Transplant units in Scotland remain open at present and are trying as best they can to continue as normal, but these are exceptional times and no one knows the full impact of the developing COVID-19 pandemic and its effects on us all.
As more information becomes available, this guidance will continue to be updated. Please look at the Edinburgh Transplant Centre Service Updates page further information.
As always – if you have a critical medical emergency, whether related to the coronavirus or not, phone 999.
Update: Shielding letters to vulnerable individuals from the NHS
The NHS has sent letters to individuals who are at severe risk of illness if they catch Coronavirus. This includes transplant recipients and patients currently on a transplant waiting list. The letter includes shielding advice, support service information, arranging food and medication delivery, and advice for members of your household.
If you have not recieved a letter, please get in touch with your GP, transplant coordinator, or your local authority’s shielding support line.
Common questions about COVID-19
If you or a member of your family are currently on a waiting list or have had a transplant, you will likely have questions about the current situation. Below you will find information about the disease, its symptoms, and preventative measures.
You can also read the NHS Information about Coronavirus (COVID-19) and the Governments Coronavirus (COVID-19): what you need to do.
Coronavirus is a group of viruses which cause cold, flu, and more serious respiratory illnesses including Severe Acute Respiratory Syndrome (SARS).
COVID-19 is the disease caused by the newly discovered coronavirus. The new virus and disease was first reported when the outbreak began in Wuhan, China, in December 2019.
The World Health Organisation reports that the disease is spread from person to person through small droplets from the nose or mouth.
The virus affects the lungs and airways, meaning the symptoms of coronavirus are very similar to more common illnesses including the cold or flu.
The main symptoms to look out for include:
- A high temperature (fever) greater than 37.8oC
- A new continuous cough
- Shortness of breath
If you have these symptoms, you may not have coronavirus. But you should still follow advice on how to limit the spread of the virus just in case.
If you have any of these symptoms and have worsening breathlessness or deterioration in your symptoms you should contact NHS 24 on 111 and make clear that you have had a transplant and are taking immunosuppressants. They will give you further advice.
Try to stay at home as much as possible, only going out for essentials, such as shopping and medication, and one form of exercise a day. If you rely on someone else to get your shopping or medication, this advice applies them also.
- You can go out for a walk and another form of exercise, but avoid any contact with other people while you are out.
- Shop for basic necessities such as food and medicine. This must be as infrequent as possible. When you need people to deliver food or medication to you, avoid any close contact with them unless absolutely necessary.
- Ideally all members of your family/household should self-isolate with you. If so, you can live together as normal. However, other members of your household/family may not be able to completely self-isolate themselves, for example if they need to go out for shopping or medication, etc. When they leave the house, they should try to avoid contact with others as much as possible. If they do need to go out and come into contact with other people, you should avoid close contact with them in the house and, if practical, use a different bedroom and/or bathroom.
To avoid catching or spreading germs including coronavirus, follow these steps:
- Wash your hands with soap and warm water often. You can use han sanitiser gel if you do not have soap or water at hand.
- Try to avoid close contact with people who are unwell. Two metres is the recommended distance.
- Cover your mouth and nose with a tissue or your sleve when you cough or sneeze. Try not to use your hands. Throw away tissues in the bin and always wash your hands afterwards.
You should contact NHS 24 on 111 and make it clear that you have had a transplant and are taking immunosuppressants. They will give you further advice.
If you are caring for someone with a transplant and they develop symptoms of COVID-19 and they subsequently become confused or start to become unconscious, you should phone 999 and tell them you are looking after someone in this patient group and you are worried about COVID-19 infection and their health.
Transplant units are looking at the risk and benefits for reviewing each patient face-to-face in the clinic. If you have an upcoming appointment, the unit will contact you if they decide either to conduct your appointment by telephone or to postpone it.
Social shielding is a practice to protect the most vulnerable people from the virus. This includes people on transplant waiting lists as they will have underlying health conditions making them more at risk of infection or complications if infected. Transplant recipients are also vulnerable because their immune system is less able to fight off the virus.
Shielding aims to reduce the risk of spreading coronavirus to vulnerable individuals, by minimising all contact them and other people.
It is advised that vulnerable individuals self-isolate at home and avoid face-to-face contact with others for a minimum of 12 weeks. Those who provide essential support such food shopping, medications, health care or personal support should continue to visit, taking precautions where needed. Those who care for a vulnerable person must stay away if they have coronavirus symptoms.
If you are at higher risk of severe illnes from COVID-19 and need support with shielding, you can contact your local authority’s shielding support line. Through this you will be able to arrange for food and medicine deliveries, and signpost you to other support services.
Social distancing is the practice of reducing social interection between people. This will reduce the transmission of coronavirus (COVID-19)
It has also been called “physical distancing”, to describe being physically distant from other people. This is because it’s important to keep in touch with each other via phonecalls, texts, or other communication services, without being present of each other.
You can social distanc by:
- Avoiding contact with someone who is displaying symptoms of coronavirus (COVID-19).
- Avoid non-essential use of public transport where possible.
- Work from where possible. Speak to your employer about this and they should support you during this time.
- Avoid large and small gatherings in public spaces. If out and about try to keep 2 metres between you and other people.
- Avoid gatherings with family and friends. Keep in touch through phonecalls, internet, and social media.
- Use telephone or online services to contact your GP, other health services, or other essential services.
