Ovarian cancer and COVID-19 (coronavirus): advice for patients in England

If you are immunosuppressed, it means you have a weakened immune system due to a particular health condition or because you are on medication or treatment that is suppressing your immune system. This includes people who have:

• a blood cancer - such as leukaemia or lymphoma
• lowered immunity due to treatment - such as steroid medication, biological therapy, chemotherapy or radiotherapy
• lowered immunity due to inherited disorders of the immune system
• an organ or bone marrow transplant
• diseases that affect the immune system such as poorly controlled HIV
• other diseases or treatments as advised by your specialist

People who are immunosuppressed, or have specific other medical conditions, may have a reduced ability to fight infections and other diseases, including Covid-19. Most people in this group will be under the care of a hospital specialist.

You will know that you are in this group if your GP or medical team have informed you that you are eligible for:

1. a third primary dose of the Covid-19 vaccine 
2. new treatments for Covid-19

The Government has published specific guidance for people aged 12 and over who are immunosuppressed and are therefore at greater risk of serious illness if they become infected with Covid-19. 

If you are immunosuppressed in England, the guidance is to:

• ensure you have had all of the vaccines you are eligible to receive, including your booster
• continue to follow any condition-specific advice you may have been given by your specialist
• consider continuing to wear a face covering in public spaces
  
• work from home if this feels right for you – if you cannot work from home, speak to your employer about what arrangements they can make to reduce your risk
• reduce the time you spend in enclosed crowded spaces
  
• practice social distancing if that feels right for you
  
• ventilate your home by opening windows and doors to let fresh air in
  
• consider asking friends and family to take a rapid lateral flow antigen test before visiting you
  
• ask home visitors to wear face coverings and wear a face covering yourself
  
• wash your hands regularly and avoid touching your face

You are also eligible for extra vaccine doses:

People aged 12 and over who were severely immunosuppressed at or around the time of their first or second dose of the Covid-19 vaccine will be give three doses (rather than two) as part of their primary vaccination schedule. If you have completed their primary vaccine course, you will be offered a first booster (as a fourth dose) at least three months after administration of their last dose, and then a second Spring booster in 2022.

The NHS urges people who are immunosuppressed (and their household contacts) to come forward for any vaccine doses they are eligible for as a matter of urgency. We strongly encourage you to take up this invite as soon as possible to ensure you have the highest possible level of protection.

You may be offered new treatments if you test positive for Covid-19:

The NHS is offering new monoclonal antibody and antiviral treatments to people with Covid-19 who are at highest risk of becoming seriously ill and are 12 years of age or above (although only some treatments are suitable for people aged 12 to 17). Find out more on NHS.UK.

You can read the guidance for people whose immune system means they are at higher risk on GOV.UK.

At the start of the pandemic, the government introduced tailored 'shielding' advice to protect 'clinically extremely vulnerable' people from Covid-19. Being clinically extremely vulnerable (CEV) meant someone was thought to be at high risk of serious illness from Covid-19 due to a medical condition or treatment they were currently receiving. 

The shielding programme has now ended in England. The government has said that most people who were identified as CEV are now well protected after receiving their primary and booster vaccination doses. For most people who were CEV, you are no longer at substantially greater risk than the general population.

You were likely to have been considered CEV if you were diagnosed with ovarian cancer and you were having: 

• chemotherapy, or have had chemotherapy in the last three months.
• targeted cancer treatments that can affect the immune system - such as a PARP inhibitor (Olaparib, Niraparib, and Rucaparib).
• immunotherapy or any treatment that affects the immune system

The shielding programme ended in England on 15th September 2021.

Previously, the government wrote to everyone on the Patient Shielding List in March 2021 to say that shielding advice was being paused from 1st April 2021. Since 19th July 2021, clinically extremely vulnerable people have been advised to follow the same guidance as everyone else, whilst potentially thinking about extra precautions they could take to lower their chances of catching Covid-19. 

Shielding ended because we know a lot more about the virus and what makes someone more or less vulnerable to Covid-19, the vaccine continues to be successfully rolled out, and Covid treatments are becoming available. If you were part of the clinically extremely vulnerable group, you are advised to keep following the same general guidance as everyone else, as well as any specific advice you may have been given by your doctor or specialist. 

There is no longer separate guidance for people previously identified as CEV, although the government recommends anyone with underlying health conditions takes care to avoid routine coughs, colds and other respiratory viruses.

Your medical team can also help you decide what additional precautions, if any, you want to take. 

These could include:

• considering whether you and those you are meeting have been vaccinated – you might want to wait until 14 days after everyone’s second dose of a Covid-19 vaccine before being in close contact with others
• considering continuing to practise social distancing if that feels right for you and your friends
  
• asking friends and family to take a rapid lateral flow antigen test before visiting you
  
• asking home visitors to wear face coverings
  
• avoiding crowded spaces
• have your booster and/or third primary dose of the Covid-19 vaccine when offered so you have the greatest possible protection

You should also get your booster vaccine when offered. 

