Shielding IBD
A message to people living with IBD (Crohn’s disease or ulcerative colitis) in the UK
We know that this is a very worrying time for everyone. Five days have passed since I recorded my 10 top tips video for people with IBD during the coronavirus pandemic. Things have moved very fast.
During this time the UK has moved to lockdown and introduced a system to ‘shield’ the most vulnerable people from coming into contact with coronavirus (https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19). Everyone is already being asked to stay at home. This really is incredibly important. We have to slow the virus from spreading. Social distancing is critical. However, shielding goes further with the strong recommendation of avoiding all face to face contact for a period of 12 weeks.
Remember – we will want you to continue the medicines you take for your IBD. This includes any infusions you may have. Please continue to attend for any infusion.
There are 1.5m vulnerable people in England and a further 200,000 in Scotland that we want to shield from getting coronavirus infection. There are 6 categories of people affected; those with IBD fall under category 5 “People on immunosuppression therapies sufficient to significantly increase risk of infection”. We don’t believe all people with IBD need to be in this shielding group. We have therefore, with the British Society of Gastroenterology (https://www.bsg.org.uk/covid-19-advice/bsg-advice-on-ibd-patient-risk-groups/) and Crohn’s and Colitis UK (https://www.crohnsandcolitis.org.uk/news/advice-for-people-with-crohns-and-colitis-self-isolation-social-distancing) generated a risk grid.
People fall into one of 3 categories –
highest risk = shielding;
moderate risk = increased risk from background but not so much as to merit shielding and
lowest risk = the same as the background population.
IBD is a dynamic state with people moving from remission to flare and back with a large degree of unpredictability. Medicines will change over time. The grid is designed to reflect this and allows people to move in between categories. Please do not stop your medicines to alter your category. This makes it much more likely you will have active disease and may therefore increase your risk from COVID-19 infection.
Your IBD teams will be able to use this grid to work out what group you are in. Many are actively doing this. But we want you to also be able to self-identify with your grouping. Crohn’s and Colitis UK have devised a decision tree that will do the job. We have made an online tool that will tell you and also alert the NHS as to your grouping. This will keep your data very secure and protect your privacy. We hope this will go live tomorrow and I will follow with all the details then.
There has been some confusion around text message send from NHS England instructing lots of patients taking the medicine azathioprine to follow shielding advice. This was done to identify many patients who have had transplants who also take this drug. However, many people with IBD on azathioprine are actually in our moderate risk grouping. Please follow the grid; this is designed for you and approved by the government (use the resources above). If you are still unsure then please contact your local IBD team. But please remember they, like all of us, are under intense pressure at the present time.
For further information please visit the Crohn’s and Colitis UK website who have an excellent COVID-19 section including FAQs (https://www.crohnsandcolitis.org.uk/news/coronavirus-covid-19-advice).
Lastly, I appreciate how difficult life is for many people just now. I hope by now we all understand just how important it is we stay at home to stop the spread of this virus. However, the shielding advice – designed to protect so many of you who live with IBD – goes even further. Please take extra special care of your mental health. I will be back very soon with more advice on how to stay well during this unprecedented time. For now, be kind and please stay safe.