Going Into Work If Im Clinically Extremely Vulnerable
Your employer has a duty of care to protect employees from risks to their health and safety. Employers should do all they can to enable you to work as safely as possible. If youre concerned about going into work, you should speak with your employer in the first instance to discuss your options. If you cant find a resolution, you should contact your trade union, Health and Safety Executive, or get advice from ACAS or Citizens Advice.
If you do go into work, think about how you will get there. Walk or cycle, if you can, or drive in your own car. If you need to use public transport, try speaking to your employer about changing your working hours so you can travel at quieter times of the day.
You might also think about trying to reduce the number of people you spend time with. Your employer could support you in this by changing shift patterns so youre with the same people each time, or by working in smaller teams.
England
In England, the government has recommended a gradual return to workplaces and it’s no longer advised that everyone works from home where possible. This includes people who are CEV.
Employers should still be taking steps to protect the health and safety of their workers and they should be able to explain to you the measures they are taking to keep you safe. The government has released guidance to help people work safely during coronavirus.
Scotland
Wales
Northern Ireland
Is There A Role For T Cell Mediated Immunity
Grifoni et al. measured SARS-CoV-2-specific CD4+ and CD8+ T cells responses in 20 COVID-19 cases and healthy control donors. CD4+ T cell and antibody responses were observed in all COVID-19 patients analyzed, and CD8+ T cell responses in most. In this same study, CD4+ T cell responses were also detected in 4060% of unexposed individuals. It has been suggested that SARS-CoV-2-specific T cells in unexposed individuals might originate from memory T cells to cross-reactive epitopes derived from exposure to common cold human coronaviruses, which widely circulate in the human population with mild self-limiting respiratory symptoms. Whether this previous immunity is relevant in influencing clinical outcomes in childhood is unknown, but it may be of value in herd immunity and vaccine development .
Other Things That Might Affect Your Risk
Having 2 or more conditions might increase your risk, regardless of your age. If your condition is severe or poorly controlled, this might also increase your risk of serious illness from COVID-19.
Other factors might also increase your risk of severe illness if you contract COVID-19, including:
- age risk increases as you get older, even for those under 70
- being male
- smoking.
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Multisystem Inflammatory Syndrome Presentation In Children
Although acute SARS-CoV-2 infection tends to be mild or symptom-free in most pediatric cases, several reports of a multisystem inflammatory syndrome in children , temporally associated with SARS-CoV-2, with overlapping features of atypical Kawasaki disease , toxic shock syndrome and macrophage activation syndrome , have started to appear in the literature . The CDC case definition for MIS-C comprises: age < 21 years, fever, severe illness with two or more organ systems affected, laboratory evidence of inflammation, laboratory or epidemiologic evidence of SARS-CoV-2 infection and no other alternative diagnosis . Cytopenias distinguished MIS-C from KD and the degree of hyperferritinemia and the pattern of cytokine production differs MIS-C from MAS .
Some Us Government Contracts For Covid
Another question raised by that study: why asthmatics were significantly overrepresented in the studys cohort of individuals diagnosed with Covid-19. About 9% of the U.S. population has asthma, but 14% of the Covid-19 patients enrolled in the study were asthmatic.
Spergel said that could be due to the fact that asthmatics might be more likely to undergo Covid-19 testing, since they regularly experience symptoms like coughing and difficulty breathing that are associated with the virus. A higher rate of testing would logically turn up a higher rate of cases, he added.
Chinthrajah said there is a need for far larger studies to determine the true incidence of Covid-19 in asthmatics and the potential risks associated with it. Studies with thousands of patients would allow researchers to parse the potential risks with more nuance, such as whether asthma type, severity, medication use, or age influence risk. Those studies would also allow researchers to measure how risk might differ by geography, race, and ethnicity.
Patel and her colleagues did find stark racial disparities in their study, which showed that Black patients were both more likely to have severe Covid-19 and to suffer from asthma. Neptune, the Johns Hopkins researcher, said the latter finding was in line with historically alarming rates of asthma in Black communities.
