Covid-19 Questionnaire

Have you had a high temperature ? (this can mean feeling hot to touch on your chest and back - you do not need to measure your temperature)

Have you had a new continuous cough? (coughing a lot for more than an hour, or three or more coughing episodes in 24 hours - if you usually have a cough, it may be worse than usual)

Have you lost sensations of taste or smell?

Have you had close contact (under 2 metres) with anyone with a confirmed Covid-19 diagnosis or someone exhibiting the above 3 symptoms in the last 14 days?

Have you recently travelled abroad and/or been instructed by the government to quarantine?

Have you been contacted by the government or NHS and told to self-isolate for any reason?

Do you fall under the clinically vulnerable category or the clinically extremely vulnerable category? (see below)

Confirmation

Clinically Vulnerable People

This category of risk includes:

  1. Anyone aged 70 and older (regardless of medical conditions)
  2. Anyone under 70 with an underlying health condition (that is,anyone instructed to get a flu jab as an adult each year on medical
    grounds) – such as:
    a/ chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic
 obstructive pulmonary disease (COPD), emphysema or bronchitis
    b/ chronic heart disease, such as heart failure
    c/ chronic kidney disease
    d/ chronic liver disease, such as hepatitis
    e/ chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
    f / diabetes
    g/ a weakened immune system as the result of conditions such as HIV and AIDS, or medicines (such as steroid tablets )
    f/ being seriously overweight (a body mass index (BMI) of 40 or above)
    g/ pregnant women

Clinically extremely vulnerable people

This category of risk includes:

  1. Solid organ transplant recipients.
  2. People with specific cancers:
    a/ people with cancer who are undergoing active chemotherapy
    b/ people with lung cancer who are undergoing radical radiotherapy
    c/ people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
    d/ people having immunotherapy or other continuing antibody treatmentsfor cancer
    e/ people having other targeted cancer treatments which can affect theimmune system, such as protein kinase inhibitors or PARP inhibitors
    f/ people who have had bone marrow or stem cell transplants in the last 6months, or who are still taking immunosuppression drugs
  3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease(COPD).
  4. People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
  5. People on immunosuppression therapies sufficient to significantly increase risk of infection.
  6. Women who are pregnant with significant heart disease, congenital or acquired.
  7. Other people have also been classed as clinically extremely vulnerable,based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions.

More information about who has been classed as clinically extremely vulnerable is available on the NHS Digital website.