Dare you disagree with Government guidelines? The following are excerpts of the new guidelines posted last night on the Government’s website. Unfortunately, people on ‘immunosuppression therapies sufficient to significantly increase the risk of infection’ are still on the list with no justification of what this risk should be. Based on the experience emerging from pwMS getting COVID-19 on MS disease-modifying therapies (DMTs) this statement is incorrect. On balance pwMS on DMTs don’t appear to be at increased risk of getting COVID-19, severe COVID-19 or dying from COVID-19. In terms of dying from COVID-19, the same risk factors playing out in the general population appear to be playing out in pwMS, i.e. older age, comorbidities and disability. Advanced disability is linked to age; pwMS who are disabled tend to be older.
The good news is that shielding is now less intense and people who are shielding can at least go out and meet with people albeit at a distance. This will be good news for many people. Please be aware that this virus does not appear to be spread outdoors unless you are in close contact with people.
Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19 (Updated 31 May 2020)
Clinically extremely vulnerable groups
Expert doctors in England have identified specific medical conditions that, based on what we know about the virus so far, place some people at greatest risk of severe illness from coronavirus. Disease severity, history or treatment levels will also affect who is in this group.
Clinically extremely vulnerable people may include:
- Solid organ transplant recipients.
- People with specific cancers:
- people with cancer who are undergoing active chemotherapy
- people with lung cancer who are undergoing radical radiotherapy
- people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
- people having immunotherapy or other continuing antibody treatments for cancer
- people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
- people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
- People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD).
- People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
- People on immunosuppression therapies sufficient to significantly increase risk of infection.
- Women who are pregnant with significant heart disease, congenital or acquired.
- Other people have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions.
More information about who has been classed as clinically extremely vulnerable is available on the NHS Digital website.
If you’re still concerned, you should discuss your concerns with your GP or hospital clinician.
Staying at home and shielding
People classed as clinically extremely vulnerable are advised to take additional action to prevent themselves from coming into contact with the virus. If you’re clinically extremely vulnerable, you’re strongly advised to stay at home as much as possible and keep visits outside to a minimum (for instance once per day).
This is called ‘shielding’ and the advice is now updated:
- If you wish to spend time outdoors (though not in other buildings, households, or enclosed spaces) you should take extra care to minimise contact with others by keeping 2 metres apart.
- If you choose to spend time outdoors, this can be with members of your own household. If you live alone, you can spend time outdoors with one person from another household (ideally the same person each time).
- You should stay alert when leaving home: washing your hands regularly, maintaining social distance and avoiding gatherings of any size.
- You should not attend any gatherings, including gatherings of friends and families in private spaces, for example, parties, weddings and religious services.
- You should strictly avoid contact with anyone who is displaying symptoms of COVID-19 (a new continuous cough, a high temperature, or a loss of, or change in, your sense of taste or smell).
The Government is currently advising people to shield until 30 June 2020 and is regularly monitoring this position.
For full details please refer to the Government’s website.