SPARN update regarding shielding 02.07.2020
As part of the initial response to COVID-19 many children and young people were advised to shield. This was intended to protect them in case their health conditions or the medicines they were taking might have made them vulnerable to severe illness if they were infected with COVID-19. The original shielded patients list tried to identify people with particular conditions which might put them at risk of severe illness from COVID-19. It was developed early in the outbreak when we had less knowledge about which patients would be severely affected by COVID-19. Our experience and knowledge of the impact of COVID-19 infection on children and young people has been developing over time. New evidence and research findings allow us to reconsider and update the advice about which children are at the highest risk of severe infection.
Over the last few months it has become clear that children and young people are at much lower risk from COVID-19 than older people. This applies even to those with underlying health conditions and to those taking most kinds of medicines which affect the immune system.
The Royal College of Paediatrics and Child Health (RCPCH) has recently updated their advice regarding shielding and our current advice is in line with RCPCH recommendations. As a result, most children and young people who are currently advised to shield no longer need to do so.
The majority of children with rheumatology conditions no longer need to shield.
We continue to recommend that a small group of children should continue to shield. This includes the following groups:
- Children recently treated with Cyclophosphamide.
- Children receiving “high dose steroid treatment”. High dose steroids are defined as ≥ 0.5mg/kg/day prednisolone, for 4 or more weeks, within the last 4 weeks.
- Children whose Specialty consultant believes them to be particularly vulnerable for a separate, specific reason not defined above.
Children and young people that no longer need to shield will be told this by their Paediatric Rheumatology team or their GP. This could take place in a phone call, a consultation or by letter. You may also receive a letter from the Scottish Government explaining that you or your child has been removed from the official “shielding” list.
We are only able to give good information around these issues because of research studies from around the UK and elsewhere.
The more patients and families with Paediatric Rheumatology conditions contribute to these studies the more we can be sure that this information applies well to our group of patients.
The following centres around Scotland are taking part in a study run by the University of Southampton: Aberdeen, Dundee, Edinburgh, Lanarkshire, Ayrshire & Arran, Dumfries, Glasgow.
This study consists of a weekly electronic questionnaire that takes less than 10 minutes for families to complete. If you or your child is looked after by one of these SPARN network clinics and you would like to take part in this study please get in touch with your local Paediatric Rheumatology Team to find out how.