Shielding and Bronchiectasis

[Balsam]

Re the Living Risk Prediction Algorithm QCOVID published BMJ. States that Non-Cystic Fibrosis Bronchiectasis is on Shielding List.

[Hidden]

It’s been on the official shielding list from the outset, but as with asthma and COPD, only if it’s classed as severe.

[Balsam in reply to Hidden]

Where is this written down, please. That severe Bronchiectasis is a shielding condition?

[Hidden in reply to Balsam]

In the NHS list of conditions. I have bronch and have been on the shielding list since the beginning.

[Balsam in reply to Hidden]

Thank you

[Hidden in reply to Balsam]

As per LP’s reply: the NHS guidance lists it, and the government CEV and shielding advice as available at gov.uk has always referenced severe bronchiectasis as grounds to shield, as does chapter 9 of the JCVI green book, which is available online via google. What exactly is meant by severe is a little more woolly and open to interpretation, particularly if you have advancing age as a factor or other non-respiratory comorbidities that might turn mild NCFBE into a need to shield when a person’s situation as whole is taken into consideration, but I believe the BLF have some information on what constitutes severe available on their website.

[Balsam in reply to Hidden]

Thank you

[Greenfingers20 in reply to Hidden]

Mine is mild but GP put me on extremely vulnerable for my peace of mind-and online shopping !

[Hidden]

In addition to what Charlie has said, a combination of health issues with individuals who have more than one or several health issues mentioned on the at risk group list.

You may find all the information regarding this here: (updated 16 Feb 2021)

COVID-19: guidance on shielding and protecting people defined on medical grounds as extremely vulnerable

Information for shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19.

gov.uk/government/publicati...

[Balsam in reply to Hidden]

Thank you

[Bronchi1]

No shielding in Scotland currently but I'm doing it all the same!

[teddyd]

I have asthma and bronchietasis. My GP phoned me the week before shielding even started to tell me to shield and that I would receive a letter to confirm it. I just presumed that everyone with bronchietasis was told to shield.

[Dotdashdito]

Hi I live in Scotland East Ren have bronc which is described by the specialist as minor. I do however have a lot of flare ups and was on the shielding list. I hope that helps

[Mooka]

blf.org.uk/support-for-you/...

This is from the BLF site. It lists their criteria for severe Bronchiectasis. I hope that helps.

[Rattle in reply to Mooka]

Thanks! That is excellent information and very up to date too (from Feb 25th)

[Ju10]

Hi I have bronchiectasis asthma and possible copd I have had no shielding letter and I have waited more or less to my age group and I am going in older group

[Carnival567]

When I was diagnosed with bronchiectasis 12 years ago the consultant told me to keep away from people with colds etc. If that’s what I had to do then seems sensible to do now, especially as I have other severe comorbidities. Even without a letter it would be sensible to shield unless you have to go out to work, in which case you should consult with your GP. Good luck x

[Izb1]

I am classed as having mild bronchiectasis along with rhuematoid arthritis and havent been put on the shielding list, even though my rheumy people have said being on methotrexate puts me at risk from infections as my immune system is compromised. My gp has taken the rescue meds of me now as they are only given to severe cases and I am not severe . I have been shielding since this all began and only go out when i have to and think this is sensible. I have had my covid jab a couple of weeks ago and wonder if I was offered this due to age, rather than condition.

[Hidden in reply to Izb1]

I have inflammatory arthritis myself (likely PsA), and mtx isn’t actually a reason to shield: rheum criteria are a points system where 3 points or more makes you CEV, as per the table below. Hydroxy and sulfa aren’t considered a risk, but all other DMARDS (including biologics and anti-tnf) are awarded one point each. Steroids are considered a major risk, as is cyclosphosphamide, but otherwise it boils down to how many meds you’re on excluding the two mentioned above, plus any other comorbidity. I’m CEV on the grounds that I take mtx and lef, alongside having another non-rheum issue that gives me my third point. Interestingly, whilst mtx does of course increase the general risk of infections, they think that it may be protective in rheum patients that get covid, as the immunosuppressive factor may reduce the risk/likelihood of a cytokine storm. A cytokine storm is essentially the immune system over-reacting to something and what causes really severe illness, so suppressing the immune system reduces the risk of that happening. I haven’t looked into it, but I’m guessing that could be partly why the RA drug tocilizumab has been found to save lives in severe covid.

As for the bronch bit, even if you’re not severe, I would argue removing your access to rescue meds is not appropriate. Are you under a respiratory team? If so, I would contact them and ask for their advice, and for that advice to be passed via letter to your GP. I quite routinely have to ask my Endo to write to my GP about stuff they won’t take on my say so but that is absolutely clinically correct 🙄 The good news though is that you have had your vaccine, even if the why you got it was your age, and like you say, shielding or not, only going out when you have to is sensible advice plenty of other people could do with following!

[Izb1 in reply to Hidden]

Thanks for that Charlie. I tried the hydroxy with the metho and baricitinib, both not suitable. My respiratory consultant discharged me last year saying there was nothing further he could do for me, so as I have found with most things, I am left to get on with things myself, which I am happy to do for the moment. If things weren't so bad with covid I would insist on a referral but will wait until things calm down and I am able to use public transport safely x