People who have been advised to self-isolate for 12 weeks by the NHS should be considered to be ‘furloughed workers’ if they are unable to work from home.
The furlough worker job retention scheme will ensure that employees unable to carry out their normal duties will receive 80% of their wages, and employers apply via the HMRC portal.
Guidance for patients on a transplant waiting list
This COVID-19 guidance is for individuals who are currently on a transplant waiting list. Almost all people on a transplant waiting list will still be at increased risk due to their medical condition. It is recommended that individuals on a transplant waiting list follow shielding measures for at least 12 weeks to keep themselves safe.
Individuals on a transplant waiting list may be more at risk of severe illness from coronavirus because of their medical condition. It is recommended you follow current guidance on social distancing and social shielding to keep yourself safe and reduce your risk of exposure to coronavirus.
The current advice is for transplant waiting list patients to shield themselves for 12 weeks, even if you are feeling fit and healthy.
The NHS has identified this group as being at risk of severe illness if you catch coronavirus. This is because you have an underlying disease of health condition that means if you catch the virus, you are more likely to be at risk of serious illness than others.
Guidance for transplant recipients
This COVID-19 guidance is for individuals, of any age, who have received an organ transplant and remain on ongoing immunosuppression medication. It includes advice for transplant recipients and their carers, including immunosuppressant medication.
There are some medical conditions which put people at a higher risk of severe illness from COVID-19. Transplant recipients are a high risk group as they take immunosuppression medication which makes it difficult for their bodies to fight the virus. It is therefore very important that anyone who has had a transplant self-isolates and avoids contact with other people that may put them at risk of contracting the virus.
Advice: From now, and until further notice (initially for 12 weeks, but this may need to be extended), transplant recipients should self-isolate at home and rigorously follow the guidance on the NHS Inform website and the measures outlined, as detailed below.
At present there are no anticipated shortages of immunosuppressants, your doctor will advise you if any alternative medications need to be considered.
Recent reports have raised a potential issue of ACE Inhibitors (ACEi) or Angiotensin Receptor Blockers (ARBs) drugs to treat hypertension. There is no clinical or scientific evidence to suggest that treatment with ACEi or ARBs should be discontinued because of the COVID-19 infection. You should not stop taking these drugs.
You should avoid using ibuprofen and other non-steroidal anti – inflammatory drugs (NSAID) if you think you have COVID-19 infection to treat symptoms such as headache, sore muscles or joint pains as they may have potential aggravating effects. In general, paracetamol is a better alternative. It is very important that you do not exceed the recommended daily doses of paracetamol. Patients already taking prescribed NSAID’s, including ibuprofen should continue with them.
Contact whoever issues your prescriptions in advance of you running out. If you do not have anyone who can go to the pharmacy to pick them up for you, let the pharmacy know and they should be able to make arrangements for someone to deliver them to you.
No. You should keep taking them as prescribed unless your doctor specifically tells you otherwise.
Yes. You need to self-isolate even if you are fit and healthy because you are likely to be more at risk to get the virus as your immune system is less able to fight the virus than other people.
Guidance for carers and family
This COVID-19 guidance is for carers or family members of individuals who are on a transplant waiting list or have recieved a transplant.
Current government advice is to stay at home as much as possible.You can continue to work if it is essential work and cannot be done from home. Speak to your employer about your situation as you may be able to work from home and they should be able to help.
Please take precautions to strictly socially isolate and take the relevant precautions when you arrive home. This may include:
- Avoiding members of your household when you arrive.
- Removing your clothing and taking a shower when you arrive home.
- Maintaining good hand hygiene.
If you are able to, move any vulnerable individuals out of your home, to stay with friends or family for the duration of the home isolation period. If you are unable to move vulnerable indviduals out of your home, stay away from them as much as possible and continue to take precautions such as hand hygiene and 2 metres distance apart.
If a vulnerable person you live with starts to display symptoms and have worsening breathlessness or deterioration, you should phone NHS 24 on 111 and make clear the medical condition(s) of the individual.
Looking after your mental health and wellbeing while staying home
If you are self-isolating, it’s important to take care of your mind as well as your body. You may feel bored, frustrated or lonely. You may also be low, worried, or anxious, or concerned about your finances, your health or those close to you. It is okay to feel like this – everyone reacts in their own way to uncertainty. It’s important to remember that staying at home may be difficult, but you are helping to protect yourself by doing it.
We have set up a Well-being page which includes recipes, movie and TV show recommendations, book and podcast recommendations, and other activities that you may find enjoyable whilst you stay home. These recommendations come from the staff of the Transplant Centre so you may recognise a name or two whilst you browse the pages.
You can visit the NHS Inform page for more information or call their helpline on 0800 028 2816 and make sure you get further support if you feel you need it.
The following documents contain financial advice and where to go or who to contact for advice.
The WR&HP Team are providing a phone advice service from Monday 30th March 2020. Open the document above for what advice they can provide and their contact details.
The Department of Work and Pension have made changes to the way that UK benefits system and Statutory Sick Pay. Open the document above to see these changes
NHS Inform offers general advice around COVID-19 on their website:
Or call the NHS Inform helpline on 0800 028 2816.
If you are worried you might have been in contact with someone with confirmed coronavirus, call 111, and make sure to let the call handler know that you have had a transplant and are taking immunosuppressants.