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Since the announcement of the second lockdown in England, we know there’s been some confusion about which rheumatology patients are considered clinically extremely vulnerable (CEV). We want to clarify that our guidance remains very much the same, and we encourage our members to use our risk stratification.


According to the latest Government guidance, adults on immunosuppression therapies sufficient to significantly increase risk of infection are considered clinically extremely vulnerable (CEV). Back in the summer, CEV people will have received a letter from the NHS and/or their GP explaining what this means for them. During this second lockdown, they will also (if they haven’t already) receive a further letter explaining the new guidance.


To determine the level of risk to your patients and define whether they're considered CEV, please refer to our risk stratification guide for rheumatology, which provides more detail. The CEV group are those patients who fall into the guide's 'shield' column. For children and young people, our risk stratification is superseded by RCPCH's shielding update.


CEV people are being asked to stay at home as much as possible, but current shielding measures in England are not as stringent as previous shielding guidance. Individuals classed as CEV should be encouraged to continue to seek support from the NHS and other health services for their existing health conditions and any new concerns. This means CEV people may continue to receive in-person care if needed.


Read our full COVID-19 guidance