Shielding is back as two million extremely vulnerable people told to ‘stay at home’ during second Covid lockdown
MORE than two million extremely vulnerable people have today been told to stay at home during the second lockdown.
Just hours before MPs voted in favour of the new lockdown, the Department of Health published it's new guidelines for those with underlying health issues.
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Weeks after reassuring people that shielding wouldn't return and "soft advice" would be used, the new guidance - published just hours before lockdown begins - repeats the same core message.
The Department of Health has told them to "stay at home at all times".
But crucially, this time, the "clinically extremely vulnerable" group are being encouraged to get outside to exercise regularly and are reminded to make sure they keep all medical appointments.
Charities blasted the timing of the new guidance, coming just hours before stricter measures are introduced at midnight - and two days after it was promised.
The new advice is aimed at people with specific cancers, those with severe asthma, other severe respiratory conditions, pregnant women with significant heart disease and others deemed extremely vulnerable by their GP and hospital doctors.
Like last time this group will again be able to get priority access to supermarket delivery slots, so they don't have to go out to get good.
They should also only work if they can do so from home and may be entitled to benefits during the four-week national lockdown.
The guidance adds that they "may" be eligible for Statutory Sick Pay, Employment and Support Allowance, Universal Credit or the Coronavirus Job Retention Scheme.
The new advice also states that children who live with someone who is clinically extremely vulnerable, but are not clinically extremely vulnerable themselves, should still attend school.
The majority of those considered to be clinically extremely vulnerable may have already received a letter from the NHS or their GP.
'Clinically vulnerable'
There is also a separate group classed as clinically vulnerable, which now includes everyone aged 60 and over regardless of any underlying conditions.
It means almost 5.9 million extra people are considered to be at a higher risk of Covid-19 than in the first lockdown.
Pregnant women and obese people should also be "especially careful to follow the rules and minimise your contacts with others," the guidance states.
It also includes younger people with underlying health conditions, such as diabetes and asthma.
Everyone else is expected to follow the new restrictions.
This includes staying at home unless shopping for essential items or exercising and not meeting up with people outside of the household.
What is the new guidance for clinically extremely vulnerable people?
The updated guidance, which clinically extremely vulnerable individuals are strongly urged to follow, includes:
- Socialising: stay at home as much as possible, except to go outdoors to exercise or attend health appointments. People can exercise with those they live with or in their support bubble.
- Work: If people cannot work from home, they should not attend work. They may be eligible for Statutory Sick Pay, Employment and Support Allowance, Universal Credit or the Coronavirus Job Retention Scheme during this period of national measures. People in the same household who are not clinically extremely vulnerable can still attend work, in line with the new national restrictions
- School: as evidence has shown there is a very low risk of children becoming very unwell from Covid-19, most children originally on the shielded patient list no longer need to be and therefore can still attend school. If they are unsure, parents should contact their child’s usual GP or hospital clinician to check whether they should still be considered clinically extremely vulnerable. If a GP or clinician has advised that a child should remain on the shielded patient list, they are advised not to attend school. Children who live with someone who is clinically extremely vulnerable, but aren’t themselves, should still attend school.
- Going outside: Avoid all non-essential travel – they should continue to travel to hospital and GP appointments unless told otherwise by their doctor. They are strongly advised not to go to any shops or to pharmacies.
Councils in England will also be given £32 million to support the clinically extremely vulnerable over the next month.
It will be used to provide access to food and befriending services, for the most at risk and enable them to stay at home as much as possible over this short period.
An online service will also be set up to allow people to request priority access to supermarket delivery slots and inform their council if they need help.
NHS Volunteer Responders can also help with a regular, friendly phone call, and transport to and from medical appointments.
Dr Jenny Harries, Deputy Chief Medical Officer for England, said: “We have previously said that where the conditions of transmission of the infection alters significantly we would alert patients in relative regions.
“With the prevalence of the virus continuing to increase across England and in places across the world, it’s right that we adjust our advice for the clinically extremely vulnerable accordingly so they can feel as safe as possible over the coming few weeks.
“Our guidance for this group of individuals has always been advisory, but I would strongly urge all those who are clinically extremely vulnerable to take these extra precautions to keep themselves as safe as possible.”
The clinically extremely vulnerable group includes those with reduced immune systems, for example due to organ transplants, or those with specific cancers or severe respiratory conditions, such as cystic fibrosis.
Officials say the group list is updated regularly as patients’ conditions or the scientific evidence changes.
Definition of clinically extremely vulnerable groups
People who are defined as clinically extremely vulnerable are at very high risk of severe illness from Covid-19.
There are two ways you may be identified as clinically extremely vulnerable:
- You have one or more of the conditions listed below
- Your hospital clinician or GP has added you to the shielded patients list because, based on their clinical judgement, they deem you to be at higher risk of serious illness if you catch the virus
Adults with the following conditions are automatically deemed clinically extremely vulnerable:
- solid organ transplant recipients
- those 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 that 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
- those with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
- those with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
- those on immunosuppression therapies sufficient to significantly increase risk of infection
- adults with Down’s syndrome
- adults on dialysis or with chronic kidney disease (stage 5)
- women who are pregnant with significant heart disease, congenital or acquired
- other people who 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
Due to new evidence, those with chronic kidney disease (stage 5) and those undergoing dialysis, as well as adults with Down’s Syndrome, are also being added to the shielding patient list by the NHS.
Those with more general underlying health conditions or who are 70 or over may still be more vulnerable to Covid-19 than the general population, so are also advised to stay at home as much as possible, to carefully follow the rules and minimise contact with others.
Health officials said all those classed as clinically extremely vulnerable should now receive a letter explaining the changes to the guidance.
The new national restrictions will come into force from Thursday and are set to be reviewed on 2 December.
In his address to the nation on Saturday, Prime Minister Boris Johnson said: “If you are clinically vulnerable, or over the age of 60, you should be especially careful to follow the rules and minimise your contacts with others.
“I know how tough shielding was, and we will not ask people to shield again in the same way again.
"However we are asking those who are clinically extremely vulnerable to minimise their contact with others, and not to go to work if they are unable to work from home.”
England's chief medical officer Chris Whitty added that the more than two million people on the previous shielding list need to take "extra precautions", but shielding would not be reintroduced due to "the issue of people having significant problems with loneliness and feeling completely cut off from society".
The Government has classed "clinically vulnerable" people as those aged 60 and over, and those under 60 with an underlying health condition including chronic diseases, respiratory diseases like asthma, pregnant and overweight people.
Previously, this only applied to those aged 70 and over, which means a further 5.9 million people now need to take extra care.
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While campaigners have welcomed the guidance for vulnerable people, they warn that announcing it just a day before lockdown has given them little time to prepare.
Sarah MacFadyen, head of policy at Asthma UK and the British Lung Foundation, said: “Any clear guidance and clarification is a step forward.
"However only announcing this less than twenty four hours before lockdown begins leaves people with serious lung conditions almost no time to prepare for the changes that will severely impact their lives over the next month.
“With people advised not to go to shops, including the pharmacy, it’s vital that delivery systems are easy to access and properly funded so no one is left without essentials.
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"The government must ensure local authorities are given as much help as possible to support people and that the money promised gets to where it is most needed.
“We saw in the first lockdown the huge toll having to stay at home can have on someone’s mental and physical health, so it’s important that people in the clinically extremely vulnerable group continue to stay active and go outside if they feel comfortable doing so and while taking the advised precautions.
"They should also continue to take steps to manage their lung condition by going to regular appointments and seeking medical help if it is needed.”
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