Coronavirus (COVID-19)

Current on: Friday 27th March 

Last updated on: Friday 27th March

On this page:

• Shielding advice for very high-risk groups
• Stay at home to stop the spread of coronavirus
• If you develop symptoms of COVID-19
• Make sure you can get what you need
• Manage your asthma well to reduce the risk from coronavirus
• What to do if your asthma is getting worse
• Help if you’re feeling anxious

The coronavirus outbreak is a rapidly developing situation and the most up-to-date information for people in the UK can be found on the NHS website.

Shielding advice for very high-risk groups

The Government has released guidelines for people who are at higher risk of needing critical care if they catch coronavirus because they have a severe respiratory condition, including severe asthma.

Some people have already been sent a letter and texts from the Government asking them to “shield” – this means staying at home for at least 12 weeks and having shopping and medicines delivered. We strongly recommend you follow this guidance if you are in one of the high-risk groups.

Letters are still being sent out. If you think you are at risk, but haven’t had a letter yet, please wait until after 29^th March (or 30th March if you are in Scotland or Wales, and later next week in N. Ireland) to discuss your concerns with your doctor or hospital clinician. In the meantime, you should stay at home and avoid contact with others. The decision to shield is a deeply personal one. We are not able to advise individuals about whether they should shield or not.

We have been contacted by people, including key workers, who are concerned because they are not sure whether they qualify for a shielding letter or not. Doctors have been asked to use their discretion about who needs to start shielding. If your doctor tells you that you aren’t in the shielding group, you may feel frustrated because you won’t be eligible for support or time off work if you can’t work from home. You might still be able to get local support from a mutual aid network. We also suggest you approach your employer directly to discuss your need to shield. The Government advice is that employers must support vulnerable and at-risk workers to protect themselves. This ACAS advice for employees who want to shield may be useful when talking to your employer.  

You can also request Government support for shielding, whether you have been sent a letter or not. 

We understand that the term 'severe asthma' is open to interpretation. Following the Government announcement, the Department of Health and Social Care shared further recommendations about who in the severe asthma group should shield. Our clinical leads used this to develop the advice below. However, your own clinician is ultimately responsible for deciding whether to recommend you shield or not.

We will update this advice if anything changes and we will continue to push for support for people with asthma who need to shield. We will also monitor how all guidance is being implemented to ensure people with asthma are sufficiently protected and supported.

The current high risk groups are adults and children who are taking:

• Any biologic therapy, also called a mAb (Xolair/omalizumab, Nucala/mepolizumab, Cinqaero/reslizumab, Fasenra/benralizumab)
• Steroid tablets or liquid every day
• Antibiotic tablets or liquid for asthma every week (e.g. azithromycin)
• Tiotropium
• A combination inhaler that also contains a long-acting bronchodilator (e.g. Seretide, Fostair, Symbicort) at a high daily steroid dose (speak to your doctor about whether you are on a high dose or not)
• An inhaler with a high daily steroid dose (speak to your doctor if you're not sure if you're on this type of inhaler) AND you are taking Montelukast

Or, if:

• You have been admitted to hospital for your asthma in the last 12 months
• You have ever been admitted to an intensive care unit for your asthma

Then you should follow the shielding advice, which means:

• Stay at home at all times and avoid any face-to-face contact with others for at least 12 weeks.
• Get food, medicines and other essential items delivered, and have the person delivering them leave them at the door. You can ask friends and neighbours to help with this, or use delivery services. If you can’t do this, public services and charities are gearing up to help people who have to stay at home. From Tuesday 24^th March you may be able to register for extra services from Government.
• Use phone or online services to contact your GP or other services if needed.
• Inside your home, minimise all non-essential contact with other people you live with.
• People who provide essential support for you, such as healthcare or support with your daily needs or social care, can still come to your home. But if they have symptoms of COVID-19, they should not come. You should make a plan for how your care needs will be met if your carer becomes ill.
• If you get symptoms of COVID-19, which means a fever or a new continuous cough, use the NHS 111 online coronavirus service or call 111 as soon as you get symptoms. Do not wait for your symptoms to get worse.
• If someone else lives with you, they do not have to follow the shielding guidance. They should follow the social distancing guidance very closely and do what they can to support you with shielding.
• There is more information for people who live with you in the government shielding guidance and we would strongly suggest you read it and apply it as much as you can.

We know that shielding is hard. But we believe it is the best way to protect people who could become very unwell if they get COVID-19.

