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

BRCA gene mutations

Page reviewed 30th September 2021

Information for ovarian cancer patients in England who are currently receiving treatment

The national shielding programme ends for people in England 

The shielding programme - which was paused on 1st April 2021 - has now officially ended in England. This means that people who were previously considered clinically extremely vulnerable (at higher risk of serious illness from Covid-19) will not be advised to shield in the future or follow specific national guidance.

If you were part of the clinically extremely vulnerable group, you will receive a letter from the government telling you more about the latest changes and available support. You should continue follow the same general guidance as everyone else, as well as any specific advice you may have been given by your oncologist or medical team.

We understand that you may have lots of questions or feel uncertain about the decision to end the shielding programme, which was introduced in March 2020 to help protect people thought to be at high risk of becoming seriously ill if they caught coronavirus. 

The government has explained that it is the right time to end shielding as the situation is now very different to the start of the pandemic. We know a lot more about the virus, the vaccine continues to be rolled out, new treatments and interventions are improving patient care, and extra doses of the vaccine are now available to help protect people who are immunosuppressed. That's why the government thinks it is no longer appropriate to advise people to follow restrictive, centralised guidance. However, they will continue to assess the situation and, based on clinical advice, will respond accordingly to keep the most vulnerable safe.

Please see our FAQs below to find out more information. You can also click here to get in touch with Ovacome who offer expert support for those affected by the disease, or email us at info@ovarian.org.uk if you have any questions. 

The UK has approved four Covid-19 vaccines 

Three safe and effective coronavirus vaccines (developed by Pfizer/BioNTech, Oxford/AstraZeneca and Moderna) are now available in the UK, and a fourth (developed by Janssen) will be available later this year. The vaccine is free and will be available to everyone who will benefit, starting with those most at risk. Everyone who is clinically extremely vulnerable people - including ovarian cancer patients - should now have been offered the second dose.

Click here to read our Covid-19 vaccine FAQs to find out more. 

FAQs for patients in England 

Who was previously identified as 'clinically extremely vulnerable'?

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 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. 

You are likely to have been considered clinically extremely vulnerable if you have been diagnosed with ovarian cancer and you are currently 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.

In February 2021, the government added 1.7 million people to the Shielding Patient List in England. This was following the the use a new risk-assessment tool that's been developed to help doctors identify groups of clinically vulnerable people. The tool (called QCOVID) takes into account someone's ethnicity, weight, age, and if they live in a deprived area to work out if they are more likely to become seriously ill from Covid. It also considers underlying health conditions, such as:

  • Lung or oral cancer
  • Blood and bone marrow cancers
  • Solid organ transplant 
  • If someone has had chemotherapy in the last 12 months
  • If someone has been prescribed oral prednisolone by a clinician four or more times in the last six months 
  • If someone has been prescribed immunosuppressants by a clinician four or more times in the last six months

You can find out more about the risk-assessment tool here.

Anyone who has been added to the Shielding Patient List was prioritised for vaccination and received guidance on staying well during the pandemic. 

Your clinician or GP may also have added you to the Shielded Patient List if, in their clinical judgement, you were at higher risk of serious illness if you catch the virus. 

If you have had ovarian cancer in the past and made a full recovery, you are unlikely to have been considered 'clinically extremely vulnerable'.

If you do not receive a letter from the government then you were not considered to be clinically extremely vulnerable.

What does the guidance for people previously considered clinically extremely vulnerable say?

The shielding programme has now officially ended in England.

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. 

The situation is now very different to when shielding was first introduced at the start of the pandemic. This is why the government has decided it is the right time to end the shielding programme. 

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.

 You might also want to keep thinking about extra things you can do to keep yourself safe. This 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

The government has acknowledged that not everyone will be as well-protected by the Covid-19 vaccine as others. If you are immunosuppressed due to underlying health conditions or medical treatment, you may not have a full immune response to the vaccine. If this is the case, please talk to your clinician at your next routine appointment about any extra steps you might need to take to help stay safe. 

There is different guidance for people living in Scotland, Wales and Northern Ireland

Why has the shielding programme ended?

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 (which was paused on 1st April 2021) as the situation is now very different to when shielding was first introduced. 

We know a lot more about the virus, the vaccine has been offered to all adults, other treatments and interventions are becoming available to improve patient care, and third doses and booster vaccines are now being offered to help 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. 

Will shielding ever be used again in 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.

Is there still a Shielded Patient List?

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.

What extra steps can I take to lower my risk of infection?

If you were identified as clinically extremely vulnerable, we understand that the end of many Covid-19 restrictions this year may have 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 once restrictions lift. 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 
  • check whether the number of Covid-19 cases are falling in your area using the BBC postcode checker
  • check whether the people you plan to meet are vaccinated

You can read more about the steps you can take to keep yourself and others safe here.

I've been diagnosed with ovarian cancer since March 2020 - will I have been added to the Shielded Patient List?

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.

Where can I get a copy of the latest letter for clinically vulnerable people?

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.

Where can I find support?

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
The NHS Volunteer Responders programme is still available to help support those who need it. Volunteers can collect and deliver shopping, medication and other essential supplies. Call 0808 196 3646 between 8am and 8pm, 7 days a week to self-refer or visit NHS Volunteer Responders for further information. There may also be other voluntary or community services in your local area that you can access for support.

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.

Where can I find mental health support?

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. 

What about my treatment? Will it be safe to go into hospital?

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. 
Wider measures are also being taken by all hospitals that are treating Covid patients to ensure that Covid and non-Covid patients are kept separate. For example, there may be separate entrances for Covid and non-Covid patients, all patients admitted to hospital as an emergency will be tested for Covid, and patients going into hospital for surgery or another elective procedure will be asked to isolate for 14 days and be offered a Covid test wherever possible.

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.

Will there be any problems accessing my cancer drugs?

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.

What do I do if I have COVID-19 symptoms?

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.

What should I do if I'm experiencing ovarian cancer symptoms?

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.

Where can I find out more about the Covid-19 vaccine?

Do you have another question?

If you have a question that hasn’t been answered, please email us at info@ovarian.org.uk - we may not know the answer straight away, but we will do our best to find out.

Government guidance is regularly being updated. Sign up here to be kept up to date with the latest government advice, information and advice from experts, and tips on your wellbeing during this uncertain time.