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Shielding of extremely vulnerable people

Learn more about shielding against coronavirus COVID-19 - what it is, who it affects and answers to some frequently asked questions. [UPDATED 19 March 2021]

Who is classed as 'extremely vulnerable'?

Updated: 25 February 2021

If you fall within one of the following groups of people, you should have received a letter from your medical team.

People falling into this extremely vulnerable group

People who:

  • have had an organ transplant
  • are having chemotherapy or antibody treatment for cancer, including immunotherapy
  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer
  • are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)
  • have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine
  • have been told by a doctor they you have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)
  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)
  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)
  • have a serious heart condition and are pregnant

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.

If you think you fall into one of the categories of extremely vulnerable people listed above and you have not received a letter or been contacted by your GP, you should discuss your concerns with your GP or hospital clinician.

Some people have also recently received a letter from their GP asking them to shield, or stating that they are potentially at high risk of serious illness if they catch the virus. This is because a new risk assessment has been developed to identify people that might be at high risk from COVID-19.

The new approach analyses individual’s medical records to assess whether somebody may be more vulnerable that was previously thought. People identified by this new process will be prioritised to receive the vaccine.

The new approach was developed by the University of Oxford, who turned their research into a risk-prediction model called QCovid®. This is an evidence-based model that uses a range of factors such as age, sex, ethnicity and existing medical conditions to predict risk of death or hospitalisation from COVID-19.

As soon as an individual is flagged as potentially clinically extremely vulnerable, they will be sent a letter outlining how they have been identified, that they are being added to the Shielded Patient List as a precautionary measure, and highlighting additional guidance to support them.

Don’t be afraid to get in touch with them, we know it hasn’t always been clear who should follow what guidelines, and it’s important that you feel confident in the best ways to keep yourself safe.

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What are the updates to shielding measures?

(updated 19 March 2021)

Today, the government have announced that clinically extremely vulnerable people in England will no longer need to shield from 1 April 2021.

This means that those on the shielded patient list can begin to follow the national restrictions alongside the rest of the population.

However, these people are still advised to take extra precautions to keep themselves safe from COVID-19.

From today and over the next two weeks, people on the shielded patient list will receive an advice letter that sets out practical steps on how to reduce their risk of catching the virus.

These include:

  • continuing to maintain strict social distancing
  • keeping overall social contacts at low levels
  • continuing to work from home where possible.

Read the full advice and guidance about these updates.

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Am I in the priority group for COVID-19 vaccines if I'm shielding?

(updated 22 January 2021)

If you are currently shielding, then it is our understanding that you should be entitled to receive the vaccine by mid-February. However, not everyone who has been diagnosed with a brain tumour will need to shield.

If you're unsure of whether you're on the shielding list you can:

Read more about vaccinations

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If I want to go outside, what can I do to keep safe?

(Updated 7 January 2021)

Now that the shielding advice has been reintroduced, if you are shielding you should stay home as much as possible, and only go outside for medical appointments, exercise or if it is essential. 

If you do have to go outside, you should try to follow the following advice to keep safe:

  • Keep your distance from people outside your household. The government are still suggesting keeping two metres away from people as a precaution. You can also lower the risk by avoiding being face-to-face with someone, so you could try keeping side-to-side.
  • Wear a face covering. You must now do this by law in the following places:
    • Public transport
    • Indoor transport hubs (i.e. airports, train stations etc)
    • shops and supermarkets
    • indoor shopping centres
    • banks, building societies and post offices
  • Avoid crowded spaces, for example avoid travelling at peak times.
  • Do not share or exchange personal belongings (such as cups) with others.
  • Wash your clothes regularly.

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Can I get any help with food and medicines if I’m shielding?

(Updated 07 January 2021)

You can make arrangements for medications to avoid you having to to collect prescriptions yourself. This can include:

  • asking someone who can pick up your prescription from the local pharmacy, (this is the best option, if possible)
  • contacting your pharmacy to ask them to help you find a volunteer (who will have been ID checked) to deliver it to you.
  • use an online NHS pharmacy who will offer free delivery of medicines
  • call 0808 196 3646 (8am to 8pm) to arrange for an NHS Volunteer Responder to pick up prescriptions for you.

You may also need to arrange for collection or delivery of hospital specialist medication that is prescribed to you by your hospital care team.

If you receive support from health and social care organisations, for example, if you have care provided for you through the local authority or health care system, this will continue as normal. Your health or social care provider will be asked to take additional precautions to make sure that you are protected.

You can also get support from the NHS Volunteer Responders to help with your shopping. The scheme has volunteers who can collect and deliver shopping, medication or other essential supplies to those who are shielding.

There are also check in and chat volunteers who provide telephone support to individuals who are at risk of loneliness.

This support will continue until at least March 2021 and you can call 0808 196 3646 to arrange this help. You can also apply online.

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What about hospital or GP appointments?

(Updated 07 January 2021)

The advice from the government is that wherever possible, during this time, people should try to access medical help remotely, for example over the phone or internet.

However, you should continue to access the essential services that you need, and you should contact the NHS if you need urgent or emergency care.

If you have a scheduled hospital or other medical appointment, talk to your GP or specialist to ensure you continue to receive the care you need in an appropriate setting, and to determine which of these appointments are absolutely essential.

It's possible that your hospital may need to cancel or postpone some clinics and appointments. You should contact your hospital or clinic to confirm appointments.

Please note: guidance in the video below was correct at the time of filming during the begininning of the pandemic. Some Government restrictions and guidance may have changed multiple times since filming.

What should you do if you are living with someone who is extremely vulnerable?

Updated 07 January 2021

We know that within our community, many people are living with their loved ones who would be classed as extremely vulnerable. Therefore we wanted to share the updates from the government for these people.

Unfortunately, the advice is currently to try to stay 2 metres away from other people within your household, especially if they display symptoms of the virus or have been advised to self-isolate.

Everyone within the household should continue to regularly wash their hands with soap and water for 20 seconds, avoid touching their face and clean frequently touched surfaces.

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What should I do if I’m caring for someone who is extremely vulnerable?

(Updated 09 July)

If you're caring for someone who is extremely vulnerable due to risk of severe illness from coronavirus (COVID-19), there are some simple steps that you can take to protect them and to reduce their risk at the current time.

  • Ensure you follow advice on good hygiene.
  • Wash your hands on arrival and often, using soap and water for at least 20 seconds or use hand sanitiser.
  • Avoid touching their face, particularly their eyes, nose and mouth.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
  • Put used tissues in the bin immediately and wash your hands afterwards
  • Do not visit or provide care if you're unwell and make alternative arrangements for their care
  • Provide information on who they should call if they feel unwell, how to use NHS111 online coronavirus service and leave the number for NHS 111 prominently displayed
  • Information about different sources of support that could be used and further advice on creating a contingency plan is available from Carers UK
  • Look after your own well-being and physical health during this time.

It can help to talk to other people about how they are coping with these challenges and to connect with people digitally.

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About the author

I’m a member of the Children and Families Team at The Brain Tumour Charity and previously practised as a Speech and Language Therapist, working with children of all ages. I’m dedicated to supporting children, young people and families affected by a brain tumour by being there every step of the way to provide help, understanding and support, when it’s needed most.

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