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Clinically extremely vulnerable or at risk from coronavirus

Updated guidance

Guidance for Islanders at high risk of serious illness from COVID-19 has been updated. This is in light of lowered active cases of COVID-19 in Jersey currently and the vaccination programme status.

Although we currently have a low number of known active cases of COVID-10, everyone should continue to follow Public Health guidance. This is particularly important for those at higher risk. 

Vaccination

You can book a vaccination appointment if you're:

You must bring your letter from the vaccination team to your appointment if you're clinically at risk or clinically extremely vulnerable.

Book your vaccination appointment

Clinically extremely vulnerable (high risk/ severely vulnerable)

If you are in one of the categories below, you should have received a letter from your GP or specialist doctor explaining that you are considered at high risk of severe illness as a result of COVID-19 and more likely to need hospital treatment if you're infected. If after looking at this list, you feel you fall within the high risk category, but have not received a letter, contact your local GP surgery and ask for further advice.

Factors that mean someone is at high risk (severely vulnerable) are:

  • solid organ transplant recipients
  • people with specific cancers or receiving certain cancer treatments:
  • people with cancer who are undergoing active chemotherapy
  • people with lung cancer who are undergoing radical radiotherapy
  • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
  • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
  • people having immunotherapy or other continuing antibody treatments for cancer
  • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
  • people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection
  • women who are pregnant with significant heart disease, congenital or acquired
  • adults with Down's Syndrome
  • adults with kidney dialysis or stage 5 kidney disease

Clinically at risk (moderate risk/vulnerable)

For people of older ages, and for people with certain medical conditions, there are additional risks if you become infected with COVID-19. Factors that put someone in the moderate risk (vulnerable) category include:

  • people with less severe respiratory conditions, including: Individuals with a severe lung conditions, including those with asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission, and chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema; bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD). 
  • people with chronic heart disease, such as heart failure, including: Congenital heart disease, hypertension with cardiac complications, chronic heart failure, individuals requiring regular medication and/or follow-up for ischaemic heart disease. This includes individuals with atrial fibrillation, peripheral vascular disease or a history of venous thromboembolism. 
  • people with chronic kidney disease, such as kidney failure (stage 3 or 4)
  • people with chronic liver disease, such as hepatitis, Cirrhosis and biliary atresia
  • stroke, transient ischemic attack (TIA). Conditions in which respiratory function may be compromised due to neurological disease (e.g. polio syndrome sufferers). This includes individuals with cerebral palsy, severe or profound learning disabilities, multiple sclerosis, epilepsy, dementia, Parkinson’s disease, motor neurone disease and related or similar conditions; or hereditary and degenerative disease of the nervous system or muscles; or severe neurological disability.
  • any diabetes, including diet-controlled diabetes
  • HIV infection at all stages
  • anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma and those with systemic lupus erythematosus and rheumatoid arthritis, and psoriasis who may require long term immunosuppressive treatments
  • individuals being treated with systemic steroids for more than a month 
  • individuals who are receiving immunosuppressive or immunomodulating biological therapy including: but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid sparing agents such as cyclophosphamide and mycophenolate mofetil.
  • all bone marrow or stem cell transplant recipients
  • people with problems with their spleen, for example, if you have sickle cell disease or have had your spleen removed dysfunction of the spleen: This also includes conditions that may lead to splenic dysfunction, such as homozygous sickle cell disease, thalassemia major and coeliac syndrome
  • people who are seriously overweight (a body mass index (BMI) of 40 or above)
  • severe mental illness: Individuals with schizophrenia or bipolar disorder, or any mental illness that causes severe functional impairment.
  • adult carers: Those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill
  • younger adults in long-stay nursing and residential care settings 

The way people are affected by the virus varies largely across different individuals. In terms of age, the impact will likely be most linked to level of frailty, strength of immunity and the presence of underlying conditions and ill-health, rather than a person's exact age as a number alone. Individuals should see the risk as higher the older they are, but also be aware that this can vary from person to person.

