Alert Level 2 Update!

Information for Alert Level 2. 

We have recognised some of you with children are understandably concerned about sending your immune compromised children back to school.  Professor Andrew Day has very kindly written some guidelines to help you with your decisions.

 

Over the last 6 weeks the country has been through totally unprecedented lengths to stamp out and control the novel coronavirus (SARS-CoV-2). And together, as a country, we have made amazing progress.

Yesterday we heard about the next steps we will take: with de-escalation from Alert Level 3 to Level 2.

When Level 2 was instituted the number of cases were increasing steadily, and there were concerns about risk of community spread. Now as we de-escalate, the situation is very different, with very few cases, and no concerns about community spread. Consequently, the risk of contracting the infection is currently very low.

In addition, over the course of the last few weeks there have been tremendous efforts across the world to understand more about how SARS-CoV-2affects people with IBD. More than 1000 people with IBD in many different countries who acquired the infection have been notified through these initiatives. Generally, from this we know that people with IBD are not at a greater risk of having worse infections. The main factors that have influenced the risk of having more severe infection with this virus have been age (particularly older adults), coexisting conditions (such as heart disease or chest problems), current treatment with steroids, current smoking, and uncontrolled disease.  We know also that the infection is much less common in children, that children don’t spread the virus like adults do, and that spread from asymptomatic children is uncommon.

With the phased move to Level 2, schools and universities will be reopening. In terms of children and adolescents with IBD returning to school, the general rule is that those who were at school before COVID-19 should be able to return to school. It is not in children’s best interest to exclude them from school for further extended periods, while the risk of infection in the community is very low. However, some children may still be at greater risk, and we would suggest more caution for them.

## Children with IBD who are currently on steroids (such as for treatment of a recent flare of disease) or who are having multiple immunosuppressive medications or who have other significant associated conditions should delay return to school for now.

Most children who are on two immunosuppressive medications will be fine to head back to school if they are well and stable with their IBD : some children in this situation may need to delay their return to school; e.g. children that may have an infliximab infusion scheduled later this week.

## Other children with IBD (who are stable, on no medications, on Pentasa or similar medicines, or on one immunosuppression medicine) are fine to return to school.

These outlines may not cover all eventualities:  if you are not sure, it would be best for you to discuss directly with own doctor. In addition, these outlines may change over time.

Also, if you have not had a chance yet, it remains important to arrange the flu vaccine for your child with IBD. Finally, it is important for us all to maintain vigilance and stick to the basics (hand-washing, physical distancing, cough etiquette and so on).

 

There is some extra guidance around what Alert level 2 means for people "at risk", click here to read what the advice is from the Government.

 

New Zealand Society of Gastroenterology has shared some guidelines for IBD Patients in New Zealand - staying safe & well during Alert level 1 & 2 of the COVID-19 outbreak.

Click here to download the full PDF document.