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Jul 12, 2020

People at higher risk from coronavirus


Advice for people at higher risk from coronavirus, including older people, people with health conditions and pregnant women.

Who's at higher risk from coronavirus

Coronavirus (COVID-19) can make anyone seriously ill. But for some people, the risk is higher. There are 2 levels of higher risk:

  • high risk (clinically extremely vulnerable)

  • moderate risk (clinically vulnerable)

Important The lists below may not include everyone who's at higher risk from coronavirus and may change as we learn more about the virus.People at high risk (clinically extremely vulnerable) People at high risk from coronavirus include people who:

  • have had an organ transplant

  • are having chemotherapy or antibody treatment for cancer, including immunotherapy

  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer

  • are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)

  • have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)

  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine

  • have been told by a doctor they have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)

  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)

  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)

  • have a serious heart condition and are pregnant

Information:If you're at high risk from coronavirus, you should have received a letter from the NHS. Speak to your GP or hospital care team if you have not been contacted and think you should have been. What to do if you're at high risk If you're at high risk from coronavirus, you're advised to take extra steps to protect yourself. This is called shielding. See what to do if you're at high risk from coronavirus.People at moderate risk (clinically vulnerable) People at moderate risk from coronavirus include people who:

  • are 70 or older

  • have a lung condition that's not severe (such as asthma, COPD, emphysema or bronchitis)

  • have heart disease (such as heart failure)

  • have diabetes

  • have chronic kidney disease

  • have liver disease (such as hepatitis)

  • have a condition affecting the brain or nerves (such as Parkinson's disease, motor neurone disease, multiple sclerosis or cerebral palsy)

  • have a condition that means they have a high risk of getting infections

  • are taking medicine that can affect the immune system (such as low doses of steroids)

  • are very obese (a BMI of 40 or above)

  • are pregnant – see advice about pregnancy and coronavirus

What to do if you're at moderate risk If you're at moderate risk from coronavirus, you can go out to work (if you cannot work from home) and for things like getting food or exercising. But you should try to stay at home as much as possible. It's very important you follow the general advice on social distancing. This includes trying to stay at least 2 metres (3 steps) away from anyone you do not live with or anyone not in your support bubble. What is a support bubble?Unlike people at high risk, you will not get a letter from the NHS.Information:Get help and support If you're at a higher risk from coronavirus, you can get help from an NHS volunteer with things like getting food, medicines and other things you need. Call 0808 196 3646 (open 8am to 8pm) to get help from NHS Volunteer Responders.Other things that can affect your risk A report by Public Health England found that other things might also mean you are more likely to get seriously ill from coronavirus. These include:

  • your age – your risk increases as you get older

  • being a man

  • where in the country you live – the risk is higher in poorer areas

  • being from a Black, Asian or minority ethnic background

  • being born outside of the UK or Ireland

  • living in a care home

  • having certain jobs, such as nurse, taxi driver and security guard

See the full report on disparities in the risk and outcomes of COVID-19 on GOV.UK. Advice for people at high risk from coronavirus (shielding)

If you're at high risk (clinically extremely vulnerable) from coronavirus (COVID-19), there are extra steps you're advised to take to protect yourself. These extra steps are called shielding. Information:This advice is for people who have received a letter from the NHS saying they're at high risk. If you're not sure whether you're at high risk, see who's at higher risk from coronavirus. From 1 August 2020, people in England who are at high risk from coronavirus will no longer be advised to shield. See GOV.UK: guidance on shielding and protecting people who are clinically extremely vulnerable from coronavirus.How to protect yourself if you're at high risk Do

  • stay at home as much as possible

  • try to stay 2 metres (3 steps) away from anyone you do not live with when outside your home

  • only meet other people outdoors, in groups of up to 6 – try to stay 2 metres away from each other at all times

  • wash your hands as soon as you get home

  • wash your hands with soap and water often – do this for at least 20 seconds

  • use hand sanitiser gel if soap and water are not available

  • get food and medicine delivered and left outside your door – ask friends and family to help or register to get coronavirus support on GOV.UK if you need it

  • prepare a hospital bag, including a list of the medicines you're taking, in case you need to go into hospital

Don't

  • do not have visitors inside your home, including friends and family, unless they're providing essential care

  • do not go into other people's homes – except to use the toilet or get to their garden

  • do not share or pass things to people you do not live with, including food and drinks

  • do not go into any other indoor places, such as shops

Support bubbles If you live alone or you’re a single parent who lives alone with your children, you can meet with 1 other household without staying 2 metres away from them. This is called a support bubble. Find out more about meeting people from outside your household on GOV.UK.If you live in Leicester If you're shielding and you live in Leicester:

  • avoid meeting people you do not live with (or only meet with 1 other person, ideally the same person each time)

