Updated NHS guidelines ASTHMA

[MrsKypp]

Hi

As us asthmatics most likely already know, we are at a higher risk of more serious problems if we get Covid-19.

I received an email today from Asthma UK with the updated NHS Guidelines for us:

LINK: www.asthma.org.uk/advice/triggers/coronavirus-covid-19/shielding-advice-high-risk/

Shielding advice for very high-risk groups
Who is advised to shield, and what should you do if you are shielding?

LAST UPDATED WEDNESDAY 15 APRIL 2020

The NHS now say that you would be considered at very high risk if ALL THREE of these things apply to you:

1. You have asthma, AND

2. You are taking certain extra controller medicines as well as a preventer inhaler (for example, you are taking Montelukast, salmeterol or formoterol, or you are on a combination inhaler like Seretide, Fostair, Symbicort, Flutiform, Fobumix, DuoResp Spiromax, Combisal, Sereflo, Sirdupla, Aloflute, AirFluSal, Relvar Ellipta, Fusacomb or Stalpex), AND

3. You are taking continuous or frequent oral steroids

The British Thoracic Society also says that you are at very high risk if:

You are taking a biologic therapy for severe asthma


For anyone else out there with asthma, here's a little something to cheer you up:

[NeurotrashWarrior]

Was just coming to post this. There were some threads for asthmatics and lots of confusion around who was and wasn't shielded that I can't find now; this will be helpful there.

[MrsKypp]

I even read a thread somewhere on MN that claimed having asthma didn't matter because Covid19 affects a different part of the lungs or some such wishful thinking...if only.

So glad we are allowed to say "asthmatics" and don't have to say "living with asthma". I live with my family; asthma would be unwelcome and pushed out the door the minute it tried to enter my house.

[NeurotrashWarrior]

Haven't listened to it but just spotted this:


https://www.theguardian.com/science/audio/2020/apr/14/covid-19-how-vulnerable-are-people-with-asthma?CMP=ShareiOSAppp_Other

[topcat2014]

Oh, I am on 2 out of three

[FaithInfinity]

I was confused and not deemed high risk. However I’ve started on Montelukast and have needed steroids in recent weeks so I was told by my occupational health department that she feels I am unstable and therefore extremely vulnerable and I need to shield! Not loving the idea of being stuck at home but I must admit I feel safer.

These guidelines are much clearer.

[HermioneWeasley]

I am asthmatic and take montelukast as well as pulmicort.

Does that mean I’m very high risk? I didn’t get a letter and my asthma is really well controlled

[Keepdistance]

I think it's clear all asthmatics are at higher risk. So theyve narrowed it down by more medicines. But realistically CV isnt going to be great if you generally are triggered by cold/flu.
Really think they need to reconsider any asthmatics (and diabetic/pregnant) people going back to work.

Im not sure it will help but take vit D if you can just in case it makes a difference

[Mummyoflittledragon]

Thanks for putting this out there. I’ve just texted my friend. Her fiancée has asthma. I don’t think it applies but he was struggling and taking different meds a couple of months ago. I think it’s important this goes around to as many people as possible.

[MrsKypp]

@HermioneWeasley

It looks like you meet criteria 1. and 2. but not 3.?

@Keepdistance

I agree - everyone with asthma is at risk, then those of us at the more severe end of the spectrum will be at higher risk again.



I meet criteria 1 & 2, but not sure what "frequent" means in 3. I sometimes take Prednisolone. I always get bad infections from colds e.g. 2 months bronchitis every time.

[MrsKypp]

@Mummyoflittledragon

So glad you find it useful. I was glad too when AsthmaUK emailed it to me today. We do need reliable and clear info - the previous documents failed to list my spray (Seretide) whereas this clearly states what's included.

The only part open to interpretation is 3. "frequently" ... is that 6 times a year, each month, every 3 months etc ?

[neverdidnt]

Frequent prednisolone is defined as four or more prescriptions over the last six months. Not sure how to do a clicky link, but all the shielding guidance is here: digital.nhs.uk/coronavirus/shielded-patient-list/methodology/rule-logic

[MrsKypp]

@Neverdidnt

Thanks! Just difficult when you don't take Prednisolone at regular intervals, so maybe 10 times one year, 3 another, 7 another etc

I suppose we need to look at the last 6 months specifically. I took it 3 times in that case, but also a lot of antibiotics and nebuliser.

[CatherineOfAragonsPomegranate]

Thank you for this OP. I have the virus and my breathing is very bad. My phonecalls to 111 have not been taken very seriously just told to take more symbicort.

It isn't working. It is like I have a chest infection. Cannot even walk from the living room to the kitchen without feeling breathless. But no wheezing and as usual without wheezing all is good.

Hopefully they are becoming aware of how serious the impact is for asthmatics now.

[Starlight1243]

They need to stop changing the criteria all the time. My dh inhaler was listed as the high dose steroid inhaler alongside his blue inhaler and asthma uk stated he needed to isolate so he met 2 out of 3 criteria.

[Didkdt]

I don't think that criteria has changed it's just AsthmaUK jumped the gun on who would be shielded

[neverdidnt]

@MrsKypp I think doctors can use clinical discretion to move people to the shielded group if they are very close to meeting the criteria and there are other factors too, like the antibiotics and nebuliser in your case. It might be worth you contacting your GP for advice?

[Massivejugs]

I don’t meet the criteria as I came off montelukast last year after being on it since 2006 - I started to get a fast heartbeat on it.

I have only had steroids a couple of times this winter but I am on 50mcg of seritide twice a day. I double up when things aren’t going well.

I am shielded - my GPs decision, they phoned me on 20th March.

It isn’t cut and dried.

[NeurotrashWarrior]

Catherine, do you have a peak flow monitor? Have you checked it? Not all asthmatics wheeze.

I'd call Gp in morning perhaps.

[Kittywampus]

Thanks for the update

[wailedAndNearlyLevitated]

Thanks for posting this OP. I meet points 1&2 but as a previous poster said the gauging frequency of prednisolone is tricky. I know it’s technically 4 instances in 6 months, I’ve gone back over my prescriptions and had 6 so far this year, but only 2 inside the last 6 months, as well as nebulisers. So technically not shielding, although my GP has advised me to do so.

[wailedAndNearlyLevitated]

*when I say this year I mean the last 12 months, not since jan!

[MyFriendFlicker]

I take seretide 250. Had adverse reaction to montelukast so don't take it and I take prednisolone but not for asthma. I presume that means I don't fit the criteria for asthma but I probably do for auto immune disease.

[CatherineOfAragonsPomegranate]

Sorry for the late reply @NeurotrashWarrior. No. But I called 111 and mentioned it (you would have thought they would have) and they are sending a prescription for one to my local pharmacy. My son is picking it up for me tomorrow. If its bad or gets worse I'm to phone GP.

Thanks for your advice.

[Kittywampus]

Someone posted this article on another thread : www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30167-3/fulltext

It sounds quite positive news for asthmatics

[NeurotrashWarrior]

Ah good @CatherineOfAragonsPomegranate. Do you know your normal "good" peak flow?

Hope you feel better soon.