UK CF Medical Association's statement on coronavirus

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Here, the UK CF Medical Association (UKCFMA) gives feedback on the monitoring of data collected through the UK CF Registry about the number of people with CF who have had coronavirus (COVID-19). It also advises how people with cystic fibrosis and their families can help minimise their risk of COVID-19.

If you have questions that are not answered in the below please contact our Helpline on [email protected]. While we endeavour to answer all of your questions, please note specific medical questions should be answered by your CF team who have a full understanding of your medical history. We are continuing to update our Q&A page on coronavirus and have also created an FAQ for those with concerns about how coronavirus may impact education, work or finances.


CFMA statement on living with COVID-19

2 March 2022

Results from UK CF Registry for December and January showed a significant increase in the number of reported positive COVID-19 test results for people with CF, likely related to the Omicron variant and in line with the wider UK trends. However, despite the high number of positive tests, the numbers of hospitalisations and severe illness reported remained low, confirming earlier results that suggest COVID-19 disease does not cause disproportionate illness in people with CF.

Vaccines against COVID-19 continue to show good effectiveness to protect individuals and the population. We strongly recommend that people with CF and their families access vaccines as soon as they are made available to them, including the booster doses.

Some people with CF are clinically extremely vulnerable, especially those who have received a transplant. If you have any questions or concerns about your personal situation, please discuss them with your CF team.


CFMA statement as we approach step 4 of the roadmap

14 July 2021 

The CFMA appreciates that this is an unsettling period for people with CF and their families as the government moves towards step 4 of the COVID-19 roadmap on 19th July.

It is important to bear in mind that this progress towards step 4 has been possible because of the levels of vaccination achieved by the NHS and the effectiveness of the vaccines (especially after two doses) to prevent severe illness and hospitalisation.  People with CF will also benefit from this protection if fully vaccinated.

In the statement for “clinically extremely vulnerable” people, the UK government highlight that all patients with reduced immune function are at increased risk even if doubly vaccinated, and they should consider this in their day-to-day activities.  This is relevant to people with CF who have a reduced immune system, for example if they are on high dose steroids or on immune suppressing medications after a transplant.  People with CF in this situation should talk with their CF team if they require further advice or guidance.

It is reasonable to consider that all people with CF have some vulnerability to COVID-19 disease and as such should receive vaccination and follow the guidance for adults who are considered to be “clinically extremely vulnerable”.  The situation for children under 16 years of age is less clear and, at present, the CFMA recommends that families follow the government advice for this age group.  The results from the UK CF registry suggest that COVID-19 is not a significant illness in children with CF, and it is important that children are not excluded from school and the other activities of childhood.

The latest advice, for people who are clinically extremely vulnerable is not dramatically different to the advice given to all, namely avoiding unnecessary contacts and crowds and behave with care, especially when case numbers are high or rising.  Wearing a tight-fitting face covering will no longer be a legal requirement from 19th July and the government advice supports people making their own judgement on this.  Many hospitals and other health institutions will continue to request that visitors, staff and patients wear face coverings.  It seems sensible for people with CF to wear face coverings when on public transport and whenever they might feel vulnerable.

The government is planning to provide a booster dose of the COVID vaccine in the autumn, and people with CF, classified as clinically extremely vulnerable, are included in the priority group for this next round.  We would strongly encourage accessing this third dose as soon as it is available.

To see the latest England CEV guidance click here

To see the latest Scottish CEV guidance click here


UKCFMA update on COVID-19 vaccinations

13 April 2021 

With the accelerated rate of the COVID-19 vaccination roll out, more information surrounding side effects are coming to light. We appreciate this can be concerning, particularly with the media coverage on the risk of clotting. However, we would still encourage everyone with CF to still take up their second vaccination.

Side effects for the COVID vaccinations are consistently monitored and reviewed and the benefits of vaccination in protecting you against the serious consequences of COVID-19 outweigh any risk from the vaccine.

We recommend to complete your course with the same vaccine you had for the first dose. If your first dose was with the AstraZeneca vaccine, then you should have the second dose of the AstraZeneca vaccine. The first dose of the vaccine will have given you some protection, particularly against severe disease. However, having the second dose will give you higher and longer lasting protection. If you have specific concerns or queries you should raise these with your local CF centre.

 


UKCFMA update on COVID-19 guidance

2 March 2021

People with CF aged over 16 years should have been offered their first vaccination. If you have not been contacted, you can use the national booking system on the NHS England website to book a slot here.

