Coronavirus (COVID-19): shielding support and contacts

People who have had a transplant of heart, lung, stomach or other part of intestine, liver and kidney.

People will be in this group because they need to take medications to prevent rejection of the transplanted organ.

1. People with cancer who are undergoing active chemotherapy. Or people who have had radical radiotherapy for lung cancer.
2. People with cancers of the blood or bone marrow who are at any stage of treatment. This includes cancers such as leukaemia, lymphoma or myeloma.
3. People with cancer who are having immunotherapy or other continuing antibody treatments.
4. People with cancer who are having other specialised, targeted treatments which can affect the immune system. This includes protein kinase inhibitors or PARP inhibitors.
5. People who have had bone marrow or stem cell transplants in the last 6 months. Or people who are still taking immunosuppression drugs.

People in this group include:

• anyone with cystic fibrosis
• anyone with severe asthma and is on regular inhalers and long-term steroid tablets to control their asthma. For example, Prednisolone or regular injections
• anyone with severe COPD. This means being too breathless to walk 100 yards, having 2 or more lung infections per year or requiring oxygen to help with your breathing. This usually means anyone who has been on several different inhaler medications in the last year. This must include two long acting preventers (e.g. Long Acting Beta Agonists and Long Acting Anti-Muscarinic Antagonists), and a steroid inhaler
• if you are on home oxygen for your lung condition

There are many conditions classed as a rare disease. Not everyone with a rare disease will be in the shielding group

Your clinician will know if you should be in the highest risk group. They will make sure that you are added to the list. Once added you will receive a letter.

Immunosuppressive therapy may be used to keep a person from rejecting a bone marrow or organ transplant. It may also be used to treat conditions in which the immune system is overactive, such as autoimmune diseases and allergies.

In some cases these treatments may put people into the shielding group. Situations include:

• People on high dose corticosteroids (equivalent to Prednisolone 20mg or more) for 4 weeks or more
• People on specific single therapies, e.g. Cyclophosphamide. These medications are usually prescribed by specialists in hospitals. Clinical judgement is needed to determine if medications indicate highest risk
• People on lower dose of corticosteroids (equivalent to Prednisolone 5mg per day for 4 weeks or more), in combination with other disease modifying medication
• People on several different disease modifying medications taking into account their other chronic medical conditions

People on a single Disease Modifying medications (DMARD) or Biologic such as Methotrexate, Azathioprine, Ciclosporin, Leflunomide plus others, would not automatically be in the shielding group if they are otherwise healthy. This should be discussed with your specialist or GP if you are not sure.

People who are receiving renal dialysis treatment

People receiving and those starting renal dialysis.