What is classed as severe?

[EvieJo]

Hi all, is there any current guidelines for what is considered severe asthma for the purposes of shielding?

I’m asking because work are saying I should be shielding because I was before but I’m no longer on oral steroids and not even sure I’d meet the criteria anymore.

I understand shielding is not compulsory and as I’ve pointed out at work, I’ve already been redeployed to an area where I can work alone mostly so I consider myself to be safe as possible regardless. I just wanted to know what the current ‘criteria’ is for sheilding with asthma as it changed a lot from what they were saying at the start.

Many thanks

[Claire-Rose]

I am classed as clinically extremely vulnerable with severe asthma and received and email and text so I think you will be contacted if you are in that category also I heard people fit in to that category if they are on continuous amounts of steroids or have had 4 courses in a year. It also depends on the medication you take if you are on a high dose steroid inhaler for example fostair 200/6 and /or on biologic treatments then you will also fit this category

[Wheezycat in reply to Claire-Rose]

No, the Fostair alone doesn’t do it. I am on that, at that dosage, and I did not meet the criteria. I had not been on oral steroids for a while. A year earlier I would have matched the criteria.

[Claire-Rose in reply to Wheezycat]

Really that is crazy especially since I got a steroid card with that inhaler which shows how strong it is and high dose steroids weaken your immune system. Just don’t think it’s fair you have to be on 4 or more lots of steroids or be in and out of hospital. Some people don’t like to go to their Gp or hospital they like to just manage it at home doesn’t mean they are not clinically extremely vulnerable

[Wheezycat in reply to Claire-Rose]

Sorry, I have only just seen this response. I missed it earlier. You have a point regarding the system, but as I am retired it didn’t make much of a difference. During the first lockdown it got difficult at one point to get hold of food, but that was resolved. He difficulty was due to many of our main stores would only, at one point, accept those who were on that list, and I wasn’t prepared to go to shops just then (nor am I now.)Re steroid card, when this was first flagged up I asked at my pharmacy, but they said it wasn’t needed for Fostair 200/6. I have since heard that I should have (?), but also that they are now sent out from a central point (?), so I am just waiting to see what happens.

It has to be said I have been on an extended good period - long may it last!

[twinkly29]

Severe asthma for shielding seems to have a different level or criteria to actual diagnosed by a hospital severe asthma. That sounds confusing I know. My first thought though is it's not up to work to decide!

[twinkly29]

Also maybe see if you can discuss with GP, letting them know the redeployment bits etc and hopefully they'll give you a sensible answer?

[EmmaF91 Community Ambassador]

NICE (and i think the Gov) are using this description for severe asthma

“asthma that requires treatment with high-dose inhaled corticosteroids plus a second controller (and/or systemic corticosteroids) to prevent it from becoming 'uncontrolled', or which remains 'uncontrolled' despite this therapy.” (European Respiratory Society and American Thoracic Society definitions)

There’s usually a stipulation of 2+ steroid courses in a year also.

Hope this helps

[Poobah]

I've received the second lockdown shielding letter and I'm on Fostair 200/6, a LAMA inhaler & Montelukast. I've only had one course of oral steroids in the last 12 months. I'm no longer under the hospital consultant. I must admit I was surprised to get the second letter.

[Norfolkcatlady]

I shielded earlier in the year and was told I'd remain on the shielding list when it ended. Although I know people who've received an email this time I haven't and no shielders I know seem to have received a letter. My asthma is really bad at the moment, I'm on my second lot of steroids in a month and I work at a school so I've been told by my asthma nurse that I must stay at home for lockdown. Everything seems to be really confusing this time. No one really seems to know what we should be doing!

[ninelives in reply to Norfolkcatlady]

Bless you.I haven't received a text message and only got my shielding letter this morning (Tuesday) perhaps your is in the post?.

Good luck.

[Norfolkcatlady in reply to ninelives]

Still no letter in the post this morning. Just going to follow my GP and asthma nurse's advice. Obviously Matt Hannock doesn't love me enough to contact me anymore! 💔🤣

[EvieJo]

Not surprising it’s a bit hit and miss again - you would think it would be a bit clearer second time around. I’ve not had letter this time round despite being on the highest dose of steroid inhaler and long acting BA, montelukast and 4 courses of pred in last 6 months.

I’m not particularly bothered as I’m staying at work this time anyway - only because I’m able to work mostly in isolation so I don’t feel that vulnerable. Would prob feel differently if this weren’t the case, in which case I would need the email/letter for work 🙄

[Claire-Rose in reply to EvieJo]

Sounds like you should have definetly received the shielding letter or email

[Nutzs47]

I’m on fostair 100/6,spiriva ,montelukast and fexofenadine and didn’t get to shield last time as app although I’m high risk as I’ve not had any hospital admissions and only had 1course of preds it’s classed as well managed at primary care level

[Claire-Rose in reply to Nutzs47]

I think the fostair needs to be 200/6 for you to need to shield or/and have needed 4 or more courses of pred

[Laurenhulk90]

I'm also unsure!

I only found out about my asthma diagnosis 7 weeks ago, so it's all so new to me.

I'm on 200/6, montelukast, Spiriva and have been on 40mg Pred since end of September - i'm not expected to be off them anytime soon.

Because i wasnt on the list first time round as its a new diagnosis, i'm assuming i wont be on the list this time!

No idea what i should be doing - my GP surgery havent been helpful!!

[dicof]

I don’t understand how they decide. I’m on montelukast, Fostair 200/6 , a second high dose steroid inhaler-ciclesonide, 640mgs a day, which helped replace the oral steroids, as I’d been on them for 4 of the last 6 months, (but only 3 actual courses, just very long ones-which is why the number of courses is rather meaningless) . I was advised to shield last time round, but have heard nothing this time- I thought it was because the criteria must have changed as asthma is now recognised not to be as high a risk as thought first time round, compared to other health issues, or age.In fact I’ve read that trials have been done giving steroid inhalers to people with COVID pneumonia, and found that has helped! I wonder whether if we have a slightly suppressed immune system we may be at higher risk of catching it, but unlikely to be any more ill with it than other people? Perhaps? I’m hoping so!