The UK CF Registry has captured data on over 289 people with CF who have tested positive for COVID-19. Broadly, outcomes have been similar to those seen in the general population. Age is the most important determinant of outcome after COVID-19 infection. Adults with CF should continue to take all practicable measures to avoid infection. The combination of age, more advanced CF lung disease and other CF-related problems, increase the risk of more severe illness and the need for treatment in hospital.

Alongside the planned easing of restrictions across the UK, shielding has been extended in England and Wales to 31 March 2021. Shielding will continues in Scotland for the foreseeable future for those on the shielded patient list. Northern Ireland did not formally reintroduce shielding during the current lockdown. If you are on a shielding list, you should have been contacted by your CF team or received a letter from your GP. If you are unsure about whether you are on a list, think that you should be, or think that you are and should not be, please get in touch with your CF team for clarification.

In line with the re-opening of schools in England and phased re-opening of schools in Scotland, Wales, and Northern Ireland, the UKCFMA recommends that all children with CF should attend school unless advised against doing so by their clinicians. The benefits of education outweigh the risks of COVID-19 for most children with CF. There are only a very small number of children with severe disease and multiple comorbidities who have been advised by their clinicians to continue to shield. If you are unsure what you and your child should do, please contact your CF team.

As earlier in the year, current advice is to work from home if possible. Everyone not on the shielding list, including those with CF, should continue to follow current Government guidelines. Employers cannot compel those with shielding notifications to go into work. Adults with CF who choose to go into work should ensure that their workplace has adequate infection control policies in place.

It is important that people with CF continue to follow their respective Government’s advice and take measures to avoid infection. Strict social distancing, wearing a face covering and cleaning hands continue to be very important. If you have concerns about your own circumstances, please discuss these with your CF team.


UKCFMA update on COVID-19 guidance

11 January 2021

The Medicines and Healthcare products Regulatory Agency (MHRA) has now approved two COVID-19 vaccines manufactured by Pfizer/BioNTech and Oxford/AstraZeneca. Roll out for both has already started. People with CF on the shielding list will be in priority group 4 for the vaccination, if over the age of 16 years. It is hoped that they will be offered the first dose of the vaccine by mid-February. Those not on the shielding list but who are considered to have a "serious underlying health condition" will be able to access the vaccine in priority group 6. We would encourage everyone to take up the offer of vaccination as soon as it is made available to them. This will be a major step towards ending the pandemic and enabling people to resume normal lives.

We now have information that over 171 people with CF in the UK have been infected with COVID-19. Broadly outcomes have been similar to those seen in the general population. Age is the most important determinant of outcome after COVID-19 infection. Adults with CF should take all practicable measures to avoid infection. The combination of age, more advanced CF lung disease and other CF-related problems, increase the risk of more severe illness and the need for treatment in hospital. For further information on the latest research, please look at the November 2020 paper on the global impact of COVID-19 on people with CF, and a further publication from April 2020. Similar results have also been found when reviewing the impact of COVID-19 on children with CF.

With the new variant of COVID-19 in the UK, the transmission of the virus has significantly increased. So far there is no evidence to suggest that this strain results in more severe infection or worse outcomes, but we are monitoring the situation and will update you as more information becomes available. Regardless of this, it is important that people with CF continue to follow their respective governments' advice and take measures to avoid infection. Strict social distancing, wearing a face covering and cleaning hands continue to be very important.

With all devolved nations currently in lockdown, shielding has been re-introduced for those on the Shielded Patient List (except for Northern Ireland). If you are on the shielding list, you will have been contacted by your CF team or received a letter from your GP. If you are unsure about whether you are on the list, or feel you should be, please get in touch with your CF team.

As earlier in the year, the advice is to work from home if possible or not go to work. Everyone not on the shielding list, including those with CF, should continue to follow current Government guidelines. Employers cannot compel those with shielding notifications to go into work, but adults with CF who choose to do so should ensure that their workplace has adequate infection control processes in place. Children with CF should follow the national guidance with respect to school attendance. They should only shield if they have been instructed to by their CF team. The Government will announce what support will be available to those shielding to help people to stay safe. Please keep an eye on the Cystic Fibrosis Trust website which will provide further information when available.

If you have concerns about your own particular circumstances, you should discuss these with your CF Centre.


