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COVID-19: What is a risk group?

Most people who catch COVID-19 will likely experience mild symptoms and be back to normal health within days. Some people, though, are more at risk of serious illness than others.

You can find our latest features and advice on coronavirus and COVID-19 at our coronavirus hub.

Use Patient's coronavirus checker tool if you have any symptoms of fever or a new cough. Until you have used the tool and been advised what action to take, please stay at home and avoid contact with other people.

What is a risk group?

There are certain groups of people who are at greater risk of contracting COVID-19 in the first place, and of the illness hitting them harder if they do. Most importantly, being in a risk group means you are “at increased risk of severe illness from coronavirus”, according to government guidance.

Editor's note

 9th May 2020
People who have had a splenectomy (spleen removal) are now included in the 'shielded' group, along with people who have sickle cell disease (as opposed to sickle cell trait). This group was added, according to the NHS England Director of Primary Care, in April. However, not all NHS guidance has been updated to reflect this. They were previously listed in the at-risk category below.

Broadly, there are four risk groups:

  • Over-70s, regardless of any medical conditions.
  • Under-70s who have an underlying health condition - in other words, adults who are advised to have the flu jab every year on medical grounds. This group includes people who have:
  • Pregnant women.

The fourth group are at the highest risk of severe illness from coronavirus and are likely to take even more extreme measures to protect themselves. They are now classed in the 'shielded' category

  • People with complex health problems:
    • Have had an organ transplant and take medication to suppress their immune system.
    • Have cancer and are currently having active chemotherapy or radiotherapy treatment.
    • People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
    • Have blood or bone marrow cancer (like leukaemia, lymphoma and myeloma) and are at any stage of treatment.
    • Have severe respiratory/lung conditions like cystic fibrosis or severe asthma or COPD that requires admission to hospital or treatment with corticosteroids.
    • Have severe diseases of the body systems, like severe kidney disease that is managed with regular dialysis.
    • Women who are pregnant and who also significant heart disease,
    • People who have had a splenectomy.
    • People with sickle cell disease (rather than sickle cell trait).

Other factors which increase your risk

Certain lifestyle factors can also make it harder to fight off COVID-19, meaning it could take longer to recover, as doctor of immunology Dr Margo Livingston points out.


"Smoking is a definite risk factor as it compromises breathing and the lungs, which is where the virus takes hold," she explains. "Smoking also lowers the response to some medication and contributes to chronic diseases such as ischaemic heart disease and hypertension."

So, being a smoker makes it likelier that you fall into one of the main risk groups.

According to public health charity Action on Smoking and Health (ASH), the global coronavirus pandemic could be the incentive many smokers need to try to give up.

"This is a worrying time for all of us, and people are looking for what they can do to protect themselves and protect others," the organisation's chief executive, Deborah Arnott, said in a statement. "For smokers, quitting or temporarily stopping during this outbreak is one of the best things they could do right now.

"Many stop-smoking services are looking at how they can support people remotely and I urge people to also use other sources of nicotine such as NRT [nicotine replacement therapy] to help them with the cravings."

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Back to basics

When COVID-19 first broke out, the advice issued was that everybody should wash their hands with soap and warm water for 20 seconds at a time, and to do so regularly. This is because germs - including viruses like COVID-19 and the common cold - are easily spread through touch.

The stringent hand-washing guidance highlights just how important cleanliness is in safeguarding our health. It's no surprise, then, that poor hygiene can make you more vulnerable to contracting infections, like COVID-19.

"Any lifestyle that results in poor personal hygiene will increase the risk of catching the virus, or any disease," Dr Livingston says. "These people may also be suffering from other infections, which the body is trying to fight simultaneously."

She adds that having poor nutritional intake can further compromise your ability to combat illness, so maintaining a balanced diet is important to staying as healthy as possible during the outbreak.

When to worry if you're at risk

In short, try not to worry even if you or a loved-one fall into one or more risk groups. It's understandable that you might feel anxious, but if you closely follow official advice and keep up to date with any developments, there is no reason to panic.

At the time of writing, official government advice for people who fall into any of the risk groups is essentially the same as it is for everyone else - they just stress different degrees of importance.

Taking precautions

While everybody, irrespective of age and health status, is advised to adopt social distancing measures, people in any of the risk groups are strongly advised to do so.

In addition, everyone should continue to follow stringent hand-washing guidance. You should avoid touching your face - especially your eyes, nose and mouth. If you need to sneeze or cough, do so into a tissue before binning it and washing your hands again. It's important to clean and disinfect surfaces and objects that are touched often in the home, too.


If you or someone in your household develop symptoms of COVID-19, you must all move from social distancing to self-isolating.

The two symptoms to watch out for are:

  • Temperature of 37.8°C or higher (fever).
  • A new, continuous cough.

If you experience either of these symptoms, you must self-isolate. Use Patient's coronavirus checker tool to find out what to do next. Most people will experience fairly mild or moderate symptoms which can be treated at home.

Being in a risk group means you are more likely than the general population to develop complications from the virus. But it doesn't mean you should panic if you experience COVID-19 symptoms, according to Dr Adnan Sharif, consultant nephrologist at University Hospitals Birmingham.

"The advice is the same as per the general population - to stay at home," he says. "But if you begin to feel more unwell, you'll need to be assessed for medical review and/or hospital admission, based on your individual circumstances." Use Patient's coronavirus checker tool to see what steps you should take.

Getting medical advice

It's essential that you don't go to your GP, hospital or pharmacy if you have symptoms of COVID-19. Instead, use Patient's coronavirus checker tool - this will tell you if you should ring 111 (or the relevant number for your region). You should only ring 111 without checking if you don't have internet access. In an emergency, call 999 and tell them that you may have coronavirus.

If you are under the regular care of a specialist hospital department - for example, a transplant clinic, a lung consultant or (for pregnant women) a midwife or obstetrician - see if they have any information on their website or try calling the department if you need advice.

Bear in mind that all NHS services are under extreme pressure and it might take a long time for you to get through to anyone on the phone. But be patient and keep trying. Although you shouldn't panic or leave the house, it is important that you get the right advice if you're in a risk group and you are unwell with COVID-19 symptoms.

Medication and medical appointments

If you are in a risk group, you may well take regular medication. Keep taking all your medication as normal, unless a doctor has told you otherwise. If you're self-isolating because you or someone you live with has had COVID-19 symptoms, but you need to get a repeat prescription of your medication, ask someone else to collect it for you.

If there's nobody who lives near you who can help, phone your local pharmacy or your GP practice for advice. Some pharmacies are trying to organise home deliveries for people who can't get out.

Being in a risk group may also mean you have scheduled doctors' or hospital appointments. Because everybody is encouraged to follow social distancing measures, it's likely any regular, non-urgent medical appointments will be postponed or cancelled. Some surgeries are turning to telephone and video appointments to prevent people coming into the practice. Hospitals have also been advised to start looking at non face-to-face options for appointments, to reduce the risk for vulnerable patients.

Although this might be frustrating, remember that these measures are being implemented to keep you and other people safe.

Your healthcare team will be in touch with you as soon as they can to update you about any appointments they need to change.

Editor's note

This article was updated on 9th May 2020 following updated guidance from the NHS on who falls into the at risk and who is in the shielded categories.

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