COVID-19 and Immunodeficiency

Updated 15 May 2020

ASCIA COVID 19 ImmunodeficiencyThis information has been developed for people with primary and secondary immunodeficiencies, in response to the COVID-19 infectious respiratory disease pandemic caused by SARS-CoV-2, the most recently discovered coronavirus. Public health measures and restrictions that were implemented by the Australian and New Zealand governments since mid-March 2020 have been successful in controlling the spread of COVID-19.

This information has been updated, following the easing of some restrictions in mid-May 2020.

pdfASCIA PCC COVID-19 and Immunodeficiency 2020140.58 KB 

What is COVID-19 and how does it spread?

Coronaviruses are a large family of viruses that cause respiratory infections, including the common cold and more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

The most recently discovered coronavirus (SARS-CoV-2), causes coronavirus disease (COVID-19), with symptoms that include cough, fever and shortness of breath. This virus and disease were unknown before the outbreak began in December 2019.

The World Health Organisation (WHO) is assessing ongoing research on how COVID-19 is spread. Studies to date suggest that the coronavirus that causes COVID-19 is mainly spread through contact with respiratory droplets containing the virus. COVID-19 can spread when someone:

  • Inhales droplets containing the virus when a person with COVID-19 coughs or sneezes.
  • Touches a person or surface that is contaminated with droplets containing the virus, then touches their eyes, nose or mouth. From there, the virus can enter the body and cause illness.

What precautions should people with immunodeficiencies take?

Most people with immunodeficiencies and those on medications that suppress their immune system are immunocompromised and are therefore at greater risk of any respiratory infections.

However, we do not know whether people with immunodeficiencies are at risk of more severe symptoms if they get COVID-19.

Precautions they take to prevent infections are consistent with the actions listed below, and they should follow the usual advice from their physician.

People with severe immunodeficiency or immunosuppression, including those undergoing bone marrow (stem cell) transplant are at high risk from all infections. They will already be aware of the need to avoid infections, (including actions listed below) and what to do if they are unwell or come in contact with any infectious disease.

People with immunodeficiencies who receive monthly immunoglobulin replacement therapy infusions in hospitals still need to receive their treatment. Hospital infection control policies are in place with extra precautions to isolate patients with, or at risk of getting COVID-19. If infection of COVID-19 is suspected at the time of infusion, promptly contact the treating team for advice.

Additional advice for people with immunodeficiencies

In addition to the actions listed below:

  • Request telehealth (video or phone) consultations if your immunologist agrees, and discuss having the influenza vaccine, and any additional vaccines you may benefit from.
  • If you are on immunoglobulin replacement therapy, continue to have this, it as previously prescribed.
  • Do not stop or reduce medicines, including any antibiotics or other medicines used to prevent infections, or immune suppressing medicines, without discussing this with your immunologist.

What actions can reduce the spread of COVID-19 and other respiratory infections?

To reduce the spread of COVID-19 and other respiratory infections, the following actions should be taken:

  • Hand hygiene is the top priority. Regular and thorough hand washing with soap and water throughout the day, particularly after using the bathroom and before eating is vital for preventing infections. Alcohol-based hand-gel can be used to sanitise hands when soap and water isn’t available. Avoid touching your eyes, nose and mouth. Also avoid shaking hands or any other greeting that involves contact. 
  • Respiratory hygiene is also a priority. This involves covering the mouth and nose with a bent elbow or tissue when coughing or sneezing, then disposing of the used tissue immediately. It is also important to maintain at least 1.5 metres distance away from anyone, especially if they cough or sneeze.
  • Stay home if you are unwell. If anyone has a fever, cough or breathing difficulty, they should stay home, seek medical attention (call in advance), and follow the local health authority instructions. Self-isolation is required if contact has been made with someone with COVID-19 symptoms, or symptoms develop following contact with someone who has COVID-19 (see details below). Quarantine of 14 days is required for people who have travelled from overseas, even if they do not feel unwell.
  • Follow government advice and restrictions. It is important that everyone complies with government restrictions, that include the actions listed above and physical/social distancing measures

When is self-isolation required?

Self-isolation is required if contact has been made with someone with COVID-19 symptoms, or symptoms develop following contact with someone who has COVID-19. Information on how to self-isolate is on the following websites:

www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/how-to-protect-yourself-and-others-from-coronavirus-covid-19/isolation-for-coronavirus-covid-19

www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-novel-coronavirus-health-advice-general-public/covid-19-novel-coronavirus-self-isolation  

Further information

The ASCIA COVID-19 webpage www.allergy.org.au/members/covid-19 is regularly reviewed and updated, with links to the following information:

ASCIA COVID-19 information | Information from other organisations and governments Publications COVID-19 and Telehealth | Medical product supply updates | IUIS  COVID-19 Primary Immunodeficiency Survey | COVID–19 Global Rheumatology Alliance Registry | ASCIA COVID-19 Working Party | COVID-19 Symptom Checker | COVID-19 Dashboard

© ASCIA 2020

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.

ASCIA resources are based on published literature and expert review, however, they are not intended to replace medical advice. The content of ASCIA resources is not influenced by any commercial organisations.

For more information go to www.allergy.org.au

To donate to immunology research go to www.allergyimmunology.org.au

Content updated May 2020

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