Publication - Advice and guidance
Coronavirus (COVID-19): advice for people at highest risk
Advice to help people in the Covid highest risk group make informed decisions and access support services.
Who is in the highest risk group
Some groups of people are at the highest risk of severe illness if they catch coronavirus (COVID-19).
Contact your GP or specialist care provider if you fall into one of the groups below and you have not received a letter from the Chief Medical Officer.
Read more information about each group, including useful links and phone numbers, below.
Solid organ transplant recipients
Who is in this group
You are in this group if you have had a transplant of the kidney, liver, pancreas, islet cell, heart, lung, stomach or other part of intestine. This is because of the immunosuppressant medication taken to stop rejection of your transplanted organ(s).
If you’re waiting for an organ transplant
If you’re planning to receive a liver or kidney transplant from a living donor, both you and your donor will be asked to isolate for 2 weeks before your transplant.
Strictly follow the advice of your specialist clinician or your transplant unit if you have been asked to isolate because you are waiting for a solid organ transplant from a deceased donor.
If you’re in this group and you have coronavirus symptoms
If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are in the highest risk group (or on the shielding list), and the condition you have or medicine you take. Please also inform your clinical specialist.
For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.
Information and support
For more coronavirus information and support for solid organ transplant recipients and those on the transplant waiting list, visit these websites:
People with specific cancers
Who is in this group
You are in this group if you:
- have cancer and are undergoing active chemotherapy, or have had radical radiotherapy for lung cancer
- have cancer of the blood or bone marrow and are at any stage of treatment. This includes cancers such as leukaemia, lymphoma or myeloma
- have cancer and are having immunotherapy or other continuing antibody treatments
- have cancer and are having specialised treatments that can affect the immune system. This includes protein kinase inhibitors or PARP inhibitors
- have had a bone marrow or stem cell transplant in the last 6 months, or if you are still taking immunosuppression drugs
If you’re in this group and you have coronavirus symptoms
If you are worried about coronavirus symptoms, it’s important to call your existing cancer treatment helpline immediately. Or call the national Cancer Treatment Helpline on 0800 917 7711.
For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.
Information and support
For information and support related to coronavirus and cancer, you can:
- visit the Cancer Research UK website, or call on 0808 800 4040 (Monday to Friday, 9am - 5pm)
- visit the Macmillan Cancer Support website, or call 0808 808 00 00 (every day, 9am - 5pm)
- visit the Scottish Cancer Coalition website for a range of support services, from mental wellbeing to financial and welfare advice
People with severe respiratory conditions
Who is in this group
You are in this group if you have:
- cystic fibrosis
- lung conditions which require home oxygen
- severe asthma requiring regular inhaler use and long-term steroid tablets to control your asthma – for example, Prednisolone or regular injections
- severe non-cystic fibrosis bronchiectasis
- pulmonary hypertension
- severe COPD. This usually means being on several different inhaler medications in the last year. This must include two long acting preventers as well as a steroid inhaler, for example, Long Acting Beta Agonists and Long Acting Anti-Muscarinic Antagonists. Severe COPD means that:
- you are too breathless to walk 100 yards;
- you have 2 or more lung infections a year, or;
- you require oxygen to help with your breathing
If you’re in this group and you have coronavirus symptoms
If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are in the highest risk group (or on the shielding list), and the condition you have or medicine you take. Please also inform your clinical specialist.
For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.
Information and support
For more information about coronavirus and severe respiratory conditions, you can:
- visit the British Lung Foundation website or call their helpline on 03000 030 555
- visit the Asthma UK Scotland website or call the helpline on 0300 222 5800
- visit the Chest Heart & Stroke Scotland website to submit a request for help or get condition-specific guidance, or call the advice line for free on 0808 801 0899 to speak to a nurse
- contact Chest Heart & Stroke Scotland’s nationwide network of Kindness Volunteers for support, including help with shopping during the pandemic or just keeping in touch to check on your wellbeing
People with rare diseases including all forms of interstitial lung disease / sarcoidosis
Who is in this group
This group includes people with inborn errors of metabolism that significantly increase the risk of infections. For example, SCID and homozygous sickle cell disease, and adults with Down's syndrome.
There are many conditions classed as a rare disease. Not everyone with a rare disease will be in the highest risk group. Your clinician will know if you should be in the highest risk group and will add you to the list if needed.
