PWE-13 Experience of shielding during first wave of COVID-19 amongst uk patients with autoimmune hepatitis (AIH)

IntroductionIn March 2020, severe acute respiratory syndrome SARS-CoV-2 was declared a pandemic. Specific shielding guidance produced by PHE aimed to protect clinically extremely vulnerable individuals. This included people with AIH on immunosuppressants. In the first wave, advice included not leaving home. The practicalities of this and impact of enforced shielding on mental health (MH) and well-being is not well documented, although suicide theories emphasise the negative effect of social isolation and loneliness. We conducted a patient survey to assess the impact of shielding in our AIH cohort.MethodsBetween 1Jul -10 Aug 2020,292 patients with AIH, fulfilling shielding criteria were invited to participate in a clinician designed survey on MSForms® online or by hand. Paper responses were entered online for analysis.Results36%(104)participated;79% female,74% age 25-69. Immunosuppression burden:50% single agent,47%dual, 3%on ≥3.Shielding compliance was ranked on a scale from 0-10:60% 9-10/10,29%7-8/10,11%0-6/10. Reasons for breaches included: exercise, shopping, to have a drive. Responses demonstrated assessment of risk by those breaching guidance. Ease with practical aspects of living were assessed on a scale from 0-10. One third found this ‘very easy’,1/3 ‘quite easy’,1/3 ‘not very easy’. For shopping, respondents used family members(49%),online(39%),shop in person(8%),other(4%).NHS volunteers were not used for shopping. Obtaining prescriptions was reported as easy in 79%: 76% used family/online pharmacy deliveries, other methods included: friend/neighbour, hospital delivery, NHS volunteer, collection in person. Of those with long-term partners 95% continued co-habiting but 4% lived separately in this period, remaining respondents previously lived alone. Respondents were asked to rank their MH and physical well-being. 27% reported MH as ‘high’, 27%‘moderate’,46%‘low’.Whilst 87% had access to outdoor space, only 46% had access to space large enough to exercise. Questions on the impact of shielding on other household members highlighted the perceived loss of independence and ‘guilt’ associated with the negative impact of shielding on others. Pertaining to work/employment, 38%(40/104) were employed in March 2020. Of those answering the question ‘How did you work during the shielding period’: 54% worked from home (WFH), prior to COVID-19 only 5% WFH. 2% continued to commute to work.ConclusionThis survey has provided a unique insight into shielding attitudes