Rheumatology patients and COVID-19 - learn more about the risk levels

How high is my risk?

Why is this important for rheumatology patients?

Some people are more vulnerable to the new coronavirus, COVID-19 than others. If you have an autoimmune condition and/or if you are receiving treatment to control your immune system your risk from COVID-19 is higher. People with autoimmune conditions and people receiving treatment to control their immune systems should practise social distancing. Some should also self-isolate as part of ‘shielding’.

What is ‘shielding’?

If you are in a group which is ‘extremely vulnerable’ to COVID-19, you need to shield yourself to stay safe during this pandemic. You should stay at home all the time. You should not have any face-to-face contact at all except with people who provide you with essential support for at least 12 weeks. This is because your immune system might not be strong enough to fight the virus or because of other health problems making it harder to keep yourself safe. Shielding is the best way to keep yourself safe.

How can I find out if I am at ‘extremely vulnerable’?

This week, the NHS started writing to people who are ‘extremely vulnerable’. You may have had a letter already from the NHS. Please note, some rheumatology patients have not yet had a letter.

If the NHS or your rheumatology team has told you that you’re ‘extremely vulnerable’ then you should follow that advice and shield yourself.

If you’re not sure, the calculator below can help you work out your risk level.

What help can I get?

If you are in the ‘extremely vulnerable’ group, you will soon be able to ask for help getting deliveries of essential supplies like food and medicine. In England, you can register for this help on the gov.uk website.There's separate advice for Northern Ireland, Scotland and Wales.

If you’re not sure whether your medical condition makes you ‘extremely vulnerable’, register anyway.

Risk calculator

Even if you have not had a letter from the NHS, you can estimate your risk level by answering the questions below.

  If yes, score
Have you had cyclophosphamide tablets and/or infusions in the last six months? 3
Have you been taking prednisolone 20mg (or more) daily for more than four weeks? 3
Do you regularly take prednisolone 5mg (or more) daily? 2

Do you have any of the following problems: diabetes, lung problems, heart disease, high blood pressure?

Or even if you do not have any of these problems, are you over 70 years old?
1
Are you on just one immune suppression drug and/or injection (other than sulfasalazine or hydroxychloroquine) 1
Are you on two or more immune suppression drugs and/or injections (other than sulfasalazine or hydroxychloroquine)? 2

Add up the numbers above, to make your total:

 

 

If you score of 3 or more:

You are likely to be at ‘extremely vulnerable’ and probably need to shield yourself. Register for this help on the gov.uk website. If you are unsure whether you fall in this category, register for help first and then contact your rheumatology department. Do not wait to hear from your rheumatology department before registering for help, register now.

If you score 2:

You are unlikely to need to shield yourself. You should practise very careful social distancing. If you are unsure whether you fall in this category, you can contact your rheumatology department.

Score of 0 or 1:

You should continue to practise social distancing and self-isolate at your discretion. If you are unsure whether you fall in this category, you can contact your rheumatology department.

Where has this information come from?

The British Society for Rheumatology developed this risk scoring guide and shared it with rheumatology teams across the country. We have worked with the British Society for Rheumatology to develop this information.

What should I do now?

If you have read this and think you might be in the ‘extremely vulnerable’ group, register for support now. You should stay at home at all times and avoid any face-to-face contact at all except with people who provide you with essential support for at least 12 weeks. Do not make any changes to your medication without discussing with your rheumatology department.

You can find out more about the provisions for people who are ‘extremely vulnerable’ from COVID-19 by visiting the gov.uk website.

If you think you do not need to shield, you can protect yourself and others by being very careful about social distancing and you can still self-isolate, if you wish to. This is the best way to stay safe if you have a long-term condition. 

If you are unsure about your level of risk, please contact your rheumatology team.