UKCFMA update on COVID-19 guidance

4 December 2020



We are pleased to hear the Medicines and Healthcare products Regulatory Agency (MHRA) has approved Pfizer’s COVID-19 vaccination, with roll out starting imminently. Adults with cystic fibrosis (CF) have been moved up the prioritisation list and we would encourage everyone to take the vaccination as soon as it is offered. This is a great step to moving out of this pandemic and allowing people to resume their normal lives.

We are now aware of over 100 people with CF in the UK who have acquired COVID-19 and their outcomes continue to be similar to those seen in the general population. We believe it is important people with CF continue to follow their respective government’s advice and take measures to avoid infection with COVID-19. Strict social distancing, wearing a face covering and cleaning hands continue to be very important.

England is introducing a new tiered system and shielding is currently not being introduced in areas identified as tier 1 or 2, or routinely in areas identified as tier 3 areas. Formal shielding measures may be reintroduced in the worst affected tier 3 areas. If the Government feels it is necessary for you to return to shielding you will receive a new shielding notification advising you to do so. If you are advised to shield, then further support will be available from your local council and community pharmacies to help protect you during this period of heightened risk.

The UK Government continues to advise that adults with CF should work from home if possible. If this isn’t possible, then your employer is required to take steps to reduce the risk of exposure to COVID-19 in the workplace and should be able to explain to you the measures they have put in place to keep you safe at work. We advise adults with CF to take all practicable measures to avoid infection. The combination of age, more advanced CF lung disease and other CF-related problems increase the risk of more severe illness and the need for treatment in hospital. If you are unsure about returning to work, please contact your CF centre to discuss.

We continue to agree with Government advice that all children with CF in all tiers should attend school unless advised against by their clinicians. The benefits of education outweigh the risks of COVID-19 for most children with CF. There may be a very small number of children with severe disease and multiple comorbidities who are advised by their clinicians to continue to shield. If you are unsure what you and your child should do, please contact your CF Centre.

Those in the devolved nations should adhere to the social distancing guidance as set out by their respective governments. Guidance is likely to change in response to the evolving situation, so keep up to date with the specific guidance for your area.

If you have any particular concerns, please discuss them with your CF Centre.


UKCFMA update on COVID-19 guidance

5 November 2020

We now have more experience and understanding of the impact of coronavirus (COVID-19) infection on people with cystic fibrosis (CF) than we had during the first wave of the pandemic. Most adults and children with CF who have had COVID-19 make similar recoveries to people without cystic fibrosis. 

Clinicians from 19 countries have identified over a hundred children with CF who have had COVID-19 infection. Very few needed any additional support and most did not require hospital admission. Similarly, approximately 200 adults with CF from around the world have also had COVID-19 infection. The impact of the infection has been less severe than originally feared. Those with low lung function and post-transplant were more likely to be admitted to hospital for care. 

With the second lockdown in England, we agree with the advice of the Royal College of Paediatricians and the UK Government that all children with CF should attend school unless advised against by their clinicians. The benefits of education outweigh the risks of COVID-19 for most children with cystic fibrosis. There may be a very small number of children with severe disease and multiple comorbidities who are advised by their clinicians to continue to shield. If you are unsure what you and your child should do, please contact your CF Centre.

The Government advises that adults with CF should work from home if possible during the current lockdown period. Age is an important determinant of outcome after COVID-19 infection. Adults with CF should take all practicable measures to avoid infection. The combination of age, more advanced CF lung disease and other CF-related problems increase the risk of more severe illness and the need for treatment in hospital. Employers cannot compel those with shielding notifications to go into work, but adults with CF who choose to do so should ensure that their workplace has adequate infection control processes in place. If you have concerns about this you should discuss with your local CF centre.

Those in the devolved nations should adhere to the social distancing guidance as set out by their respective governments. Guidance is likely to change in response to the evolving situation, so keep up to date with the specific guidance for your area.

If you have any particular concerns please discuss them with your CF Centre.


UKCFMA update on COVID-19 guidance  

30 September 2020 

Since the middle of July the number of new cases of COVID-19 (coronavirus infection) across the UK has increased. Despite this, the risk of an individual catching coronavirus remains low and we advise people with cystic fibrosis (CF) continue to follow government guidelines to minimise these risks. The current government guidance is that shielding is paused in areas other than local lockdown, but like all other groups, people with CF should follow strict the social distancing guidance set out by their respective governments.

We are aware of 35 people in the UK with CF who have had an infection with COVID-19 and the majority have had a relatively mild illness. We are also aware that there is increasing information from around the world on how people with CF have been affected by coronavirus. The range of outcomes is similar to that seen in the general population. Age appears to be an important determinant of outcome.