  • do not form a support bubble

  • try to stay 2 metres away from other people, including anyone you live with

See Leicester City Council: coronavirus advice.Get help and support If you've been told you're at high risk from coronavirus, you can get help with things like getting food, medicines and other things you need. Government support You can either:

It's a good idea to do this even if you do not need support right now. You'll need your NHS number to register. You can find this on any letter you receive from the NHS or on your prescriptions. NHS volunteer You can also get help from an NHS volunteer. Call 0808 196 3646 (open 8am to 8pm) to get help from NHS Volunteer Responders.How to look after your health and wellbeing Staying at home and reducing contact with other people can be difficult. There are things you can try to help you stay well:

  • stay in touch with family and friends over the phone or on social media

  • spend time doing things you enjoy, such as reading, cooking, indoor hobbies, listening to the radio or watching TV

  • do light exercise at home or outside

  • spend time with the windows open to let in fresh air

  • spend time outdoors, but stay at least 2 metres (3 steps) away from other people

  • consider taking 10 micrograms of vitamin D each day if you’re indoors most of the day – this is to keep your bones and muscles healthy

For more advice about looking after your mental wellbeing while you're at home, see:

Information:More information and advice See the full advice on protecting yourself from coronavirus if you're at high risk (extremely vulnerable) on GOV.UK. Pregnancy and coronavirus If you're pregnant, you may be unsure how coronavirus (COVID-19) could affect you, your baby and your pregnancy care. It's important to tell your midwife or maternity team if you have symptoms of coronavirus. You should also ask them for help with any other concerns as you usually would.Pregnancy and your risk There's no evidence that pregnant women are more likely to get seriously ill from coronavirus. But pregnant women have been included in the list of people at moderate risk (clinically vulnerable) as a precaution. This is because pregnant women can sometimes be more at risk from viruses like flu. It's not clear if this happens with coronavirus. But because it's a new virus, it's safer to include pregnant women in the moderate-risk group. It may be possible for you to pass coronavirus to your baby before they are born. But when this has happened, the babies have got better. There's no evidence coronavirus causes miscarriage or affects how your baby develops in pregnancy. Information:For more information about things that can increase your risk of getting seriously ill from coronavirus, see who's at higher risk from coronavirus.What to do if you're pregnant If you're pregnant, it's important you:

  • wash your hands regularly

  • stay at home as much as possible and follow the advice on social distancing, such as staying at least 2 metres (3 steps) away from other people

  • stay away from anyone who has symptoms of coronavirus

You still need to go to all of your pregnancy (antenatal) scans and appointments unless you're told not to.Appointments and scans You'll still have regular appointments and scans while you're pregnant. But there may be some changes. You may find that:

  • midwife appointments are now online, by phone or by video call

  • if you need to have a scan you may have to go on your own

  • you may be asked to wear a mask or gown when you're in a hospital or clinic

  • some appointments may be cancelled or rescheduled – if an appointment is cancelled, it will be rescheduled, or you'll be able to rebook it

This is to help keep everyone safe and stop the spread of coronavirus. Speak to your midwife or maternity team for more information.Important If you're well, it's really important you go to all your appointments and scans for the health of you and your baby. Hospitals and clinics are making sure it's safe for pregnant women to go to appointments.Non-urgent advice:Call your midwife or maternity team if:

  • you've missed an appointment and need to book another one

  • you have any questions about your care or appointments

  • you do not know when your next appointment is

  • you have symptoms of coronavirus

If you get symptoms of coronavirus If you get any symptoms of coronavirus (a high temperature, a new, continuous cough or a loss or change to your sense of smell or taste):

  1. Stay at home (self-isolate) – do not leave your home or have visitors. Anyone you live with, and anyone in your support bubble, must also self-isolate.

  2. Book a test – get a test to check if you have coronavirus as soon as possible. Anyone you live with, and anyone in your support bubble, should also get a test if they have symptoms.

  3. Speak to your midwife or maternity team – they will advise you what to do. You may need to rebook some of your pregnancy appointments or have them online, by phone or as a video consultation.