Stay at home to stop the spread of coronavirus

Everyone now needs to stay at home to slow down the spread of coronavirus. If you have asthma, but are not in the high-risk groups listed above, you can only go out:

• to get essentials like food and medicine, no more than you absolutely need to
• to do a form of exercise once a day
• for any medical need
• to support a vulnerable person
• to go to work, only if it is essential.

Continue to wash your hands often, with soap and water. Don't touch your face if your hands aren't clean. And use tissues to wipe your nose or catch a sneeze, and bin them straight away. 

If you develop symptoms of COVID-19 and you have asthma:

• You need to stay in your home for 7 days if you live on your own, or 14 days if you live with others. Everyone in your household will need to stay in the house for 14 days.
• You don't need to contact 111 to tell them you are staying at home.
• If your COVID-19 symptoms don’t go away after 7 days, or get worse, or you are having difficulty breathing, call 111 for advice, or 999 if you need emergency care.
• Tell them that you have asthma, and if your asthma symptoms are getting worse.
• If you get an asthma cough and are not sure whether your cough is a symptom of COVID-19 or related to your asthma, please speak to your GP, use the online 111 service or call 111 to ensure that you get the right care. 
• Keep following your asthma action plan to manage your asthma and so you know what to do if your asthma symptoms get worse. If you are having an asthma attack, call 999 for an ambulance as usual, and tell them you have COVID-19 symptoms.
• Carry on taking all your usual asthma medicines as normal.

If somebody you live with develops symptoms of COVID-19:

• You, and everyone else in your household, need to stay at home for 14 days from the time the first person in your household got symptoms. 
• If you get symptoms of COVID-19, you need to stay at home for at least 7 days, even if that takes you past the end of the 14 days you have already been at home. 

Make sure you can get what you need

You should make plans to help you cope if the spread of the virus causes significant disruption, or if you get symptoms and need to self-isolate. This might include making sure you know how you would get your medicines, food and other essential items if you had to self-isolate, and thinking about how you would stay in touch with friends and family. You should register with your GP surgery for online services like ordering your prescriptions.

Please see the NHS advice on staying at home and advice on social distancing for more information. 

Manage your asthma well to reduce the risk from coronavirus 

When people with asthma get respiratory infections, it can set off their asthma symptoms. 

The best action you can take is to follow these simple asthma management steps:

• Keep taking your preventer inhaler daily as prescribed. This will help cut your risk of an asthma attack being triggered by any respiratory virus, including coronavirus.
• Carry your reliever inhaler (usually blue) with you every day, in case you feel your asthma symptoms flaring up.
• Download and use an asthma action plan to help you recognise and manage asthma symptoms when they come on.
  
• Start a peak flow diary, if you have a peak flow meter. If you don’t have a peak flow meter, think about getting one from your GP or pharmacist, as it can be a good way of tracking your asthma and helping to tell the difference between asthma symptoms and COVID-19 symptoms. It can also help your medical team to assess you over the phone or video.
• If you come down with flu, a cold, or any other respiratory infection, follow our tips for looking after your asthma when you’re not well.
• If you smoke it’s vital to quit now as smoking will increase your risk from COVID-19. There’s NHS advice on how to give up smoking here.

What to do if your asthma is getting worse

If your asthma is getting worse and you have symptoms of COVID-19, please use the 111 online service or call 111. Don’t go to your doctor’s surgery.

When you contact 111:

• Let them know that you have asthma and that you’re getting asthma symptoms.
• Explain how often you are using your reliever inhaler and if it’s not working completely or lasting for 4 hours.
• Follow the instructions given to you by 111.
• If your symptoms get worse quickly and you’re worried you are having an asthma attack, call 999 and let them know you may have coronavirus and are having an asthma attack. See our asthma attack advice for more information.

If your asthma is getting worse and you don't have symptoms of COVID-19, make an urgent appointment to see your GP as usual. They may ask to speak to you by phone or video. If you have an asthma attack, follow the steps on your action plan and call 999 for an ambulance if you need to.

Help if you’re feeling anxious

Some people with asthma are telling us they feel anxious and worried about coronavirus. The Mental Health Foundation has produced a great list of tips to help people cope with anxiety. Ideas include:

• Making sure you’re looking after yourself, so you feel more able to cope with whatever happens.
• Watch out for bad habits like increasing your alcohol consumption. Try to make sure you are getting some exercise
• Only looking at reliable sources of information, like the NHS and the gov.uk websites.
• Staying connected to friends and family and talking about your worries.

We hope you have found this content useful