It is important that people with CF and the parents of children with CF discuss their concerns and anxieties with their CF teams. We continue to believe people with CF should have access to personalised advice, from their specialist teams, to help inform their decisions.

Those people with CF who have had a transplant should discuss their concerns and the precautions they should take with their transplant team. 

We appreciate the increasing numbers of COVID infections will be causing people with CF and their families increasing concern. We will continue to monitor and contribute to government guidance, engage with specialist commissioners to ensure appropriate access to care for people with CF and work closely with the Cystic Fibrosis Trust and the CF Registry to report new cases of COVID-19 within the CF community.

Your CF team will support you during this pandemic. Please don’t hesitate to contact them to discuss your concerns and seek their advice.  


UKCFMA advice on the easing of shielding measures for people with cystic fibrosis and their families

29 June 2020 

This statement is an update to advice given on 23 April, 11 May and 15 May. 

The number of new cases of COVID-19 (coronavirus infection) continues to decrease across the UK. Track and trace measures are now in place for containing any local outbreak of new infection and the easing of lock down measures in the general population has not resulted in an increase in the number of daily cases to date.

Shielding has successfully minimised the number of COVID-19 infections in people with CF and their families. The now low levels of infection, and the social distancing measures that are being established in schools and workplaces, will enable those who have been shielding to gradually ease the preventive measures they have been taking over the coming weeks.

UK Governments have all now provided updated guidance on shielding. Social distancing measures, according to the latest Government advice, should be maintained during this period as activities outside of the home are increased.

Children and young people have been less severely affected by COVID-19 than older age groups. Many paediatric CF centres are advising that shielding measures can be stopped for the vast majority of their patients. Paediatric CF centres will support families as they come out of shielding and appreciate that this is an unsettling time for many. Your CF team will be able to provide advice about coming out of shielding if you have specific concerns about this.

Adults who will be returning to work should be mindful that their employers are legally obliged to ensure that they return to a safe working environment with robust measures in place to minimise their risk of acquiring infection. The Government has specifically asked employers to be mindful of the necessary working arrangements for those who have been shielding. We suggest making contact with employers well before a planned return date to make sure that social distancing arrangements are put in place within the workplace.

If sensible precautions are maintained, both by people with CF and the wider community, the risk of infection should remain very low. For a small number of people with CF, with severe or unstable disease, the very low risk of catching COVID-19 would be considered too high given the possible effects on their respiratory health. For most, the benefits of returning to school and work with appropriate precautions outweigh these considerations. If you have concerns about shielding, discuss these with your local care team, who can advise on your individual circumstances.

Most CF centres are planning a gradual re-introduction of hospital based out-patient services. However, for the foreseeable future, consultations are likely to be a mix of hospital, virtual web-based and telephone follow-up clinics.

We and the UK CFMA feel it’s really important that people with CF have personalised advice to support their decisions as shielding ends, and this is absolutely the case for people who are post-transplant who will need individual advice from their specialist team about their own levels of potential risk. Please do get in touch with your team with any specific questions you may have.


UKCFMA update on COVID-19 guidance 

15 May 2020 

This statement is an update to advice given on 23 April and 11 May. 

All CF Centres are continuing to report to the National CF Registry all cases of COVID-19 identified in people with cystic fibrosis.

So far COVID-19 has been found in 17 people with CF in the UK. No new cases have been reported in the last few weeks. The youngest was 17 years of age. Fewer than five of the 17 affected are still needing treatment. These findings indicate that people with CF and their families have been very effective in avoiding exposure to the Coronavirus. Shielding continues to be the best way to avoid infection and for the time being we recommend that people with CF continue to shield, as per the current NHS England advice.

Shielding is going to become more challenging for many families as one or more members of their household return to work. In such cases it is important that workers follow the national guidance on the ‘Living with other people’ section of the shielding advice. Thorough hand washing and changing out of work clothes immediately after returning home is particularly important.

If household members are anxious about returning to work, be aware that employers have a statutory responsibility to ensure that all workplaces are as safe as possible for all employees. Please contact your local team for advice and support in making sensible decisions if you have specific concerns about this.

Data from around the world consistently suggests that for the vast majority of children, infection with COVID-19 is less severe than in adults. Whilst this is reassuring, we still know very little about the impact of COVID-19 on children with cystic fibrosis. Although schools are now starting to re-open, until we have further information, the UKCFMA recommends that children with CF should continue with current measures to avoid infection and do not return to school.

