Clinically vulnerable - c'est moi! I think. - NRAS

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Clinically vulnerable - c'est moi! I think.

dawkin_S profile image
30 Replies

Evening all! Spent some time going through some of the swathe of government info that's just come out. By the looks of things, if we're not in the 'clinically extremely vulnerable' group (people who should be shielding), most of us would be in the category of 'clinically vulnerable'. The definition of this is back to the very first info we got - ie, people who qualify for a flu jab every year on medical grounds: gov.uk/government/publicati...

In my field of work (patisserie/bakery, operating take-away only at present) guidance is as follows:

"If clinically vulnerable.... individuals cannot work from home, they should be offered the option of the safest available on site roles, enabling them to stay 2m away from others. If they have to spend time within 2m of others, you should carefully assess whether this involves an acceptable level of risk."

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dawkin_S profile image
dawkin_S
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30 Replies
Lolabridge profile image
Lolabridge

Well done for taking the trouble to wade through the detail. It would be good for a fellow vulnerable person to agree that’s how they understand it too.

dawkin_S profile image
dawkin_S in reply to Lolabridge

Yes, definitely! I am very willing to be corrected - it's still a bit confusing to me. :)

helixhelix profile image
helixhelix

I still don’t think there is a definitive list. But it doesn’t seem as if RA is on the list of diseases that automatically tip you into clinically extremely vulnerable, and age doesn’t count. So the bit of the guidance that is most relevant is:

People on immunosuppression therapies sufficient to significantly increase risk of infection.

Which I think would be steroids + at least two other immune suppressing drugs. That’s the bit I can’t quite fathom as the English guidance doesn’t go into detail. And diabetes and heart conditions are also not in the extremely vulnerable/shielding list.

Here’s the guidance again. gov.uk/government/publicati...

cathie profile image
cathie in reply to helixhelix

Remember there are different guidelines in different parts of uk. People on biologics are sent a shielding letter.

Peejay64 profile image
Peejay64 in reply to cathie

Not all Cathie ...I haven’t received a letter even though have Asthma, RA on MTX and Biologic. So using common sense ... 🤷‍♀️

in reply to Peejay64

It’s all very contradictory. When I need an appointment at the doctors or hospital they say you can’t have a face to face appointment as your vulnerable and they say not to go back to work BUT the chart guidelines from the same health authority say I’m high risk . The government texts say I’m vulnerable 🤷‍♀️🤷‍♀️

Peejay64 profile image
Peejay64 in reply to

I reckon most of us know where we would put ourselves on the ‘risk’ ladder... it’s all the different ‘agencies/organisations’ who seem confused🙄

Cheylann profile image
Cheylann in reply to

Of course its very confusing. No ones fault as government have never dealt with anything of this magnitude so no one really knows. Common sense!

cathie profile image
cathie in reply to Peejay64

I suppose that’s all you can do but it’s not good. It seems to vary enormously across the uk.

Tinat3 profile image
Tinat3 in reply to cathie

Very confusing. I am on Leflunomide plus a biologic and I haven't received anything to say that I should be shielding x

Cheylann profile image
Cheylann in reply to Tinat3

Do what's right for you. You don't need a letter.

in reply to Cheylann

You need proof if your working

Cheylann profile image
Cheylann in reply to

Well if you are really at so much more risk than others then easy enough to get proof. I'm not sure why everyone who takes immuno suppressants fro arthritis think they are so vulnerable. They are only slightly immune suppressed as the doses are relatively low.

Different if you have other health issues as well.

Neonkittie17 profile image
Neonkittie17 in reply to cathie

On Rituximab and Methotrexate and no shielding letter received here. Doing it anyhow as I have regular chest infections.

cathie profile image
cathie in reply to Neonkittie17

I’m in edinburgh and in rituximab + leflunomide and had a shielding letter. Take care

helixhelix profile image
helixhelix in reply to cathie

This is the deconfinement guidance, not the shielding guidance - but Scotland has rejected it to

Mmrr profile image
Mmrr in reply to helixhelix

20mgs prednisolone or more a day is enough to shield without a biologic in Scotland.

