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Clarification on what constitutes a High Risk Asthmatic.
Tue 24 Mar 2020We have been asked to provide any clarification on what is classed as an Asthmatic, which you appreciate is a very widespread term.
The Asthma UK organisation has clarified with the Department of Health on who is in the high risk category of Asthmatic Vulnerable persons.
The Department of Health will be contacting individuals who they have assessed (from GP or Specialist notes) as being within the Vulnerable person groups, therefore your affected staff may provide that contact information with you for clarity. If a person is in these groups, they will get a text message or a letter this week. If an individual haven't heard anything by the 29th March, and they think they are in a high risk group, they should contact their GP.
The classification of a high risk Asthmatic is:
If you are, or your child is, taking:
- Any biologic therapy, also called a mAb (Xolair/omalizumab, Nucala/mepolizumab, Cinqaero/reslizumab, Fasenra/benralizumab)
- Steroid tablets or liquid every day
- Antibiotic tablets or liquid for asthma every week (e.g. azithromycin)
- Tiotropium
- A combination inhaler that also contains a long-acting bronchodilator (e.g. Seretide, Fostair, Symbicort) at a high daily steroid dose (see the list below)
- An inhaler with a high daily steroid dose (see the list below) AND you are taking Montelukast
Then you should follow the shielding advice, which means:
- Stay at home at all times and avoid any face-to-face contact with others for at least 12 weeks.
Classification of slightly lower risk Asthmatics:
If you are not on the medicines listed above, but any of these apply to you:
- You have had an admission to hospital in the last year,
- You have needed 2 or more courses of oral steroids in the last year, OR
- You are using your blue reliever inhaler 3 or more times per week
Then you may benefit from stricter social distancing. If you are using your reliever inhaler more than 3 times a week, current advice is that you speak to your GP or asthma nurse about improving your asthma control as soon as possible.
There is a comprehensive list of steroids below.
Relevant link: https://www.asthma.org.uk/coronavirus
Any questions or queries please get in touch.
Kind regards
Nick
What is a high daily steroid dose for different inhalers?
If you are on the dose listed or more, then it is considered a high daily dose of steroids. This will help you work out if you need to follow the shielding advice above.
We have taken this list from the British Thoracic Society’s guideline on asthma management and information from our clinical advisers. If your inhaler is not listed, it may not be able to be prescribed at a high dose. If you think you might be on a high dose and your inhaler is not listed here, you can contact your asthma nurse or pharmacist for advice.
Inhaler
Adult
Child
Clenil Modulite pMDI
250 micrograms 2 puffs twice a day
200 micrograms 2 puffs twice a day
Kelhale pMDI
100 micrograms 4 puffs twice a day
Qvar pMDI, Autohaler or Easi-Breathe
100 micrograms 4 puffs twice a day
100 micrograms 2 puffs twice a day
Soprobec pMDI
250 micrograms 2 puffs twice a day
200 micrograms 2 puffs twice a day
Alvesco pMDI
160 micrograms 2 puffs twice a day
160 micrograms 2 puffs once a day
Flixotide Evohaler
250 micrograms 2 puffs twice a day
125 micrograms 2 puffs twice a day
Budesonide Easyhaler
400 micrograms 2 puffs twice a day
200 micrograms 2 puffs twice a day
Budelin Novolizer
200 micrograms 4 puffs twice a day
200 micrograms 2 puffs twice a day
Pulmicort Turbohaler
400 micrograms 2 puffs twice a day
200 micrograms 2 puffs twice a day OR 400 micrograms 1 puff twice a day
Flixotide Accuhaler
500 micrograms 1 puff twice a day
250 micrograms 1 puff twice a day
Fostair pMDI or NEXThaler
200/6 two puffs twice a day
DuoResp Spiromax
320/9 two puffs twice a day
320/9 one puff twice a day OR 160/4.5 two puffs twice a day
Symbicort Turbohaler
400/12 two puffs twice a day
200/6 two puffs twice a day
Fobumix Easyhaler
320/9 two puffs twice a day
Flutiform MDI
250/10 two puffs twice a day
125/5 two puffs twice a day
Flutiform K-Haler
Not licensed at high doses
125/5 two puffs twice a day
Aerivio Spiromax
500/50 one puff twice a day
AirFluSal Forspiro
500/50 one puff twice a day
AirFluSal pMDI
250/25 two puffs twice a day
Aloflute pMDI
250/25 two puffs twice a day
Combisal pMDI
250/25 two puffs twice a day
125/25 two puffs twice a day
Fusacomb Easyhaler
500/50 one puff twice a day
Sereflo pMDI
250/25 two puffs twice a day
Seretide Accuhaler
500/50 one puff twice a day
250/50 one puff twice a day
Seretide Evohaler
250/25 two puffs twice a day
125/25 two puffs twice a day
Sirdupla pMDI
250/25 two puffs twice a day
Stalpex Orbicel
500/50 one puff twice a day
Relvar Ellipta
184/22 one puff once a day
92/22 one puff once a day
Asmanex Twisthaler
400 micrograms 1 puff twice a day
200 micrograms 1 puff twice a day
If being used as part of a MART regime
Fostair pMDI or NEXThaler
100/6 one puff twice a day + 1 additional puff when necessary (if using at least 5 puffs each day on average)
Symbicort Turbohaler
100/6 two puffs each day + 1 additional puff when necessary (if using at least 10 puffs each day on average)
Symbicort Turbohaler
200/6 two puffs each day + 1 additional puff when necessary (if using at least 5 puffs each day on average)
DuoResp Spiromax
160/4.5 two puffs each day + 1 additional puff when necessary (if using at least 5 puffs each day on average)
Fobumix Easyhaler
80/4.5 two puffs each day + 1 additional puff when necessary (if using at least 10 puffs each day on average)
Fobumix Easyhaler
160/4.5 two puffs each day + 1 additional puff when necessary (if using at least 5 puffs each day on average)
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Update on 'keyworkers'
Thu 19 Mar 2020Thank you for your responses to this morning’s letter. We are still awaiting clarification from the Government as to who qualifies as keyworkers. We will pass this information on to you and allocate places to pupils as soon as we receive this clarification, which will probably be tomorrow. In order to minimise risks of contagion, it will be vital that we only allocate places to pupils who have no alternative non-keyworker parent or carer.
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Stay at home: guidance for people with confirmed or possible corona virus (COVID-19) infection
Mon 16 Mar 2020 -
St Paul's Attendance Policy
Fri 13 Mar 2020With reference to St Paul’s Attendance Policy and taking current advice from the Government website who are working with the Department of Education and Public Health England, school will authorise and code an absence under the following guidelines:
Where a pupil cannot attend school due to illness, as normally would happen, the pupil should be recorded as absent in the attendance register and the school will authorise the absence. Code I (Illness) should be used in this instance.
Where a pupil is in self-isolation, in accordance with latest information and advice from Department of Health and Social Care and Public Health England, the pupil should be recorded as unable to attend due to exceptional circumstances in the attendance register. Code Y (Unable to attend due to exceptional circumstances) should be used in this instance
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How you will be informed if in the event school will be closed
Mon 09 Mar 2020Please be assured that in the event of any school closure all parents and carers of our school community will be fully informed via Parent Pay and the school website. 9.3.20