Updated: 16/3/2022
Relaxation of remaining COVID-19 restrictions from 24th February 2022
Since March 2020, the medical and scientific community has learned a lot about COVID-19. At the start of the pandemic very little was known about risk factors from COVID-19 and vaccines were unavailable, so the UK Government took a precautionary approach and advised ‘clinically extremely vulnerable’ groups to follow shielding advice. As vaccines and medical treatments have been developed, the government has gradually removed restrictive guidance for those at an increased risk of COVID-19, removing all remaining restrictions on 24th February 2022.
We understand that for people with mitochondrial disease who were previously considered to be clinically extremely vulnerable, the relaxing of restrictions may be worrying. However, the protection given to individuals through the vaccination programme has meant that people with mitochondrial disease are now advised to follow the same precautions as the rest of the general public in order to reduce their risk of catching COVID-19. This includes;
- getting vaccinated
- letting fresh air in, if meeting indoors, or meeting outside
- wearing a face covering in crowded and enclosed spaces, especially where you come into contact with people you don’t usually meet, and when rates of transmission are high
- staying at home if you are unwell;
- taking a test if you have COVID-19 symptoms, and staying at home and avoiding contact with other people if you test positive
- washing your hands, and following advice to ‘Catch it, Bin it, Kill it’.
Full government guidance on ‘Living with Covid’ can be found here;
Employment
The legal requirement to work from home has now ended, and people with mitochondrial diseases should discuss their return to work with their employer.
Employers have a legal duty to protect their workers from the risk of harm, and your employer should be able to tell you the measures that they have put in place to ensure your health and safety at work. The government continues to provide ‘Working Safely’ guidance to employers to reduce the risk of the spread of COVID-19 in the workplace, which can be found here;
https://www.hse.gov.uk/coronavirus/working-safely/index.htm
Many workplaces are continuing to offer flexible or ‘hybrid’ working options including working from home and this may be something that you can explore with your employer.
Schools
It is important that children attend school, not only in terms of their education but also for their emotional and mental wellbeing and their long-term development. If you have concerns about your child attending school, you should arrange to meet with staff to discuss the measures that have been put in place to reduce the risk of COVID-19, as well as any further measures that can help your child attend safely.
Updated government guidance can be found here
COVID vaccinations and boosters
Vaccination has proved to be the most effective way to protect those at increased risk from COVID-19 and we would strongly encourage that all adults who have mitochondrial disease and are eligible to receive two doses of a vaccination and a third booster takes the opportunity to do so.
If you have not yet received your two primary doses and a booster dose, please contact your GP or book your vaccination appointment online. Anyone who is unsure about whether they are eligible to receive a vaccination should check this with their GP or specialist mitochondrial team.
Vaccinations for children
Following a study in over 2000 children aged 12-15 years, which generated additional data about safety and effectiveness, the approval of the adult 30 microgram dose of the Pfizer BioNTech vaccine was extended to children aged between 12-15 years in June 2021. All young people aged 12 to 15 years are now being offered 2 doses of the vaccine 12 weeks apart.
In December 2021, the MHRA approved the paediatric formulation of the 10 microgram dose of the Pfizer BioNTech vaccine for primary vaccination of children aged 5-11 years. Since 31st January 2022, at-risk children aged between 5 and 11 years old have started to be offered 2 doses of an approved vaccination which should be given 8 – 12 weeks apart. This will be extended to all other 5-11 year olds from April 2022.
Again, we would recommend that all children with mitochondrial disease who are offered the vaccine should receive this provided that they are eligible to do so.
Use of antivirals
We are aware that some patients with mitochondrial disease have been sent priority PCR tests and offered treatment with antiviral drugs after testing positive for COVID-19. However, people with mitochondrial disease are not currently listed as being part of the patient cohort who are considered at highest risk of complications following infection with COVID-19 and therefore require antivirals.
Our medical board support the view that having mitochondrial disease does not automatically put you at higher risk of a more severe reaction, although some individual patients may fall into this category due to complications associated with their condition.
Patients who have received antiviral treatments are most likely to have been identified by their GP as requiring this treatment, so all queries regarding treatment with antivirals should be directed to GP’s in the first instance.
Because every patient with mitochondrial disease presents slightly differently, GPs who are unsure about a patient’s individual risk factors and eligibility for antivirals are encouraged to discuss this with the patient’s specialist team.
Managing your child’s COVID-19 infection at home
Most children with mitochondrial disease who catch COVID-19 will present with a mild infection and can be cared for at home and given plenty of fluids and rest. The use of regular paracetamol and ibuprofen, given as directed on the packaging, can help to manage symptoms including fever. Children should be encouraged to eat small amount of food regularly, particularly easy-to-digest foods such as bananas, yoghurts and custard.
However, we understand that children with mitochondrial disease can quickly become more unwell with symptoms that would produce a mild illness in the general population, and that they may also take more time to recover from illness. If your child has a fever that has lasted for more than 48 hours, or if they still remain unwell after 7 days, you should seek medical advice. We would encourage parents to trust their instincts about their child, and if at all concerned, we would always advise contacting either your GP, mito specialist, or local hospital, or by calling 111 or 999 in an emergency.
More information:
Government guidelines (England)
Government guidelines (Northern Ireland)