What is a support bubble?Important If you're worried about your symptoms or not sure what to do, get advice from the NHS 111 online coronavirus service.If you have any other symptoms If you have any other symptoms, or anything else you're worried about, you should still get medical help as you usually would. You can still have GP appointments or speak to your midwife or maternity team if you have any questions. Urgent advice:Call your midwife or maternity team immediately if:

  • your baby is moving less than usual

  • you cannot feel your baby moving

  • there is a change to your baby's usual pattern of movements

  • you have any bleeding from your vagina

  • you're feeling very anxious or worried

  • you have a headache that does not go away

  • you get shortness of breath when resting or lying down

Do not wait until the next day – call immediately, even if it's the middle of the night. If you do not have a midwife or maternity team call a GP or use the NHS 111 online service. Only call 111 if you cannot get help online. Immediate action required:Call 999 if:

  • you feel very unwell or think there's something seriously wrong

  • you have severe chest pain

Labour and birth It's really important you have a midwife with you when you give birth to keep you and your baby safe. If you and your baby are well, you may be able to give birth at home, in a midwifery-led unit or in a birth centre. If you've had any complications during your pregnancy you may be advised to give birth in a unit led by a doctor (obstetrician). There may also be some changes to what usually happens where you plan to give birth, because of coronavirus. Speak to your midwife or maternity team for more information. You can also read more about signs that labour has begun. Birth partners Having a birth partner is important for your safety and wellbeing during labour and birth. You'll be able to have a birth partner during labour and the birth if they do not have symptoms of coronavirus. But there may be limits on how long they can stay after the birth. If your birth partner has symptoms, they may not be able to come with you. You might want to have a backup birth partner just in case. If you have coronavirus and go into labour If you have symptoms of coronavirus and go into labour, you'll be advised to give birth in a unit led by a doctor (obstetrician). This is so the team can look after you and your baby more closely. You'll be cared for in an area within the maternity unit that's just for women with coronavirus. You may see the midwives and maternity team wearing aprons, masks or eye protection. These things are to keep you, your baby and the staff caring for you safe, and to stop the spread of infection. Having coronavirus should not have any impact on whether you have a vaginal or caesarean birth. Your maternity team has been advised on how to keep you and your baby safe. They will make sure you get the best care and respect your birth choices as closely as possible. After the birth After your baby is born, you should be able to have skin-to-skin contact unless your baby is unwell and needs care in the neonatal unit. You'll also be encouraged to breastfeed. There's no evidence coronavirus can be passed on to your baby in breast milk, so the benefits of breastfeeding and the protection it offers outweigh any risks. As well as enjoying this time with your newborn baby, it’s important to be aware of any signs they might be unwell. At the moment it can be hard to know what to do – but trust your instincts and get medical help if you think your baby needs it. For example, it’s common for babies to get newborn jaundice. Jaundice is usually harmless, but it’s important to be able to recognise the symptoms and to get medical help if your baby has them.If you have any questions or need help If you have any questions or concerns at any time, speak to your midwife or maternity team. If you need help with day-to-day things, you can also call the NHS Volunteer Responders on 0808 196 3646. They can help you with things like:

  • doing shopping

  • picking up prescriptions

  • taking you to appointments or hospital

You can also:

Pregnancy and Coronavirus (BSL version) Play Video Media last reviewed: 28 April 2020 Media review due: 28 April 2023More in People at higher risk from coronavirus

Page last reviewed: 10 July 2020 Next review due: 17 July 2020

Support links

Other conditions and coronavirus

Some charities have worked with the NHS to produce advice about coronavirus (COVID-19) and certain health conditions. Alzheimer's disease and dementia Alzheimer's Society: coronavirus – support for a person with dementia living alone Dementia UK: coronavirus – questions and answers Arthritis and other joint or muscle conditions Arthritis and Musculoskeletal Alliance (ARMA): coronavirus information Versus Arthritis: coronavirus (COVID-19) Asthma, COPD and other lung conditions Asthma UK: coronavirus (COVID-19) British Lung Foundation: coronavirus (COVID-19) Cancer Cancer Research UK: coronavirus (COVID-19) and cancer Macmillan: coronavirus (COVID-19) guidance for people with cancer Cerebral palsy Scope: coronavirus information and updates Crohn's and colitis Crohn's and Colitis UK: Coronavirus FAQs CICRA: Coronavirus guidance for children with Crohn's and colitis Cystic fibrosis Cystic Fibrosis Trust: coronavirus help and advice Diabetes Diabetes UK: updates – coronavirus and diabetes Heart disease British Heart Foundation: coronavirus – what it means for you if you have heart or circulatory disease HIV Terrence Higgins Trust: coronavirus (COVID-19) Kidney disease Kidney Care UK: coronavirus (COVID-19) guidance for patients with kidney disease Liver disease British Liver Trust: coronavirus (COVID-19) – health advice for people with liver disease and liver transplant patients Mental health Mind: coronavirus and your wellbeing Motor neurone disease MND Association: coronavirus and MND Multiple sclerosis (MS) MS Society: coronavirus and MS MS Trust: coronavirus, COVID-19 and multiple sclerosis Parkinson's disease Parkinson's UK: understanding coronavirus and Parkinson's Sickle cell Sickle Cell Society: coronavirus (COVID-19) and sickle cell disorder Stroke Stroke Association: information on coronavirus for stroke survivorsMore in People at higher risk from coronavirus

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