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Vaccine Distribution In Canada
As part of the Canadian Thoracic Societys COVID-19 Respiratory Roundtable panel representing Canadians living with lung disease, Asthma Canada signed a joint statement titled Prioritization of Canadians with Lung Disease in COVID-19 Vaccination Rollout. Alongside other lung health organizations, Asthma Canada is urging federal, provincial and territorial governments to prioritize people living with lung disease who are at higher risk for more serious COVID-19 complications in the vaccination rollout. From Canadians living with a lung disease such as asthma, chronic obstructive pulmonary disease , cystic fibrosis, lung cancer, pulmonary fibrosis, pulmonary hypertension, and pre- and post-lung transplant, there is widespread concern regarding when in the vaccine rollout in the provinces and territories they will have the opportunity to receive the vaccine.
We will continue to advocate for our community on this subject and will share more information as it becomes available.
Read the full statement here:English | French
Asthma And Your Risk Of Becoming Ill With Covid
How your asthma affects your risk of becoming ill with COVID-19 seems to be mainly linked to how well-controlled it is. People with well-controlled asthma that is not severe dont seem to be at higher risk of dying from COVID-19.
People at higher clinical risk are those who either:
- have severe asthma
- need regular or continuous oral steroids
- have a history of asthma attacks that have required an overnight stay in hospital.
As a result, many of these people will be in the clinically extremely vulnerable group.
However, if you have any type of asthma there is a small increase in the risk of needing to go to hospital if you get COVID-19. Although the risk of this happening is small, its still very important to manage your condition well.
Its also important to remember that your own level of risk is affected by many different interacting factors. Your asthma may play a part in your level of risk from coronavirus, but your risk is also affected by lots of other things too.
Public Health England has identified the main factors that increase the risk of catching and becoming seriously ill with coronavirus as:
- being older
- having an underlying health condition
- being a man
- your job your risk level is higher if you work outside your home and come in to contact with lots of people every day
- where you live – if lots of people in your area are infected with coronavirus, its more likely youll catch it. Find official coronavirus statistics for your area.
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Are People With Asthma Less Likely To Be Affected By Covid
What we showed and what others have shown is that asthma alone really isnt a risk factor for severe outcomes from COVID-19, and that is great news for asthma patients, Dr. Robinson told MedPage Today.
However, researchers acknowledge that more work is needed to understand the risks that asthmatic patients may or may not face with COVID, including the impact of asthma-related inflammation and the use of inhaled corticosteroids.
As we continue to learn more about the coronavirus and its impact on asthma patients, people with asthma should continue to practice recommended precautions, such as getting the vaccine, wearing a face mask, and social distancing, and follow their asthma action plans.
Risk And Protective Factors Associated With Pediatric Asthma
5.2.1. Atopy
Several mechanisms have been proposed to explain the lower morbidity of COVID-19 observed in patients with type 2 asthma.
As previously described, ACE2 is a host molecule used in cell entry by SARS-CoV-2 and other coronaviruses . Data from three different cohorts of children and adults have shown that asthma and respiratory allergy were associated with lower expression of ACE2 gene in airway cells , as type 2 inflammatory mediators and allergen exposures may decrease ACE2 expression in bronchial epithelial cells .
The South Korean nationwide cohort tested almost 220,000 adults for SARS-CoV-2, with 7340 positive cases, and information regarding asthma, allergic rhinitis and atopic dermatitis was obtained from the health insurance records. Asthma was associated with an increased risk of SARS-CoV-2 test positivity and severe COVID-19 infection . Interesting and of note, was the report that both risks were higher in non-allergic asthma, with no significant risk being found when allergic asthma was compared to the non-infected group .
5.2.2. Obesity
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Pediatric Asthma And Sars
Human coronaviruses circulate globally, commonly infecting children and generally causing mild, self-limiting upper respiratory tract infections . Asymptomatic infection also occurs. Of the seven coronaviruses identified in humans, hCoV-229E and hCoV-NL63 belong to -coronaviruses, and hCoV-OC43, MERS-CoV, SARS-CoV-1 and SARS-CoV-2 belong to -coronaviruses. Both SARS-CoV-1 and SARS-CoV-2 first emerged in China .
