$0$0$0Coronavirus risk level advice for PID patients$0$0$0$0Understanding your risk$0$0Knowing your risk level will allow you to manage your risk and make decisions about going about your daily life. $0$0Based on a consensus view from immunology specialists, PID patients have been classified into three risk groups:$0$01.     An extremely vulnerable group (highest at-risk group)$02.     Moderate risk group$03.     Lower risk group with risk equivalent to or only marginally higher than that of the general population$0$0The guidance on who falls into which group is available at: https://www.ukpin.org.uk/docs/default-source/default-document-library/ukpin_risk_stratification_covid19_finalac6baa9cd4eb6fe9b40eff00005026c1.pdf $0$0$0$0$0$0Shielding advice has not currently been issued (July 2021) but it is important in magnaging risk that you should check and confirm the category that you, or your child are in.$0$0For many people, it may not be the PID but co-morbidities that define their risk.$0$0$0$0What are co-morbidities?$0$0A co-morbidity is any other diagnosis that reduces the overall wellbeing of an individual.$0$0$0$0What are the important co-morbidities in COVID-19?$0$0$0Over 70 years of age$0$0Diabetes mellitus$0$0Any ‘significant’ pre-existing lung disease$0$0Impaired kidney function$0$0History of heart disease (heart failure, angina or heart attack)$0$0Uncontrolled hypertension$0$0Chronic liver disease$0$0$0$0$0What is ‘significant’ lung disease’?$0$0Significant or severe lung disease (bronchiectasis or COPD) encompasses:$0$0$0People who use nebulised treatments.$0$0$0$0Everyone who has severe or very severe airflow obstruction. This is measured using a breathing test called spirometry,where you blow out as hard as you can. If the amount of air you canblow out in one second is less than 50% of the normal range of values,then airflow obstruction is classed as severe. Severe or very severeairflow obstruction is sometimes described as GOLD grade 3 or GOLD grade4.$0$0$0$0People who are limited by breathlessness – this meansthat you can’t walk as fast as other people of your age owing tobreathlessness. This may be described in clinic letters as an MRC breathlessness score of 3, 4 or 5.
$0$0$0$0People who have had to be admitted to hospital in the past because of an acute attack of the lung condition.
 $0$0$0$0People who have had two or more exacerbations or flare-ups in the past year that needed emergency treatment with steroids or antibiotics from the GP or hospital.
$0$0$0$0People who are on regular steroid tablets, called prednisolone, to treat their condition.
 $0$0$0$0People who have oxygen therapy at home.
 $0$0People who use non-invasive ventilation at home – using a mask connected to a ventilator, sometimes called BiPAP, to support their breathing at night.$0$0$0 $0$0 $0$0Keep up to date$0$0It is important for the whole of society to keep themselves informed.Everyone should follow the general advice given by the Government.$0$0https://www.nhs.uk/conditions/coronavirus-covid-19/$0$0$0$0Frequently asked questions$0$0$0$0$0$0$0$0$0$0$0$0$0$0How is COVID-19 spread?$0$0$0$0The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets.$0$0$0$0Reducing the chance of infection and transmission$0$0$0$0Since droplets spread the virus, good hand hygiene is the top priority in preventing transmission of COVID-19, like most respiratory viruses.  When out and about, alcohol-based hand-gel can be used to sanitise your hands.  Washing your hands, thoroughly and frequently, with soap and water throughout the day will also help reduce the chance of infection. Wear a mask. Keep your distance from other people. HANDS, FACE, SPACE are good rules to follow. $0$0$0$0$0$0Am I specifically at risk with my immune deficiency?$0$0Having many immune problems does not specifically predispose you to increased risk of acquiring this type of viral infection; the risk comes from being exposed to it.$0$0$0$0Are PID adults or children at greater risk of becoming very sick?$0$0$0$0As indicated by the advice above specific PID conditions and major health problems as a consequence of PID, or as well as PID, are the major risk factors alongside increasing age.$0$0$0$0$0$0I think I have COVID-19, what do I do?$0$0$0$0Stay calm; the majority of people do not have severe disease.  Maintain household hygiene measures to protect those around you but isolate yourself as much as possible.$0$0Check your symptoms on 111.NHS.UK/Covid-19 or NHS24 service, if in Scotland, for the latest advice.$0$0For most patients who are following basic measures of rehydration and medicine to lower temperature and who are improving, no further action will be necessary.  If you are not getting better check again with NHS111/24 and then contact your PID centre to see if they need to provide more specific advice.$0$0$0$0I have a PID and think a household member has COVID-19, what do I do?$0$0$0$0Stay calm; the majority of people do not have severe disease.  Maintain household hygiene measures to protect the person with a PID.  The current advice is to manage the person at risk somewhere else if possible (e.g. they go to a family member).  Where this is not possible e.g. a child with PID looked after by a parent with COVID-19, then minimising contact as much as possible, ensuring hand and household hygiene are key.$0$0Check 111.NHS.UK/Covid-19 or NHS24 for the latest advice.$0$0If your family member is not getting better contact NHS111/NHS24 and follow their advice.$0$0$0$0I think I have COVID-19 can I go to my Immunologist for review?$0$0$0$0Access online 111.NHS.UK or NHS24 and follow their advice. Contact your immunology centre by phone to update them if you are not getting better. Hospitals now have specific arrangements for receiving patients with suspected COVID-19 and these are outlined on NHS 111/24.  You should not be attending your immunology centre with suspected COVID-19.$0$0This advice was updated July 2021.$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0