Are You at Risk?
People with IBD who are not using imunosuppressive medications, are not malnourished, and do not have severe active inflammation are currently believed to be at the same risk of infection and complications from COVID-19 as the general population.
Scroll down to find out your level of risk and what you should do.
What is your Level of Risk?
Refer to the guidance on the following chart to find out what your level of risk is and what you should do:
Watch the 6-minute video below for this breakdown of level of risk to patients from lowest to highest risk level.
If you are on immunosuppressive medications, you may be at increased risk for infection and serious complications of COVID-19.
Immunosuppressive and biologic medications include:
- Steroids: prednisone (Deltasone), methylprednisolone, hydrocortisone (Hydrocort, Cortate)
- Immunomodulators: azathioprine (Imuran), 6-mercaptopurine (Purinethol), methotrexate
- Anti-TNF biologics: infliximab (Remicade®, Inflectra®, RenflexisTM), adalimumab (Humira®), golimumab (Simponi®)
- Anti-IL12/23 biologics: ustekinumab (Stelara®)
- Anti-leukocyte migration biologics: vedolizumab (Entyvio®)
- JAK inhibitor small molecules: tofacitinib (Xeljanz®)
The following IBD treatments do not suppress your immune system:
- 5- aminosalicylates (5-ASA's): mesalamine, mesalazine (Asacol®, Mezavant®, Pentasa®, Salofalk®), sulfasalazine (Salazopyrin®)
- Locally acting steroids: budesonide (Entocort®), budesonide MMX (Cortiment®), steroid enemas
- Enteral nutrition (formula feeds) or dietary therapies
Watch the 4-minute video below to learn about the safety of medication use during COVID-19.
Older Adults and Vulnerable Groups
People at higher risk also include older adults, people with an underlying medical condition (e.g., heart disease, hypertension, diabetes, chronic respiratory diseases, cancer), or having a compromised immune system from a medical condition or treatment (immunosuppressive medications). More information on vulnerable populations are available on the PHAC website.
Watch the 8-minute video below to learn more from experts about risks of COVID-19 and special considerations for people with IBD.
What is Physical Distancing? 
- Keep a distance of at least two metres from the nearest person
- If possible, cancel group events and hold meetings virtually rather than in-person
- Avoid people who are sick
- Do not shake hands, hug, or engage in physical contact with other people, especially if they are sick
- Practice good hand hygiene: Wash your hands with soap and water regularly after social contact, before meals, and often in between, or use hand sanitizer that contains at least 60% alcohol when soap and water is not available. Avoid touching your face. Cough into your sleeve.
Level of Risk Differs Across People 
Please note that not everyone is at the same risk of serious COVID-19 disease. For example, children and adolescents are more likely to have mild or no symptoms of COVID-19.
We don’t know whether children and adolescents on immunosuppressive medications have a higher risk of COVID-19 complications. Therefore, we have considered everyone on immunosuppressive medications to be vulnerable for serious COVID-19 disease.
If you Work for Essential Services 
People working in essential services in the Medium Risk group (such as health care providers) should consider balance the public need for these essential services with the higher risk of contracting COVID-19. Further guidance can be provided by your local public health authority.
For more information on coping with COVID-19 if you work for an essential service, please click here.
What is Self-isolation? 
- Stay at home and monitor yourself for symptoms, even if mild, for 14 days
- Avoid contact with others
If you have no symptoms of COVID-19, you can still go outside for:
Refer to our guidance for more information on how to self-isolate at home when you may have been exposed and have no symptoms.
- Fresh air
- A run
- A bike ride
- To walk the dog
Family Members of People with IBD 
Considerations for family members of high-risk people with IBD. In general, avoid being in close proximity with other people, who might give your family member COVID-19, resulting in transmission to you. Your family members should:
- Try to avoid in-person meetings
- Try to work from home; if not possible, speak to your employer about physical distancing at work
- Use services for vulnerable people (e.g. special grocery store times, pharmacy delivery, etc.)
- Clean your residence as best as possible to avoid transmission of the virus; instructions for disinfecting your residence are available from the Centers for Disease Control and Prevention
While doing these activities, always maintain a distance of at least two arms-length (approximately two metres) from others. Refer to our guidance for more information on how to self-isolate at home when you may have been exposed and have no symptoms.
Reopening of Schools and the Economy
Some provinces and territories are starting to re-open the economy, including stores, schools, and outdoor activities. Expert guidance has been developed for different age groups and are meant to help you decide whether to continue self-isolation, or to start engaging in activities outside of your home. Please click here for the recommendations.
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