Up to 80% of asthma exacerbations are due to viral infections, including common coronaviruses . Two large population based-studies in hospitalized children, one in Norway and the other in China , found that, respectively, 10 and 4.3% of hospitalized children tested positive for hCoVs, with the most common type being hCoV-OC43 in both studies.
This fact draws attention to the possibility of these previous infections with hCoVs in children conferring partial protection against SARS-CoV-2. Despite lower respiratory tract infections with hCoVs have been described, severe illness is rare in the absence of additional risk factors . No clear association between hCoVs infections and Kawasaki disease has been identified .
MERS data on prevalence, clinical presentation and outcome in childhood are scarce. The most common symptoms in children were fever, cough, shortness of breath and vomiting/diarrhea. In chest radiographs, diffuse bilateral infiltrates were the most common abnormality .
Key Variables Of Interest
Asthma was defined as having any 1 of the following: asthma-related International Classification of Diseases, Tenth Revision code within the preceding 5 years , asthma diagnosis recorded in the problem list of the EHR or documented in physician notes . Analysis was limited to patients 65 years or younger to reduce the influence of asthma-chronic obstructive pulmonary disease overlap that occurs more frequently in older adults and is associated with worse prognosis than the individual diseases alone.
Severe COVID-19 was defined as hospitalization with a confirmed positive SARS-CoV-2 PCR test result. In addition, we included patients who died in the emergency department because their precipitous death was an indication of severe disease. Primary clinical outcomes of disease severity included length of stay, hospital readmission, intubation, duration of mechanical ventilation, tracheostomy tube placement, and death. Secondary outcomes included initial laboratory measures collected on admission and medications used to treat COVID-19.
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The Direct Result Of Racism: Covid
The fact that Covid had a disproportionate effect in the African American population almost guaranteed that asthma was going to rise to the forefront as being kind of a comorbidity of concern, she said.
Theres a need for more research into whether other conditions that are common in people with asthma factor into why Black people are dying from the virus at heightened rates. Patel said she and her colleagues analyzed other conditions among the patients with asthma and found that obesity, hypertension, sleep apnea, and a slew of other conditions were more prevalent among asthmatics.
It was interesting to see that asthma patients, despite them having increased comorbidities, did not have an increased risk of hospitalization, she said. That is something that we would like to investigate further as to what role asthma could be playing among these different comorbidities.
Chinthrajah said she is confident more research can resolve that question and the other remaining riddles around the connection between Covid-19 and asthma.
We all feel compelled to find answers, she said.
Advice For Specific Communities And Groups
COVID-19 vaccination reduces the risk of getting infected. If you get infected, COVID-19 vaccination reduces the risk of:
- severe COVID-19
- hospitalisation
- death in all people, including those at increased risk of severe COVID-19.
For information on how you can stay safe and healthy read the Living well in the COVID-19 pandemic fact sheet. This fact sheet will help you to make COVIDSafe decisions about work, transport and social activities.
You may also like to talk to you doctor to organise vaccination against COVID-19 and complete a COVID-19 Action Plan.
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Advice If You’re At High Risk
People at high risk from COVID-19 are advised to follow the same guidance as everyone else.
You are no longer advised to stay at home . But there are still things you can do to help keep yourself safe.
If you have not yet had a vaccination, you’re still eligible and can book your appointments anytime.
Who Is Considered Clinically Extremely Vulnerable With Asthma
People are regarded as clinically extremely vulnerable if they are at very high risk of severe illness as a result of coronavirus , and may need to be admitted to hospital. People with asthma may be in this group if they have severe asthma or another condition that makes them clinically extremely vulnerable.
Many children and young people who, at the start of the pandemic, were identified as clinically extremely vulnerable, have already been removed from the shielded patient list. The decision has now been made by the chief medical officer in all four UK nations to remove all remaining children and young people from the clinically extremely vulnerable list. Read more about children and the clinically extremely vulnerable list from our sister charity, the British Lung Foundation.