Visit GOV.UK for guidance on keeping yourself and others safe from Covid-19.

You can read the latest guidance for vulnerable people in England at GOV.UK. There is different guidance for people living in Scotland, Wales and Northern Ireland. 

If you were previously identified as clinically extremely vulnerable, we understand that the end of many Covid-19 restrictions and rise in Omicron cases may caused you to feel worried or anxious. It is completely up to you how and when you feel comfortable meeting up with others. It may be difficult deciding what steps you want to take to lower your risk of infection and what you feel comfortable doing. To help you decide, you may find it useful to:

• speak to your medical team to get a better understanding of your personal level of risk and to discuss any concerns or questions you may have 
• talk to your friends and family about your worries
• check the number of Covid-19 cases in your area using the BBC postcode checker
• check whether the people you plan to meet are vaccinated

There is also expert help and information available for cancer patients who need someone to talk to:

• Get in touch with ovarian cancer support charity Ovacome
• Call the Macmillan Support Line on 0808 808 00 00 or chat to one of their specialists online
• Contact the Cancer Research UK nurses on 0808 800 4040 (9am-5pm, Monday to Friday)

At the start of the Covid-19 pandemic, shielding was introduced as one of the few ways to support those who, at the time, were considered clinically extremely vulnerable (CEV). The government decided to end the shielding programme as the situation is now very different to when shielding was first introduced. 

We know a lot more about the virus, new treatments are helping to cut the risk of serious illness from the Covid-19, the vaccine roll-out has been successful, and third doses and booster vaccines are helping to protect people who may be more vulnerable to Covid-19. For these reasons, the government has decided that it is no longer appropriate to advise everyone who was on the Shielding Patient List to follow shielding measures, which can be restrictive and have a significant impact on people's lives and wellbeing. Instead, patients should discuss whether they need to follow any tailored guidance to stay safe with their specialist at their next routine appointment. 

The government will continue to assess the situation and follow clinical advice to keep the most vulnerable people safe if necessary in the future. 

The government no longer thinks shielding is the best way to keep people safe based on what we know now about Covid-19, the success of the vaccine programme and the new treatments that being made available to improve patient care. Therefore, the government does not expect to reintroduce shielding, particularly as it is very restrictive.

However, they will use the knowledge they have gained from the shielding programme to help them plan for any future emergencies or pandemics. 

We'll be regularly updating this page, so you'll always find the latest guidance here.

The Shielded Patient List will be maintained for some time. This is because the information about those who were previously identified as clinically extremely vulnerable is being used by health and social care professionals to provide care and treatment, plan health care services, and carry out medical research. More information about the Shielded Patient List can be found here.

Yes. The national list of people who were considered clinically extremely vulnerable was updated weekly. So even if you were not included in the shielding list in the first lockdown, you will have been added to the list since then.

If you are on the Shielding Patients List, you should have received a letter from the government about the end of the shielding programme. You can find a copy of the letter here.

Support getting food and medicines delivered

Priority access to supermarket delivery slots for people identified as clinically extremely vulnerable ended on 21st June. Different supermarkets may have their own policies on priority access to supermarket slots, however. Your local council may also be able to help if you are in need of support. You can find your local council here.

Also, if you want to limit your contact with others, you may decide to:

• book deliveries slots in the usual way from a supermarket
• go to the shops and pharmacy at quieter times of the day 
  
• ask friends, family or volunteers to collect medicines for you

Support to work

The government is no longer telling anyone to work from home. However, your employer still has a legal responsibility to protect you and others from risks to your health and safety. 

Your employer should be able to explain to you the measures they have in place to keep you safe at work. Some employers may request employees to undertake regular testing for Covid-19 to identify people who are asymptomatic.

If you have concerns about your health and safety at work then you can:

• raise them with your workplace union, Health and Safety Executive (HSE) or your local authority who will take action where employers are not managing the risk of Covid-19
• get in touch with the Citizens Advice Bureau, who can give you information about your rights at work
• contact Acas who can help you with a workplace problem. Visit the Acas website or call the Acas helpline on 0300 123 1100 (Monday to Friday, 9am-5pm)

If you need support to work at home or in the workplace you can apply for Access to Work which provides support for people with a disability or health condition.  

You may also be eligible to apply for Universal Credit, Employment Support Allowance or Statutory Sick Pay (SSP). Click here to find out more.

NHS services

You should continue to seek support from the NHS for your existing health conditions. You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health professional through an online consultation. To find out more visit the NHS website or download the NHS App. If you have an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.

Support for women with ovarian cancer 

We are continuing to inform and update anyone diagnosed with ovarian cancer about the latest guidance during the pandemic. 

You can sign up to receive our monthly patient e-newsletter for tips on navigating the lockdown, as well as updates on the government guidance at the bottom of the page. If there’s anything in particular you’d like to see from us, tell us on info@ovarian.org.uk. 