Dreamer85 profile image
Dreamer85

I'm on mtx & leuflunomide classed as high risk and worried about the return to work. My mum in law cut out a question from the paper & a doc has answered about mtx and said it's a powerful immune suppressant and those taking it are ultra high risk and should be shielded 🤷‍♀️ seems different in different areas. Xx

AgedCrone profile image
AgedCrone in reply to Dreamer85

He was probably talking about the methotrexate dose given to cancer patients ....the dose we take up to 25 mg a week is not a powerful dose...however combined with age & a Biologic drug these patients are told to self isolate.

Dreamer85 profile image
Dreamer85 in reply to AgedCrone

It was a 60 year old lady with psoriatic arthritis taking 20mg per week mtx who was told to shield.

I suppose all doctors will differ in opinions too.

AgedCrone profile image
AgedCrone in reply to Dreamer85

Only the doctor treating the patient concerned knows how vulnerable that person should be classed ......it depends on a whole lot more that what pills are being swallowed!

Cheylann profile image
Cheylann in reply to Dreamer85

Not the doses we take for RA. The doses for cancer completely wipe out the immunity.

dawkin_S profile image
dawkin_S

I wasn't actually looking to define the shielding group, as that doesn't apply to me personally as I know I am not 'clinically extremely vulnerable' (i.e. need to shield) as I am only on methotrexate and hydroxychloroquine, but I don't think I'm normal/average level of risk due to RA and methotrexate. Of course, I appreciate that many of you are higher risk and have more to consider on that front than I do.

This was the first new mention of an in-between category (clinically vulnerable) that I had seen in a government document, with some explanation of what that means in terms of returning to work. I've been being sensible and staying in so far, but obviously if my boss (who has been very good by the way) wants me off furlough and back to work, I need to know where I stand and be able to explain/show that to him in official terms too.

Dreamer85 profile image
Dreamer85 in reply to dawkin_S

I'm the same due back to work soon and would like to know where I stand. Waiting for a response from my doctors.

I took holidays before the furlough scheme came in because I was worried about being in work. X

dawkin_S profile image
dawkin_S in reply to Dreamer85

To be honest, I'd really like to get back to work because I enjoy it and I'm missing it, but obviously only if it's safe for me - well, as safe as anything can be nowadays!

Dreamer85 profile image
Dreamer85 in reply to dawkin_S

My doctor replied and said I shouldn't be working with the public/ customers and if I have to wear ppe. I'm a receptionist at a small opticians.

medway-lady profile image
medway-lady

My text and letters all say extremely vulnerable but I've always known it was due to the CKD and not RA. As the Kidney information is clearer but then I suppose its because of the need to dialysis a lot of those in the ICU as my function is 24% not much to loose. The letter from the Renal Unit was clear and concise stay in ! and the advice has not changed yet.

helixhelix profile image
helixhelix

There's a piece in papers today which confirms what I thought. Ie this new document from Gov't has very different definition that the flow charts etc we've been looking at previously

theguardian.com/world/2020/...

Dreamer85 profile image
Dreamer85 in reply to helixhelix

Thankyou for sharing!

cathie profile image
cathie

Just sharing my experience, Im in Edinburgh, so Scottish rules apply. I'm over 70, have diabetes, RA (take rituximab + leflunomode) and have asthma. I got a shielding letter, and was also asked to talk to my GP on phone to sort a few things out - what would happen if I became v ill with the virus. He told me that while I was seen as vulnerable he didn't think I was frail vulnerable so not to worry unduly - but to keep shielding. I've also just spoken to the dentist who also said that they're only doing extractions in the most extreme circumstances for people in my category. I was offered a weekly food parcel by the Scottish government too, which I didn't need as have lovely neighbours and a daughter nearby.

I'm oK about being inside, but do have access to a wee garden which helps. Keep well

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