Hiqa: Over 70s at greater risk from Covid-19 but other at-risk groups must be wary

On examining a range of international studies, the authority found that the strongest evidence available suggested that people over 70 were at greater risk of severe illness from the virus.

There is strong evidence internationally that people over 70 are at greater risk from Covid-19, according to a review by the Health Information and Quality Authority (Hiqa), which said a precautionary approach is required for other at-risk groups.

Following a request from the National Public Health Emergency Team, Hiqa has carried out a review of who is considered to be “extremely medically vulnerable” to Covid-19 and at greater risk of severe illness.

On examining a range of international studies, the authority found that the strongest evidence available suggested that people over 70 were at greater risk of severe illness from the virus.

It cautioned, however, that other medically vulnerable groups were also at risk and, in the absence of scientific evidence, these at-risk groups should continue to adopt a precautionary approach to the virus.

Those considered to be ‘extremely medically vulnerable’ to Covid-19 include the following:

• people over 70 years of age, 
• people who have had an organ transplant, 
• patients with cancers, such as lung or blood cancers, or who are receiving immunotherapies or treatments affecting the immune system, 
• people with severe respiratory conditions, including cystic fibrosis, severe asthma, pulmonary fibrosis/ lung fibrosis/ interstitial lung disease and severe COPD, 
• people with rare diseases and other conditions that significantly increase the risk of infections, 
• people receiving immunosuppression therapies that affect the immune system, 
• women who are pregnant with significant heart disease, congenital or acquired.

HIQA said international evidence and Irish data on Covid-19 illness and death rates should be reviewed on an ongoing basis to update current risk categories.

HIQA’s Director of Health Technology Assessment, Dr Máirín Ryan, said the review findings did not support the removal of any of the groups categorised as ‘extremely medically vulnerable’.

“These groups should be extra vigilant and follow HSE Infection Prevention and Control Guidance due to the potentially increased risk of experiencing severe illness due to Covid-19,” the Deputy Chief Executive of HIQA said.

We have published our advice to NPHET on the categorisation of groups which are at the highest risk of having a severe illness from COVID-19. You can find out more here: https://t.co/bAjFWww49w pic.twitter.com/73fcVNE6XC

— HIQA (@HIQA) December 4, 2020

Dr Ryan also stressed that individuals concerned that they may fall into an at-risk group should take precautions and seek advice.

“It is important for individuals to consider their own level of risk,” Dr Ryan said. 

For example, adults aged 50 years and older with multiple chronic conditions, living under circumstances of increased deprivation are not included in the ‘extremely medically vulnerable’ category, but are at increased risk of severe disease if they develop Covid-19.

As part of the review, Hiqa has published an updated guide for people falling into the ‘extremely medically vulnerable’ group, which details the steps people, their carers and families, can take to reduce the risk of contracting Covid-19.

Going to places at quiet times, keeping your distance, not touching things if you do not need to touch them, cleaning your hands and wearing a face covering, featured among the advice given.

“Managing who comes into your home is the most important part of keeping your home as a safe haven,” the updated guidance also states.

Hiqa advised that a number of agencies and groups were available to help when needed including the following organisations:

• HSE Safeguarding and Protection Teams.
• SAGE (1850 71 94 00 from 8 in the morning until 10 at night) www.sageadvocacy.ie.
• ALONE (0818 222 024 from 8 in the morning until 8 at night) www.alone.ie.
• The HSE confidential recipient at 1890 1000 14.
• Alzheimer Society of Ireland 1800 341 341 (www.alzheimer.ie).
• If you need medical assistance call your GP or in an emergency call 112 or 999 
• Family Carers Ireland 1800 240724. (https://www.familycarers.ie/media/1986/family-carers-ireland-emergency-plan.pdf).