Vulnerable Patients

Every member of the public should already be practicing social distancing as per government advice. Guidelines on this can be viewed on the Gov.UK COVID-19 Guidance on Social Distancing page.

On Monday 16th March the UK government announced a package of measures, advising those who are or may be at increased risk of severe illness from COVID-19 to be particularly stringent in following social distancing measures, which can be viewed through the link above.

This group has been identified to the public as those who:

  • Are aged 70 or older (regardless of medical conditions)
  • Are under 70 with an underlying health condition listed below (i.e. anyone instructed to get a flu jab as an adult each year on medical grounds)
  • Have chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
  • Have a chronic heart disease, such as heart failure
  • Have a chronic kidney disease
  • Have a chronic liver disease, such as hepatitis
  • Have chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
  • Have diabetes
  • Have problems with their spleen – for example, sickle cell disease or if they have had their spleen removed
  • Have a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
  • Are seriously overweight (a BMI of 40 or above)
  • Are pregnant

This increased risk group, who broadly speaking comprise the criteria of adults eligible for an annual flu vaccine, will not receive a letter but have instead been asked to take steps to reduce their social interactions in order to reduce the transmission of Coronavirus.

The very high risk groups, who may have received a letter already or will do in the forthcoming weeks, are being advised to follow shielding measures- stay at home at all times, and avoid any face to face contact for at least 12 weeks. Those classed as very high risk are:

  • People with a solid organ transplants such as a kidney or liver transplant
  • People with specific cancers
  • People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
  • 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 COPD.
    • Patients with Chronic Obstructive Pulmonary Disease (COPD) who have required hospitalisation in the last 12 months or patients who have required 2 or more courses of steroids and/or antibiotics in the last 12 months
    • Patients with asthma with a history of hospitalisation in the last 12 months or ever been admitted to intensive care
  • People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
  • People on immunosuppression therapies sufficient to significantly increase risk of infection
  • People who are pregnant with significant congenital heart disease
  • All patients on the following medications: Azathioprine, Mycophenolate (both types), Cyclosporin, Sirolimus, Tacrolimus
  • Patients with significant heart failure which has required hospitalisation for their heart failure within the last 12 months

Please also see: COVID-19: guidance for rheumatologists.

If you are under consultant care for your condition, you might like to consider contacting your specialist care team for further advice.

Furthermore, GPs will be contacting additional patients with long term conditions that are also potentially considered to be at very high risk in the next few weeks.

If you continue to have concerns or queries about your clinical risk then please contact us by completing our Ask a Doctor a Question form.