Protecting those who are vulnerable to severe illness due to COVID-19

This guidance is for everyone in the Bailiwick who is classed as Clinically Extremely Vulnerable (CEV). For a definition of CEV, please see the description below.

We know that a number of people in our community will have been shielding for a long time to protect themselves from COVID-19.

We also understand that stopping shielding can be a worrying time.

If you are considering going to public indoor places where you are unsure how well ventilated they may be, and/or you may be in a crowd of people, you should consider the following:

• Maintain a 2 metre social distance where possible.
• Practice good hand hygiene.
• Practice good respiratory etiquette.
• Consider wearing a face covering.

Definition of Clinically Extremely Vulnerable

People who are defined as clinically extremely vulnerable are at very high risk of severe illness from coronavirus.

People with the following conditions are automatically deemed clinically extremely vulnerable:

• 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 that 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 disease)
• people on immunosuppression therapies sufficient to significantly increase risk of infection
• problems with your spleen, for example splenectomy (having your spleen removed)
• adults with Down’s syndrome
• adults on dialysis or with chronic kidney disease (stage 5)
• women who are pregnant with significant heart disease, congenital or acquired
• other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs.

Clinically Extremely Vulnerable patients accessing new treatments in Guernsey:

Patients should contact their GP if they think they meet the criteria below and wish to access the new medications (antivirals or “neutralising monoclonal antibodies” -nMABs) for Covid.  These drugs have been shown to reduce the risk of hospitalisation, although detailed assessment is necessary to determine which, if any, might be suitable for an individual.  Some are tablets, but some require intravenous administration.

Who can qualify?

You must be in the “highest risk cohort” defined as (summary below or please see PDF download for full details):

• Down's syndrome
• sickle cell disease
• HIV or AIDS
• chronic kidney disease (CKD) stage 4 or 5
• certain types of cancer
• had certain types of chemotherapy in the last 12 months
• had radiotherapy in the last 6 months
• had an organ transplant
• a severe liver condition (such as cirrhosis)
• a rare condition affecting the brain or nerves (multiple sclerosis, motor neurone disease, Huntington's disease, or myasthenia gravis)
• certain autoimmune or inflammatory conditions (such as rheumatoid arthritis or inflammatory bowel disease)
• a condition or treatment that makes you more likely to get infections

A Doctor or Specialist will confirm if you are eligible for treatment.

• You must have a new diagnosis of COVID-19, within the last 5 days (PCR or Lateral Flow test)
• You must have symptoms of COVID-19,
• You must not be hospitalised or be needing new oxygen treatment for COVID-19.

I think I may qualify – what should I do?

• Contact your GP as soon as possible.
• Make clear that you think you may qualify for these new treatments.

What will happen next?

• Your GP will assess you, possibly with a face-to-face consultation.
• If your GP thinks you are suitable for one of these drugs, they will either prescribe the appropriate drug or refer you into secondary care, depending on the drug.

Where can I find further information?

• There is further information available here, but please note this is a UK link and in Guernsey you need to contact your GP as above to access these drugs. Treatments for coronavirus (COVID-19) - NHS (www.nhs.uk)

It is extremely important to note that COVID-19 vaccination remains extremely important to help prevent severe disease and hospitalisation in this group – the availability of treatments does not change this.