Covid-19 and PBC

6/2/2022

Statement from the PBC Foundation Medical Advisory Board

Since our last advice about Covid, there have been major developments. Although infections are still prevalent, the infections tend to be less severe, a smaller proportion of patients are admitted to hospital because of Covid and deaths from Covid are far fewer. Vaccination has been very effective and safe and treatments for those with Covid are far more effective in preventing serious illness and death. However, despite the relaxations in social activities, Covid has not gone away; infections are occurring, and, although for most people, the infection is mild, it may be serious and long Covid can affect many people.

Thus, while there is a great deal to celebrate, Covid has not gone away and will continue to affect us.  People with PBC, especially those with advanced disease, and those on immunosuppression are among those who are at greater risk. Note that UDCA and obeticholic acid are not immunosuppressive agents.

Advice from the Medical Advisory Committee includes:

Get yourself vaccinated: if you are eligible for vaccination, whether first, second, third or booster, take full advantage of the offer and get vaccinated. There are very few side effects from the vaccine and these contrast with the many, proven benefits to yourself and others: vaccinated people are less likely to get severe disease, less likely to require hospital admission, less likely to die from Covid and less likely to infect others.

Take sensible precautions:

• if you are in an enclosed space, consider wearing an appropriate mask, keep your distance where possible and ensure adequate ventilation

• Continue to use hand washing and sanitisation

• Avoid contact with people known to have Covid

Do go out and meet others: maintaining physical activity and keeping our mental health are important too.

For the clinically vulnerable

This group includes those who are on immunosuppressive drugs and those with advanced liver disease; if you are in this group, guidance includes:

• considering whether you and those you are meeting have been vaccinated – you might want to wait until 14 days after everyone’s most recent dose of a Covid-19 vaccine before being in close contact with others

• asking friends and family to take a rapid lateral flow antigen test before visiting you

• asking home visitors to wear face covering

• avoiding enclosed crowded spaces

Work for those who are immunosuppressed: HSE Guidance for England includes the following:

• UK government public health guidance advises people who are immunosuppressed or clinically extremely vulnerable, to work from home if they can. If they cannot work from home, they should talk to their employer about any temporary arrangements that could be made to reduce the risks.

• Employers have responsibilities to their employees who are immunosuppressed or clinically extremely vulnerable or live with people who are in these categories. Employers can help to support these workers by explaining clearly how they are managing the risks from Covid-19, asking and responding to any concerns they may have and making sure everyone works safely. Factors that should be included in addressing the employee’s safety are travel to and from work as well as in the work place.

Please note that the situation regarding Covid-19 is continually changing and advice given by the UK’s 4 nations varies. The advice given above is current at the time of writing, but further details should be obtained from the national bodies.

More information is available at:

https://www.gov.uk/government/collections/coronavirus-covid-19-list-of-guidance

https://www.gov.scot/collections/coronavirus-covid-19-guidance/

https://gov.wales/coronavirus

https://www.nidirect.gov.uk/articles/coronavirus-covid-19-regulations-and-guidance-what-they-mean-you

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