Ovacome's support line is now open extended hours, and you can call them for free on 0800 008 7054.

We understand that it is normal to feel anxious or go through feelings of depression at this time. There are a number of organisations and services who are there to help support your mental health and wellbeing. If you’re feeling anxious or low, visit Every Mind Matters or GOV.UK for advice and support. 

The Let’s Talk Loneliness website also has a variety of tips, advice and further resources that you may find helpful.

Ovacome's support line is now open extended hours, and you can call them for free on 0800 008 7054

If you feel like you are still struggling to cope, you can also speak to your GP. 

The NHS is working hard to diagnose,  treat and care for people with cancer, and ensure that these services return to operating as they did before the pandemic. 

Changes were made to the way services were delivered during the pandemic to keep patients and staff safe. For example:

• Covid-protected hubs were established across the country to ensure that cancer treatment continued.  The hubs support hospitals across the NHS and independent sector to work together to maximise capacity and ensure that people receive the treatment that they need. Some patients may start to see their treatment move to a different hospital as these hubs are set up.  You will remain under the care of your treating hospital and clinical specialist team and should contact them with any questions about your treatment and care.
• Most hospitals are now using more telephone or internet consultations to avoid unnecessary trips to the hospital. You may be called to arrange your treatments in this way, and planned treatments may need to be moved to help with running a smooth service. You can read a helpful guide put together by Ovacome about how to prepare for these appointments here.
• Some patients may have their chemotherapy at home or have fewer radiotherapy appointments, to reduce visits to hospital while continuing with their treatment.  
• For some people, it may be safer to delay surgery. Your doctor may suggest a different treatment in the meantime, such as chemotherapy or hormonal therapy. 

If you have an urgent medical question relating to your ovarian cancer please contact your specialist hospital care team, directly. Where possible, you will be supported by phone or online. If your clinician decides you need to be seen in person, the NHS will contact you to arrange a visit in your home, or where necessary, treatment in hospital.

For more guidance, information and sources of support please visit the British Gynaecological Cancer Society's patient information page on their website.

The government is helping pharmacies to deliver prescriptions which will continue to cover the same length of time as usual. If you do not currently have your prescriptions collected or delivered, you can arrange this by:

1. Asking someone who can pick up your prescription from the local pharmacy, (this is the best option, if possible);

2. Contacting your pharmacy to ask them to help you find a volunteer (who will have been ID checked) or deliver it to you.

You may also need to arrange for collection or delivery of hospital specialist medication that is prescribed to you by your hospital care team.There are currently no medicine shortages as a result of COVID-19. The country is well prepared to deal with any impacts of the Coronavirus and we have stockpiles of generic drugs like paracetamol in the event of any supply issues.

The Department of Health and Social Care is working closely with industry, the NHS and others in the supply chain to ensure patients can access the medicines they need and precautions are in place to prevent future shortages.

There is no need for patients to change the way they order prescriptions or take their medicines. Patients should always follow the advice of doctors, pharmacists or other prescribers who prescribe and dispense their medicines and medical products. The NHS has tried-and-tested ways of making sure patients receive their medicines and medical products, even under difficult circumstances. If patients order extra prescriptions, or stockpile, it will put pressure on stocks, meaning that some patients may not get the medicines or medical products they need.

If you are experiencing symptoms of any infection or illness, including Coronavirus, you should:

• arrange to have a test 
• contact your cancer team know as you would normally.  You can do this as well as using the NHS 111 online Coronavirus service. If you do not have access to the internet, call NHS 111. Make sure you mention that you are an ovarian cancer patient who has been considered to be at risk. Do this as soon as you get symptoms.

If you fall ill from COVID-19, or any other condition, and require treatment in hospital, you will still be treated as normal and will absolutely not be denied any medical intervention because you are clinically extremely vulnerable.

The following advice is from the British Gynaecological Cancer Society.

Some existing cancer patients have open access to their gynae-oncology service, normally via the Clinical Nurse Specialist (CNS). If you have already had a gynaecological cancer diagnosis and have symptoms concerning for recurrence (such as persistent bloating and stomach pain), please get in touch with your CNS via their usual contact details. Please be aware that many staff have been re-deployed to look after acutely unwell patients, so there may be a delay, or a CNS from another cancer team may be covering the gynaecological cancer team.  Please be understanding with us if this is the case. We will try our very hardest to look after you and get back to you as quickly as we can.

Sometimes you may be referred to another hospital in your area, if your normal hospital is very busy. We have been working together to help get you seen and treated as soon as we can. We are all one big NHS team, now more so than ever. Please bear with us and be understanding, if this is the case.

You can find out more in our Covid-19 vaccine FAQs. You can also read more here:

• NHS Covid-19 vaccine page
• GOV.UK COVID-19 vaccination page
• Joint Committee on Vaccination and Immunisation