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Public Health England (PHE) published guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19 on Saturday 21st March 2020.
Prof Janet Lord FMedSci, Director of the Institute of Inflammation and Ageing, University of Birmingham, said:
“In addition to older adults, those with pre-existing chronic conditions such as COPD already have compromised immune systems or are on medications that suppress the immune system. This means that they are more likely to contract COVID19 in the first place and they are sicker as a result.
“We know for example that the immune system of the older adult is less able to control the inflammation that occurs as a result of trying to fight infections and they are therefore more likely to develop the “cytokine storm” that then damages the major organ systems of the body, resulting in multiorgan failure and death.
“The advice is good, if these vulnerable groups can isolate themselves this reduces the chance of them coming in to contact with someone who has the infection, probably not yet with symptoms. It is also important for these groups to try and do everything they can to keep enhancing their immune system. Keeping physically active is a really good way to do this, a brisk walk indoors or in the garden if possible or just going up and down stairs a few times will help the lungs and also keep inflammation down.”
Prof Paul Hunter, Professor in Medicine, University of East Anglia (UEA) said:
“The reasons why the groups of people covered by the latest advice on shielding are more at risk are varied depending on what pre-existing illness they currently suffer from. Those people who recover from COVID-19 recover because their body’s immune system has managed to successfully fight off the infection. There are many elements to our immune system and these include antibodies and many different specialised cells whose role it is destroy invading pathogens (bacteria and viruses that cause disease).
“Many of the people covered by the advice on shielding will have a very damaged immune system, either because of disease or because they are being treated with drugs that supress the immune system. For example people with solid organ transplants such as kidney, heart or liver transplants will be on a cocktail of drugs aimed at supressing the immune system. This is to stop the body fighting off its new organ. It will also stop the body fighting off COVID-19. This same rational covers most of the other risk groups including people with certain cancers or those taking immune suppressive treatments for diseases such as multiple sclerosis or Crohn’s disease. The reasons why people with chronic lung disease are at especial risk is partly because they may also be taking immune suppressive drugs but also because their lungs and airways may already be quite damaged because of their illness.
“The recent guidance from PHE on this topic is timely and absolutely crucial. If someone in one of these risk groups does not follow this advice, then their chances of surviving the epidemic is significantly reduced.”
All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19/
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