SOCIAL DISTANCING – everyone is now advised to do this as best they can
The government created 2 populations –
A high risk population that was felt to be more likely to have complications or be susceptible to covid, and a
severe risk population that should shield population who were advised to self-isolate.
The high risk populations are –
The current pregnancy advice from the royal college is as below.
Severe risk population that should shield population
A smaller group of particularly vulnerable patients are advised
to self isolate.
*Immunosuppressive medications include: Azathioprine, Leflunomide, methotrexate, Mycophenolate (mycophenolate mofetil or mycophenolic acid), ciclosporin,
cyclophosphamide, tacrolimus, sirolimus.
It does NOT include Hydroxychloroquine or Sulphasalazine either alone or in combination.*
* Biologic/monocolonal includes: Rituximab within last 12 months; all anti-TNF drugs (etanercept, adalimumab, infliximab, golimumab, certolizumab and biosimilar variants of all of these); Tociluzimab; Abatacept; Belimumab; Anakinra; Seukinumab; Ixekizumab; Ustekinumab; Sarilumumab; *** Small molecules includes: all JAK inhibitors – baracitinib, tofacitinib etc
**** Co-morbidity includes: age >70, Diabetes Mellitus, any pre-existing lung disease, renal impairment, any history of Ischaemic Heart Disease or hypertension.
Patients who have rheumatoid arthritis (RA) or CTD-related interstitial lung disease (ILD) are at additional risk and may need to be placed in the shielding category.
All patients with pulmonary hypertension are placed in the shielding category
NB This advice applies to adults, children and young people with rheumatic disease. We do NOT advise that patients increase steroid dose if they become unwell