Health conditions and risk of severe illness with Covid-19

Those at higher risk of severe illness (RED)

Adults with the following conditions are automatically deemed clinically extremely vulnerable:

  • Solid organ transplant recipients
  • those with specific cancers:
    • people with cancer who are undergoing active chemotherapy
    • people with lung cancer who are undergoing radical radiotherapy
    • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
    • people having immunotherapy or other continuing antibody treatments for cancer
    • people having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
    • people who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs
  • those with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
  • those with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
  • those on immunosuppression therapies sufficient to significantly increase risk of infection
  • adults with Down's syndrome
  • adults on dialysis or with chronic kidney disease (stage 5)
  • pregnant women with significant heart disease, congenital or acquired
  • women who are 28 weeks or more pregnant
  • other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions.

Those at increased risk of severe illness (AMBER)

If you are over 60 or clinically vulnerable, you could be at higher risk of severe illness from coronavirus. You:

  • should be especially careful to follow the rules and minimise your contacts with others
  • should continue to wash your hands carefully and more frequently than usual and maintain thorough cleaning of frequently touched areas in your home and/or workspace

Clinically vulnerable people are those who are:

  • aged 70 or over (regardless of medical conditions)
  • under 70 with an underlying health condition listed below (that is, anyone instructed to get a flu jab each year on medical grounds):
    • chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
    • chronic heart disease, such as heart failure
    • chronic kidney disease
    • chronic liver disease, such as hepatitis
    • chronic neurological conditions, such as Parkinson's disease, motor neurone disease, multiple sclerosis (MS) or cerebral palsy
    • diabetes
    • a weakened immune system as the result of certain conditions or medicines they are taking (such as steroid tablets)
    • being seriously overweight (a body mass index (BMI) of 40 or above)
  • pregnant

Those with very little additional risk from Covid-19 (GREEN)

Staff in this category can more likely work on site. These include:

  • Type 2 diabetes well controlled by diet and/or tablets and with no complications (in particular no ischaemic heart disease)
  • Stable asthma only needing a reliever inhaler and not requiring hospital admission, no steroid treatment
  • High blood pressure without complications and controlled by a single medication (but not an ACE inhibitor)
  • Treated viral hepatitis without fibrosis
  • Treated epilepsy (not if underlying cause is due to MS/ tumour)
  • Splenic dysfunction or spleen removed
  • Dyslexia
  • Learning difficulties and Dyspraxia but able to follow hygiene precautions
  • Treated HIV with undetectable viral load and CD4>350
  • Low dose immunosuppressant drugs
  • Uncomplicated obesity BMI>40

Please note that all of the above may be complicated by additional or multiple conditions/comorbidities and other factors such as age, ethnicity (individuals of BAME background at additional risk), Body Mass Index) and gender. It is possible that such combinations will entail increased risk for such individuals and more detailed consideration may be required.

In cases where additional advice is required, contact Occupational Health at: