. This could save a lot of explaining.

Unfortunately the antiviral situation depends a lot on the specific country you go to, some make it easier than the UK, some are behind. It might be worth looking this up in advance. I haven't heard of doctors in any country issuing antivirals for travel yet, although it's not a ridiculous idea since it sometimes done with antibiotics and I think widely for antimalarials.

[LilyMistri2 in reply to bertie203]

all very sound advice. As if Traveling wasn’t stressful enough! I will keep researching, that reminds me to call a relative doctor abroad today! X

[OldTed60]

have you tried self testing your own vaccine response at all? I was due to start Rituximab so following my 6th vaccine, I bought from Monitor My Health (cheaper and nhs lab) self test and totally confounded my expectations to find I had an off the charts positive antibody and vaccine response showing. As far as I’m aware I’ve never had Covid and was feeling much as you describe ie very anxious about getting it. But I think dropping my immunesuppressant for a week following each vaccine must have allowed me to mount a strong immune response. I did ask a rheumatology registrar a few years ago and he said as I was well established on Mycophenolate this is what I could do so if I wanted so I took my lead from him. Feeling less anxious now although still careful as I have regular hospital inpatient and outpatient appointments and infusions and don’t want to have to postpone. Also found even a bad cold recently gave me nasty bacterial eye infection and made me very unwell with chesty cough - so don’t fancy getting Covid.

Still wearing my FFP3 mask when inside shops and other public places but at least I’m going to these now. Not sure I’d be confident enough to go abroad quite yet but can’t afford to anyway and passport expired years ago so not an issue for me. If you have good travel insurance then maybe easier to get antivirals in other countries than it would be here?

[LilyMistri2 in reply to OldTed60]

hi Ted, thanks for these details. Gosh there’s a lot of interesting stuff in your message! I didn’t know it was possible to come if Mycophenolate for a week! I’m on 1000mg a day since 2019. You sound like you have a clued in consultant. My consultant didn’t suggest anything to up my chances of a good antibody response. In fact during the time of half my vaccines I’ve been down with colds and stress. So god knows what level Of antibodies I carry. Thanks for the lab details. I’ll look them up. Like you, my mask is a feature of my life. But I still haven’t gone to a big theatre or cinema yet. Many art galleries though! Thanks Ted! X

[OldTed60 in reply to LilyMistri2]

you’re a braver person than me - still been avoiding art galleries mostly and never been to cinema or theatre since pandemic started! I’m on 3g MMF. My rheumatologist didn’t suggest this at all. I told a rheumatolgy registrar when he phoned a few years back that I was going to try this having read up somewhere that it may help. He said not the departmental recommendation but if I wanted to then I should stop the day of the vaccine and stay off for 7 days - could help. I’ve also had 2 rounds of IViG since then which is human plasma so maybe this contained Covid antibodies from healthy people too? Anyway it was £40 well spent getting this monitor my health home test kit - although first one I spoiled with not getting enough blood, second one got lost in postal strike so third one (they sent me for free) lucky! X

[LilyMistri2 in reply to OldTed60]

thanks for the clarity. X