Letters to the editor

We surveyed 603 long-term ventilation (LTV) patients in two large centres, Nottingham University Hospitals and Newcastle upon Tyne Hospitals, about shielding, and 86.6% reported observing strict adherence to shielding. Of those surveyed, 30 (5%) reported having developed COVID-19 symptoms but only two (0.33%) tested positive with none requiring admission. Figure 1 shows comparative retrospective data from our LTV patients demonstrating a 76% reduction in hospital admissions between March to June 2019 and 2020. Similarly, a 37% reduction was also observed in all-cause acute NIV admissions (54 in 2019 to 34 in 2020). These reductions are superior to what can be achieved by pulmonary rehabilitation (33%)1 or by using combined inhaler therapy for COPD (24%).2 It is likely that these vulnerable patients were trying to avoid hospital admission, but it would be dif cult to be treated in the community for severe hypercapnic respiratory failure requiring non-invasive ventilation.