Extension Of Shielding

[roopower]

My son, who is taking hydroxychloroquine, methotrexate and benepali for rheumatoid arthritis , was sent a shielding letter from the rheumatoid department that he is under at the hospital. He did not receive an extension letter and went back to work at the hospital at the beginning of July. On the second day one of the managers took the decision to send him home and his immediate boss phoned and told him not to return until the beginning of August.
There are quite a lot of covid patients at the hospital although my son does not work on the wards he sometimes goes there to collect a patient for an MRI scan.
Today his boss has rung and wants a copy of my sons extension letter, which they know he hasn't had! My son has rung the rheumatoid dept and they have not sent any extension letters out and the GP doesn't know anything about it. From what my son has gathered noone really knows if he should be in work or not and no-one will make a decision.
He is quite prepared to go into work but his job is preparing patients for MRI scans and going through the paperwork with them, both of which require him to be close up.

Sorry to be so long winded but does anybody have any ideas or advice please? At present hes just going round in circles and thats not doing his mental health any good!
Thank you for bearing with me.

[bednobs]

You say he had a shielding letter but what did it actually say? My rheum dept sent patients a letter explaining the scoring they were giving to cetain things (1 point for steroids over 10mg pd, 1 point for anti tnf therapy , 1 point for various other things) and invited pats to add up their own scores and do what was recommended for their score. According to their criteria I was just to take extra care. Separately I received a letter from my gp saying they considered me extremely clinically vulnerable and that I should immediately sheild for 3 months. Happily this means I get to chose when I am extremely clinically vulnerable (ie for shopping slots and when I wanted to work from home) and when I just need to take extra care ie when it suited me to meet my friend for a coffee or when I wanted my husband to go to the shops :)

[woofgang]

I don't think anybody got an extension to shielding letter?

[bednobs]

I had a letter on 22nd June explain ing the position and change in shieldong guidance

[bednobs]

Whichome said from 1st August I can got to work if I can't work from home

[bednobs]

https://ibb.co/ystKm0Q

[Sqad]

Roo, this is indeed arpvlem and I am no expert on the subject but here is my advice for what it is worth.
Patients with RA are not more susceptible to C19 than the average population but this will vary as to their medication and one institution differentiates in the following way,
group 1..those on hydroxychloroqine and sulfasalazine.....no big deal and should carry on as usual ....washing hands etc.
Group 2 those on methotrexate and one other drug....maintain social distancing and your son seems to be in that group
Group3 those that are on steroids or than 20mgms should self shield.
Your son seems to be on a group where the advice seems to a matter of personal opinion and as such I would advise him to contact the Medical Officer of the hospital for his 4ruling on the matter of should he return to work.

[Ringlet]

Woofgang, I got an extension to shielding letter. My first shielding letter took me up to end of June. The second one, which arrived a couple of weeks ago, says to continue to shield until 1st August, when the situation will be reviewed again.

[roopower]

Thank you everyone for your replies. Simon's initial letter definitely said that he should self isolate for 12 weeks. They included a sheet which was completely foreign to me but Simon said that on the drugs he takes he is on the middle tier but working at the hospital with the high number of cases he is more at risk. Just a side note, the local media have had a field day about the number of deaths at the hospital but some wards are like God's waiting room with average age of patients being 85! He will try to contact someone else from the hospital tomorrow. Thank you again.

[AuntPollyGrey]

Sqad you have missed out those on Biologicals , namely TNF blockers. they suppress the immune response and I was told by my consultant that I would be no more likely to catch covid-19 than any other person, but the consequences could be severe. As it was I did contract Covid (positive test) and it was the fact that the TNF's were still in my system that prevented the virus from causing an inflammatory response in the lungs, which is what kills most people who contract the virus.

[Sqad]

APG.... yes, all you say is quite correct but when answering queries on AB l fo d it dicvult to pitch my answers between them being factually correct, but not too technical as to be completely misunderstood.

[Peter Pedant]

Next time he/they ring he says - "can I come back to work?"
IF they ask - "how does he feel", it is NOT his decision or else they will say he is self-certifying, it is theirs.

and good luck -

[Peter Pedant]

In the long series published
being old, male and diabetic feature as ever are associations
there doesnt seem to be a spike for either cancer or HIV ( figures for drug induced immunosuppression are likely to be small )

SINCE the later fatal stages of Covid are associated with hyperactivity of the immune system
I wondered if the immunosuppressed are favoured ( they dont have an immune system to go haywire see?) - that is it would factor favouring survival
[ er I should add that I am permanently immunicompromised from chemo and NHL]

and in April of this year Giovanonni was good enough to confirm the idea after looking at a few patients ( well done Dr G)
4 x lower
https://www.acnr.co.uk/2020/04/clinical-viewpoint-immunosuppression-and-covid-19/

[Peter Pedant]

oh me
if they dont understand what I write
so what ? it happens every day
and I have far more trouble from those who say they do

[dannyk13]

I received a letter in late June with guidance for after the 6th July and also for after 1st August which said go back to work if you can as long as the business Covid-safe.
The advice was also to stay at home where possible as I am still at risk of severe illness if I catch Coronavirus.
I think that all the above applies to anyone who has been shielding.