Update: Coronavirus Covid-19 and people with conditions affecting the gastro-intestinal system

25th March 2020

Everyone in the UK should adhere to guidance by the NHS. This now includes:

Stay at home to stop coronavirus spreading. Everyone must stay at home to help stop the spread of coronavirus.

This includes people of all ages – even if you do not have any symptoms or other health conditions.

You can only leave your home:

  • to shop for basic essentials – only when you really need to
  • to do one form of exercise a day – such as a run, walk or cycle, alone or with other people you live with
  • for any medical need – for example, to visit a pharmacy or deliver essential supplies to a vulnerable person
  • to travel to and from work – but only where this is absolutely necessary

Do:

  • wash your hands with soap and water often – do this for at least 20 seconds
  • always wash your hands when you get home or into work
  • use hand sanitiser gel if soap and water are not available
  • cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
  • put used tissues in the bin straight away and wash your hands afterwards
  • try to avoid close contact with people who are unwell

Don’t:

  • do not touch your eyes, nose or mouth if your hands are not clean

Patients at high risk of severe illness with Covid-19:

Further information can be found on the government website.

This includes advice for “shielding” for those deemed extremely vulnerable.

People falling into this extremely vulnerable group include:

  1. Solid organ transplant recipients.
  2. People with specific cancers:
    • people with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
    • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
    • people having immunotherapy or other continuing antibody treatments for cancer
    • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
    • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD.
  4. People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell).
  5. People on immunosuppression therapies sufficient to significantly increase risk of infection.
  6. Women who are pregnant with significant heart disease, congenital or acquired.

For these individuals the main implications of shielding, in addition to the “Stay at Home” policy that affects all, are that people in this category should not leave their homes even for shopping and that this is currently expected to continue for 12 weeks.

For other chronic conditions affecting the intestine, pancreas or liver and not specifically covered above:

Regarding other chronic conditions, not listed above and affecting the intestine, pancreas or liver there is little evidence that the conditions themselves affect risk for severe Covid-19 illness unless the affected individual has some other medical problem such as diabetes or hypertension. It is possible though that immunosuppressive treatments for these conditions, including those for Crohn’s disease, ulcerative colitis or auto-immune hepatitis, might in some cases increase the risk of complications if infected. The relevant specialist societies (including British Society of Gastroenterology and British Association for Study of the Liver) have identified categories of risk according to the nature of the immunosuppressive therapy.

People in the highest risk categories are advised to “shield”.  Some people may also be receiving texts from the Department of Health advising shielding if they are on the annual “flu” vaccine call-up list.

Other advice for patients receiving immunosuppression:

If you are taking such medications (oral corticosteroids/prednisolone, azathioprine, mercaptopurine, methotrexate, new injected biologics such as infliximab, adalimumab, golimumab, ustekinumab, vedolizumab, tofacitinib) and think you may be infected you should seek medical advice with your specialist team by telephone. The risks of stopping or altering medication will vary considerably from patient to patient and you should not change your therapy without consulting a doctor. There is some “expert-based opinion” available and you might wish to look at the IOIBD website, which is completely independent of Guts UK.

Advice for patients with other chronic conditions affecting the intestine, liver or pancreas:

The main risks for serious Covid-19 illness are age >70, hypertension, and diabetes. Unless you are receiving immunosuppressive drugs or corticosteroids (prednisolone) for inflammatory bowel disease or auto-immune liver disease (see above) other chronic gastroenterology conditions such as reflux oesophagitis, achalasia, irritable bowel syndrome, and diverticulitis would not be expected to carry any increased risk for severe Covid-19. Chronic pancreatitis may be complicated by diabetes which is a risk for more severe Covid-19 but we are aware of no evidence to date that chronic pancreatitis uncomplicated by diabetes carries increased risk.

The team at Guts UK want to send you our best wishes in these uncertain times. We want to reassure you, our community, that we’re still here to help, we may just take a little longer to return your calls and reply to your emails. Thank you all for your understanding and kind messages so far, stay safe and #stayathome

– The Team at Guts UK

FURTHER INFORMATION:

ABOUT US:

Guts UK’s vision is of a world where digestive diseases are better understood, better treated and where everyone who lives with one gets the support they need. We fund life-saving research into diseases of the gut, liver and pancreas.

Champion our cause; help us fight digestive diseases and change the lives of millions of people in the UK by supporting our work today.

Read more posts...

Your Comments: Mental Health Awareness Week

Digestive symptoms and conditions can have a real impact upon every-day life, that our community sometimes find others can underestimate. Managing pain, being unable to predict symptoms from day-to-day and anxiety surrounding accessing near-by toilet...

22nd May 2020

Mental Health Awareness & Digestive Diseases

Mental Health Awareness Week 2020 falls at a challenging time for many across the globe. The team at Guts UK recognise the impact that digestive diseases can have on your mental health, and this week...

20th May 2020

World IBD Day

On World IBD Day every year, patient organisations come together from all over the globe to raise awareness of Crohn’s disease & Colitis. Guts UK is proud to fund over 10 current active research projects into...

19th May 2020

Eosinophilic Awareness Week 2020

This week, Guts UK wants to raise awareness, encourage collaboration and research into eosinophilic diseases. What are Eosinophilic Diseases? Eosinophilic Diseases (pronounced ee-oh-sin-oh-fil-ik) that affect the gut are identified by the presence of a type...

18th May 2020

World Barrett’s Day

Guts UK is one of the many worldwide charities collaborating to raise awareness of Barrett’s oesophagus for the first ever World Barrett’s Day – 16th May 2020. What is Barrett’s oesophagus? Around 10% of persistent...

16th May 2020

Coeliac Awareness Week – Lockdown as a Coeliac Dietitian

Cristian Costas, coeliac dietitian shares his experience supporting patients with coeliac disease during these challenging times. What was your role before lockdown and COVID-19? I was running the dietetic-led coeliac service at Bradford Teaching Hospitals...

12th May 2020

Cancer Treatment & Covid-19

On Monday, the Health Secretary announced that hospitals are now restarting vital services including cancer care. An important part of our work at Guts UK is campaigning, raising awareness and calling for more research into...

29th April 2020

Creon 25k – Potential Short Term Stock Issues

Guts UK is the only UK charity funding a research fellowship into pancreatitis. Pancreatitis is a priority for our charity, so each November we’re proud to run a month-long Kranky Panky Pancreatitis Awareness Campaign. We...

22nd April 2020

Vitamin D Supplements & Covid19

Vitamin D levels tend to be low in people living in Northern Europe during winter months. Vitamin D is synthesised in the skin by the action of ultraviolet in sunlight. Although it is also present...

26th March 2020

World Digestive Health Day 2020

Happy World Digestive Health Day! Today is a much awaited day on the Guts UK calendar. Guts UK is the only UK charity funding research into the digestive system from top to tail; the gut,...

29th May 2020