Data has shown that age is by far the most important factor influencing a persons risk of becoming seriously ill with coronavirus. Its thought that although children can catch COVID-19, very few children develop severe symptoms, even if they have an underlying health condition.
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Coronavirus Vaccine And Booster
Coronavirus vaccine
Everyone who is clinically extremely vulnerable should have been offered the coronavirus vaccine. If you are CEV and have not had your vaccine, you should book one as soon as possible
Some children aged 12 to 15 who are at increased risk of serious illness from COVID-19, or who live with adults who are CEV, are now being offered the vaccine. Those aged 16 and 17 in the high-risk group should have already been offered a vaccination.
Find out more in the vaccine FAQ from our sister charity, the British Lung Foundation.
All coronavirus vaccines effectively reduce your risk of becoming ill with the virus should you get COVID-19. Its also now known that being vaccinated reduces your risk of becoming infected with the virus. But it doesnt mean you cannot get the virus.
Booster vaccines
The JCVI has provisionally advised that booster vaccines should be offered from September 2021 to people who are most vulnerable to COVID-19 ahead of the winter months. They have advised that the booster vaccine should be offered in two stages.
If you are clinically extremely vulnerable, you will be offered the booster COVID-19 and a flu vaccine from September, under stage 1.
Stage 2 includes everyone aged 50-69 and adults aged 16-49 who are offered a free flu vaccine each year. People in these groups will be offered a booster COVID-19 vaccine as soon as possible and practical after stage 1. They will also be offered a flu vaccine, where appropriate.
Risk Of Severe Covid May Depend On Your Type Of Asthma Experts Say
Everyone agrees about the good newsfolks whose asthma is spurred on by allergies don’t appear to have an increased risk of life-threatening illness if they contract COVID-19.
“Asthma has not risen as one of the top comorbid diseases for worse COVID-19 outcomes,” said Dr. Sandhya Khurana, director of the Mary Parkes Center for Asthma, Allergy and Pulmonary Care at the University of Rochester Medical Center. “We always worry with asthma and viral infections, because they seem to trigger asthma exacerbation unreasonably. But what we’ve seen so far is reassuring.”
But debate continues to swirl regarding the potential severity of COVID infection in people with non-allergic asthma.
Some studies have suggested that people who have asthma caused by something other than allergiesexercise, stress, air pollution, weather conditionsmight have an increased risk of severe COVID-19.
For example, Harvard researchers found that having non-allergic asthma increased the risk of severe COVID-19 by as much as 48%. That conclusion was based on data from 65,000 asthma sufferers presented in the June issue of the Journal of Allergy and Clinical Immunology.
“For those people, I think being more cautious would be good for them,” said senior researcher Liming Liang, an associate professor of statistical genetics at the Harvard T.H. Chan School of Public Health in Boston. “I think the next wave is coming. We’ve got to be more cautious.”
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Tips For Wearing A Face Mask With Asthma
The Public Health Agency of Canada currently recommends that Canadians wear non-medical face masks while in public spaces where physical distancing cannot be maintained such as on public transit, or at the grocery store.
Be sure to check your provincial or territorial authority for up-to-date guidance.
Wearing a face mask is NOT a substitute for physical distancing or frequent handwashing. Wearing a non-medical face mask is an extra measure that can be taken to protect those around you. When worn properly, a person wearing a non-medical mask can reduce the spread of their own infectious respiratory droplets.
Make sure you wear your mask properly. It should cover both your nose and mouth. If your mask gets soiled or wet, be sure to wash and dry it before wearing it again. You can read information about appropriate use of non-medical masks, and how to properly place, remove and clean a non-medical mask from the Public Health Agency of Canada.
The vast majority of people with asthma can wear a non-medical mask safely. If you are unable to wear a non-medical mask without experiencing breathing issues, do not wear a mask. Instead, make sure you are practicing physical distancing by maintaining a 2-metre distance. Schedule an appointment with your healthcare provider as soon as possible to go over your Asthma Action Plan and review your asthma symptoms and control. Your healthcare provider may suggest or ask you to consider other options to protect yourself.