Here in the UK there are two categories of ‘vulnerability’ to COVID-19, ‘vulnerable’ and ‘shielding’. I’ve known I was in the vulnerable category from day 1 – in fact before day 1 of the lockdown. From a week or so before lockdown I was already practicing ‘social distancing’ and not going into shops etc. because of the slightly increased risk of having RA and being on an immunosuppressent drug – methotrexate. Letters went out to people who should be shielding weeks ago – and those poor people have been told to, and I quote from the letter, ‘stay at home at all times and avoid all face-to-face contact. The government is currently advising people to shield until 30th June and is regularly monitoring this position … the exception is carers and healthcare workers who you must see as part of your medical care.’ So no delightful daily walks, no drives, no nuffink – for people who got their letters in March, that was for 12-13 weeks.
That’s a big ask, but of course if you’re genuinely in one of the highly at risk categories, you’d do it – for your own sake, and for the sake of staying out of hospital and not putting a big burden on your friends, family and all the NHS and caring staff.
However, to receive a letter like that, which is five pages long by the way, comes as a hell of a shock, especially if you’re not expecting it.
So two questions immediately spring to mind:
- Why have I received this letter at all?
- Why I have I received this letter near the end of May, when shielding started NEARLY TWO MONTHS AGO on the 29th of March?
The first thing I did (after telling hubby ‘BUY ME CAKE! I NEED CAKE!’) was to check the actual guidelines for who should or shouldn’t be shielding. If you’re interested (and of course this is UK and RA only) you can find them here.
If you can’t be bothered (and who can blame you?) I’ll very roughly summarize the situation – oversimplifying a bit, so if you have a concern, please actually look at the chart link above: If you’re on steroids or Cyclophosphamide OR on two immunosuppressent medications with a comorbidity (another serious long-term issue or illness e.g. diabetes), you should shield. However, if your disease is well-controlled with no comorbidity and you’re on a variety of drug cocktails (including mine, methotrexate and hydroxychloroquine) then you can choose whether to ‘self-isolate’ or just social distance, at your discretion. Now I’m not sure what they mean by ‘self-isolate’ here because the government only uses that phrase to refer to people with COVID symptoms, but the key point is that I do not fall under the shielding part of the chart.
After leaving a slightly snotty letter on the GP web form, because you now have to contact them like that, not by phone (probably a good thing in this instance!) I bethought myself of the NRAS helpline. (Nice turn of phrase, I think, ‘bethought myself’ – deliciously old fashioned – anyway, I digress.)
I spoke to a delightful lady on the helpline who explained what has been going on. Apparently what’s happened is that rheumatology departments at the hospital sent out shielding letters in March (or as near to March as they could manage given the pressure they’re under) I didn’t get one because I DO NOT NEED TO BE SHIELDING! (NRAS are not medically trained and cannot give official advice about this, but they can be damn helpful and they were!) Just recently the government, in its infinite wisdom, decided to send the list of shielded people to each GP practice an say, ‘Do you think anyone’s been missed off?’
Sounds like a good idea, doesn’t it? No harm in double checking after all. Just one problem – after 13 years of having this dratted disease I can assure you that, in general, with some notable exceptions, GPs know sweet FA about RA … and it seems that they know even less about which people with RA need to shield.
It’s taken me an hour or so (and cake) to calm down, take stock and not consider GP-icide. 🙂 Yes, the GPs are under a lot of pressure, but that’s no reason to share it with me, thank you! ‘-)
Update: 7 hours since I started writing this post. The GP surgery has not deigned to contact me except for an automatic ‘we have received your query’ email. Still, given it was a slightly snotty message I left, I guess that’s understandable!