Higher and lower risk activities

The below guidance sets out the principles that determine whether an activity is higher or lower risk. These principles also apply to children and young people who are at higher risk.

​Higher risk activity ​Lower risk activity
​Activities with people you don't live with are higher risk. The larger the number of different people you encounter and spend time with, the higher the risk. Larger gatherings and events are higher risk.
​Activities done on your own or with people you live with are lower risk. If you're going to spend time with people you don't live with, the smaller the number of people, the lower the risk.
​Activities where you may be less able to follow physical distancing guidance are higher risk.

This becomes higher risk still if the time spent not following physical distancing guidance is longer than 15 minutes.

​Activities where you can follow physical distancing guidelines are lower risk.

If you can't follow physical distancing guidance, the risk is lowered if the time spent not physically distancing is limited to less than 15 minutes.

​Not wearing a face mask increases risk, especially when you can't follow physical distancing.
​Wearing a face mask reduces risk, especially when you can't follow physical distancing.
​Activities that are indoors are higher risk. ​Activities that are outdoors are lower risk.
​Activities associated with increased production of respiratory droplets, such as singing, shouting, coughing or breathing heavily are higher risk, when done amongst a group of people.​Activities associated with less respiratory droplet production, such as normal speech, are lower risk.
​Activities where you will have to touch surfaces or items that people you don't live with have also touched, are higher risk.

This risk is lowered when you follow good hand hygiene guidance such as washing your hands frequently with soap and water for 20 seconds or using hand sanitiser (with 60 to 70% alcohol content).

​Activities where you won't have to touch surfaces or items that people you don't live with have also touched, are lower risk.

Following good hand hygiene guidance, such as washing your hands frequently with soap and water for 20 seconds, or using hand sanitiser (with 60 to 70% alcohol content) further lowers risk.

Activity guidance

Education and childcare

Children and young people at high and moderate risk are encouraged to attend school, and other daily activities where public health guidance can be followed. Children at higher risk should be cautious to follow public health guidance while they are at school, where they are able to understand and follow this. 

Indoor activities outside the home

Those at high or moderate risk are encouraged to make personal, risk-informed decisions regarding indoor activities where they may mix with those outside of their household, such as attending a workplace, visiting a pub or restaurant, going shopping, or using a gym.

These decisions may involve consideration of personal and medical circumstances, advice from a GP, and the many health and wellbeing benefits that returning to daily life and routine will have.

Travel

Many countries do not have the low levels of COVID-19 that Jersey currently has. Those at high and moderate risk are encouraged to make careful decisions about travel off-island, balancing the need to visit friends and relatives, with the risks of travel to places where there is increased risk. Appropriate travel insurance should be secured.
Public transport on-island should be avoided wherever possible, as it may be more difficult to practice physical distancing.

Car-sharing with those from different households should also be avoided, unless with a small and consistent group of close family and friends. Where these activities are unavoidable, it’s even more important to follow public health prevention measures, such as using hand sanitiser and wearing a mask. 

Visitors and carers in your home

If you are at high or moderate risk, any essential care or services delivered in your home should continue. It remains safer to limit the number of people visiting your home, and to limit visiting the homes of others, unless it is those of a small and consistent group of close family and friends.

Any visitors should be careful to follow public health information and advice, such as washing their hands when they enter your home and frequently thereafter and should stay away if they have any symptoms of COVID-19. It’s also recommended that visitors wear a mask when inside your home. If you visit the home of someone else, following these same principles will also help reduce risk.

Health and dental care

Islanders at high risk and moderate risk should attend any medical appointments they have and seek medical advice and support where needed, whether this is COVID-19 related or not. Those at higher risk should not avoid seeking treatment because of COVID-19.

Support and resources

There is support available to you through ‘Connect Me’ for your mental and emotional wellbeing, family concerns, or practical needs.

To find out what support is available you can:

  • visit the Connect Me webpage
  • phone the helpline and ask for 'Connect Me'
  • call your Parish Hall and ask about 'Connect Me'

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