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26.06.2020

New Guidance for shielded ‘extremely vulnerable’

The government has updated its guidance for people who are shielding taking into account that coronavirus COVID-19 infection rates have decreased significantly over the last few weeks. This guidance remains advisory.

People who are shielding remain vulnerable and should continue to take precautions but may now choose to leave their home, as long as they are able to maintain strict social distancing. If you choose to spend time outdoors, you may do so with members of your own household. If you live alone, you can spend time outdoors with one person from another household. Ideally, this should be the same person each time.

If you do go out, you should take extra care to minimise contact with others by keeping 2 metres apart. This guidance will be kept under regular review.

On 22 June the government set out a series of steps for further relaxing shielding guidance which will come into effect on 6 July and 1 August.

From 6 July, the government will be advising:

  • you may, if you wish, meet in a group of up to 6 people outdoors, including people from different households, while maintaining strict social distancing
  • you no longer need to observe social distancing with other members of your household
  • in line with the wider guidance for single adult households (either an adult living alone or with dependent children under 18) in the general population, you may from this date, if you wish, also form a ‘support bubble’ with one other household. All those in a support bubble will be able to spend time together inside each other’s homes, including overnight, without needing to socially distance

From 1 August the government will be advising that shielding will be paused. From this date, the government is advising you to adopt strict social distancing rather than full shielding measures. Strict social distancing means you may wish to go out to more places and see more people but you should take particular care to minimise contact with others outside your household or support bubble. In practice this means that from 1 August:

  • you can go to work, if you cannot work from home, as long as the business is COVID-safe
  • children who are clinically extremely vulnerable can return to their education settings if they are eligible and in line with their peers. Where possible children should practise frequent hand washing and social distancing
  • you can go outside to buy food, to places of worship and for exercise but you should maintain strict social distancing
  • you should remain cautious as you are still at risk of severe illness if you catch coronavirus, so the advice is to stay at home where possible and, if you do go out, follow strict social distancing

The guidance for the clinically extremely vulnerable group remains advisory. More detailed advice will be updated in this guidance as the changes in advice come into effect on 6 July and 1 August.

Unless we see a significant rise in cases we expect the shielding programme to be paused on 31 July.

Those in receipt of centrally provided food boxes and medicine deliveries will continue to receive this support until the end of July if they want it.

Read further information on schools and the workplace for those living in households where people are shielding.

The guidance below applies until the 6 July 2020.

Who this guidance is for

This guidance is for people including children who are clinically extremely vulnerable. It’s also for their family, friends and carers.

People who are clinically extremely vulnerable are at high risk of serious illness from coronavirus (COVID-19) infection. They should have received a letter advising them to shield or have been told by their GP or hospital clinician.

This includes clinically extremely vulnerable people living in long-term care facilities for the elderly or people with special needs. If you have been told that you’re clinically extremely vulnerable, you should:

  • follow the advice in this guidance
  • register online or call 0800 028 8327 to get additional support if you need it, and before 17 July so that support can reach you in time

This guidance is still advisory. You will not be fined or sanctioned if you prefer to follow the guidance on staying alert and safe (social distancing). You may also choose to remain in your own home currently if you do not feel comfortable with any form of contact with others. However, careful time outside in the fresh air is likely to make you feel better.

Clinically extremely vulnerable groups

Expert doctors in England have identified specific medical conditions that, based on what we know about the virus so far, place some people at greatest risk of severe illness from COVID-19. Disease severity, medical history or treatment levels will also affect who is in this group.

Clinically extremely vulnerable people may include:

  1. Solid organ transplant recipients.
  2. People with specific cancers:
    • people with cancer who are undergoing active chemotherapy
    • people with lung cancer who are undergoing radical radiotherapy
    • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
    • people having immunotherapy or other continuing antibody treatments for cancer
    • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
    • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD).
  4. People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
  5. People on immunosuppression therapies sufficient to significantly increase risk of infection.
  6. Women who are pregnant with significant heart disease, congenital or acquired.
  7. Other people have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions.

For more information about who has been classed as clinically extremely vulnerable, please visit the NHS Digital website.

If you’re still concerned, you should discuss your concerns with your GP or hospital clinician.

Check this is the right guidance for you

You are not clinically extremely vulnerable if:

  • you do not have any of the conditions listed above
  • you have not been told by your GP or specialist that you are clinically extremely vulnerable or received a letter saying you are clinically extremely vulnerable

If you are not clinically extremely vulnerable you should follow the guidance on staying alert and safe (social distancing)..

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