If you’re in this group and you have coronavirus symptoms
If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are in the highest risk group (or on the shielding list), and the condition you have or medicine you take. Please also inform your clinical specialist.
For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.
Support and advice
You can get more information about coronavirus and rare diseases at:
People on immunosuppression therapies that significantly increase risk of infection, and people who have had their spleens removed
About immunosuppressive therapy
Immunosuppressive therapy helps to stop rejection of a bone marrow or organ transplant. It can also treat conditions in which the immune system is overactive. For example, autoimmune diseases and allergies.
In some cases these treatments may put people into the highest risk group. Your clinician can tell you if your medications put you in this group.
Who is in this group
You are in this group if you:
- are on high dose corticosteroids (equal to Prednisolone 20mg or more per day) for more than 4 weeks
- are on specific single therapies, for example Cyclophosphamide (these medications are usually prescribed by specialists in hospitals)
- are on a lower dose of corticosteroids for more than 4 weeks in combination with other disease modifying medication
- are on disease modifying medications who also have other chronic medical conditions
If you’re not sure if you’re in this group
People who take some medication and are otherwise healthy may not need to be added to the highest risk group. This includes single Disease Modifying medications (DMARD). It also includes Biologic medications such as Methotrexate, Azathioprine, Ciclosporin, Leflunomide plus others.
Discuss this with your specialist or GP if you’re not sure.
If you’re in this group and you have coronavirus symptoms
If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are in the highest risk group (or on the shielding list), and the condition you have or medicine you take. Please also inform your clinical specialist.
For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.
Information and support
You can find more information about coronavirus and immunosuppressive therapies at:
People who are pregnant with significant heart disease, congenital or acquired
Who is in this group
You are in this group if you are being supported by a specialist heart clinic during your pregnancy.
If you’re in this group and you have coronavirus symptoms
If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are in the hisghest risk group (or on the shielding list), and the condition you have or medicine you take. Please also inform your clinical specialist.
For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.
Information and support
For more information and support about coronavirus and heart disease during pregnancy, you can:
- visit the Scottish Obstetric Cardiology Network website for links to information relating to COVID-19 and pregnancy
- visit the Scottish National Inherited Cardiac Conditions website for information about inherited cardiac conditions, for example cardiomyopathy or Long QT Syndrome
- contact Chest Heart & Stroke Scotland’s nationwide network of Kindness Volunteers for support, including help with shopping during the pandemic or just keeping in touch to check on your wellbeing
- visit the British Heart Foundation website, email hearthelpline@bhf.org.uk or call the helpline on 0300 330 3311
People who are receiving renal dialysis treatment, and people who have chronic kidney disease stage 5 or liver cirrhosis (Child-Pugh class B and C)
Who is in this group
You are in this group if you are receiving or starting renal dialysis, or if you have chronic kidney disease stage 5, or liver cirrhosis (Child-Pugh class B and C).
If you’re waiting for an organ transplant
If you’re planning to receive a liver or kidney transplant from a living donor, both you and your donor will be asked to isolate yourselves for 2 weeks before your transplant.
Strictly follow the advice of your specialist clinician or your transplant unit if you have been asked to isolate because you are waiting for a solid organ transplant from a deceased donor.
If you’re in this group and you have coronavirus symptoms
If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are in the highest risk group (or on the shielding list), and the condition you have or medicine you take. Please also inform your clinical specialist.
For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.
Information and support
Find out more about coronavirus and renal dialysis and kidney disease at Kidney Care UK.
How we identify people who are in the highest risk group
Clinicians have helped us identify the people who need to be in the highest risk group. This might include some people who do not have one of the conditions listed above.
Not everyone who has an annual flu vaccine for medical reasons will be added to the highest risk group.
Advice for people with medical conditions that are not included in the highest risk group
We have also published advice about coronavirus for people who have certain medical conditions not included on the highest risk list (which was previously called the shielding list).
How we are using your data
To identify people, we have used GP practice, local health board or national data. This is so we could write to you. All data is securely stored. This information has been shared appropriately within the NHS in Scotland. It did not include medical records.
We notify GPs and health boards about who is on the list. This is so that they can provide further advice to their patients.
When we were asking people to shield, we shared only contact details with local authorities and our partner retailers. This allowed them to provide support to help people access groceries and medication.
We will keep your contact details in case we need to contact you again. No details of medical conditions or health records are being shared. You can request to be removed from the list by asking your GP or specialist care provider.
Find more information about how the NHS handles your personal health information on the NHS inform website.