This week the Government published advice about whether children and young people who live in a household with someone who has CF should return to school. The advice is that they should only attend if "stringent social distancing can be adhered to and the child or young person is able to understand and follow those instructions". This is going to be difficult to establish and we suggest that decisions are made on a case by case basis after discussion with your local school and CF team.

Remember that regular exercise is a key component to staying well. If you can do this in your home or garden, that is fine, but if you need to go out to do sufficient exercise, you should. If you do go out, ensure this is in as safe a way as possible; do not arrange to meet others, and only go out during quiet periods. Young children should be carefully supervised.

We will continue to monitor all developments closely and will provide an update if there are any changes to these recommendations.

Continue keeping up with all of your treatments. Stay in touch with your CF team and do not hesitate to contact them if you become unwell or think you need to change your treatment.


Statement on the monitoring of data collected through the UK CF Registry about the number of people with CF who have had COVID-19 infection

23 April 2020

This statement is an update to advice given on 24 March

The UKCFMA has been monitoring data collected through the UK CF Registry about the number of people with CF who have had COVID-19 infection. 

The data suggests that so far, the UK CF community has been successful in following the specific NHS guidance for shielding and protecting and very few people with CF have suffered from COVID-19 infection.

It is also readily apparent that the UK CF community are being highly responsible in keeping up with their regular treatment to stay as healthy as possible. As a result, there has been a significant reduction in the need to admit people with CF to hospital. This has helped enormously in easing hospital pressures on much needed beds to treat emergency admissions with severe COVID-19 infection across the country. 

Some members of CF teams have had to be relocated to other parts of their hospital where there is an acute need to treat patients with COVID-19 and the way in which you are supported by your CF service will have changed considerably. Despite these changes, all CF services will do their best to provide the support you need to keep on top of your CF. In particular it is important that you continue to be in regular contact with your CF team and that you let them now if you become unwell or if you think you need to change your treatment.

Shielding and protecting can be a considerable financial and mental health burden on many families. A limited number of emergency grants are available from the Trust for those in greatest need.

Keeping in touch with friends and family and eating a healthy CF diet might help ease the mental strain of continuing to shield and protect. Finding creative ways to continue to exercise is also important. Ideally this should be in your home or garden. If this is not possible then only exercise outside your home if you are able to do this in isolation. Young children must be strictly supervised so that they do not touch infected surfaces and thorough hand washing is essential immediately after coming back indoors.

Although there might be some easing of government restrictions on social distancing over the coming weeks, shielding and protecting those who are vulnerable will remain in place until the end of June at the earliest. Thank you for the great efforts you have all made so far at this most challenging of times and please continue with all of the things that you have been doing to stay safe. 


Statement on how people with cystic fibrosis and their families can help minimise their risk of COVID-19

24 March 2020

This statement is an update to advice given on 17 March following the latest NHS advice given on 22 March.

Current guidance is that all adults and children with cystic fibrosis are in the group of people thought to be extremely vulnerable to severe illness from infection with COVID-19. All people with cystic fibrosis, their families, friends and carers should follow the specific NHS guidance for shielding and protecting.

It is essential that people with cystic fibrosis stay at home at all times and avoid any face-to-face contact for at least the next 12 weeks until further advice is available. Do not attend your local hospital or outpatients without checking with your CF service first. Routine reviews will no longer be conducted face to face.

The government has set a website where people with cystic fibrosis can register for help such as shopping deliveries and any additional care that you might need whilst shielding.

People living in the same home as someone with cystic fibrosis are not required to adopt the same protective shielding measures for themselves, but it is essential that they follow all of the guidance for social distancing. They should only go outside for food, health reasons or for essential work and must stay at least 2 metres apart from all other people at all times.

Anyone who has to enter a home where a person with cystic fibrosis is living must wash their hands with soap and water for at least 20 seconds immediately on arrival and often whilst they are there.

Strictly avoid contact with anyone with a high temperature and/or a new continuous cough. If this is somebody who lives with you then they should try and stay somewhere else.

If you develop a high temperature above 37.8 °C and/or a new continuous cough, get clinical advice using the NHS 111 online coronavirus service and contact your local CF service If you don’t have internet access call 111. If you are seriously ill call 999.

Keep up with all of your regular treatments, do some exercise and eat well as advised by your CF dietitian.

Keep positive and look after your mental as well as your physical health. The every mind matters website has some useful tips about looking after your mental wellbeing.

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