Over the weekend, the Government introduced new measures to follow to help protect extremely vulnerable people from contracting coronavirus (COVID-19), due to the risk of them developing a severe illness if they do.
They have suggested that this population of people take ‘Shielding’ measures to protect themselves.
On this page:
- Who is classed as extremely vulnerable people?
- What is shielding?
- Can I get any help with food and medicines if I’m shielding?
- What about hospital or GP appointments?
- What should you do if you are living with someone who is extremely vulnerable?
- What should I do if I’m caring for someone who is extremely vulnerable?
Who is classed as extremely vulnerable people?
People falling into this extremely vulnerable group include:
- Recipients of kidney, liver, pancreas, heart, and lung transplants
- People with specific cancers:
- people with cancer who are undergoing active chemotherapy
- people receiving radical radiotherapy for lung cancer
- 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
- People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD.
- People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell).
- People on immunosuppression therapies sufficient to significantly increase risk of infection.
- Women who are pregnant with significant heart disease, congenital or acquired.
If you fall within one of these groups of people, you will be receiving a letter from the NHS informing you of the steps that you should be following. You should receive this letter before the 29th March.
If you think you fall into one of the categories of extremely vulnerable people listed above and you have not received a letter by Sunday 29 March 2020 or been contacted by your GP, you should discuss your concerns with your GP or hospital clinician.
What is shielding?
The aim of shielding is to stop extremely vulnerable people coming into contact with coronavirus (COVID-19).
Shielding measures include:
- Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough.
- Do not leave your house.
- Do not attend any gatherings. This includes gatherings of friends and families in private spaces for example family homes, weddings and religious services.
- Do not go out for shopping, leisure or travel and, when arranging food or medication deliveries, these should be left at the door to minimise contact.
- Keep in touch using remote technology such as phone, internet, and social media.
- Do use telephone or online services to contact your GP or other essential services.
- All people coming to your home should wash their hands with soap and water for at least 20 seconds on arrival to your house and often whilst they are there
- Visits from people who provide essential support to you such as healthcare, personal support with your daily needs or social care should continue, but carers and care workers must stay away if they have any of the symptoms of coronavirus (COVID-19).
- You should have an alternative list of people who can help you with your care if your main carer becomes unwell. You can also contact your local council for advice on how to access care.
If you think you have developed symptoms of coronavirus (COVID-19)such as a new, continuous cough or fever, seek clinical advice using the NHS 111 online coronavirus service or call NHS 111. You should also contact your medical team. Do this as soon as you get symptoms.
If you are living with someone else, who doesn’t fall into any of the categories above, then they do not need to adopt these measures as well. They should however, make sure they are supporting you with these shielding measures, and continue to very carefully follow the social distancing measures.
The UK Government have said:
“Shielding is for your personal protection, it is your choice to decide whether to follow the measures we advise. Individuals who have been given a prognosis of less than 6 months to live, and some others in special circumstances, could decide not to undertake shielding. This will be a deeply personal decision. We advise calling your GP or specialist to discuss this.”
Can I get any help with food and medicines if I’m shielding?
We know that the idea of shielding can create a number of worries, including how you can make sure you have access to food and medicines. Wherever possible you should talk to your friends, family and neighbours about whether they can help support you with this. We know it can be hard to ask for help, but it is really important for you to reach out.
You can also use various online services to access resources as well. We’ve put together some information on services and resources in our blog on self-isolation.
If you aren’t able to do this, the public sector, business, charities and the general public are gearing up to help those advised to stay at home. From the 24th March, you can register for support through the Government. This support will include help with:
- Shopping deliveries
- Additional care you might need
The Government are working with pharmacies to help them deliver medicines and prescriptions. If you do not currently have your prescriptions collected or delivered, you can arrange this by:
- 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) or deliver it to 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.
What about hospital or GP appointments?
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. If you do have an appointment scheduled that you are worried about, make sure you contact your medical team or GP as soon as possible to discuss the best way forward for providing this care, and determine which of these are absolutely essential.
It is possible that your hospital may need to cancel or postpone some clinics and appointments. You should contact your hospital or clinic to confirm appointments.
What should you do if you are living with someone who is extremely vulnerable?
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 advice from the Government, alongside following social distancing carefully, about keeping them as safe as possible:
- Minimise as much as possible the time other family members spend in shared spaces such as kitchens, bathrooms and sitting areas, and keep shared spaces well ventilated.
- Aim to keep 2 metres (3 steps) away from people you live with and encourage them to sleep in a different bed where possible. If you can, you should use a separate bathroom from the rest of the household. Make sure you use separate towels from the other people in your house, both for drying themselves after bathing or showering and for hand-hygiene purposes.
- If you do share a toilet and bathroom with others, it is important that they are cleaned after use every time (for example, wiping surfaces you have come into contact with). Another tip is to consider drawing up a rota for bathing, with you using the facilities first.
- If you share a kitchen with others, avoid using it while they are present. If you can, you should take your meals back to your room to eat. If you have one, use a dishwasher to clean and dry the family’s used crockery and cutlery. If this is not possible, wash them using your usual washing up liquid and warm water and dry them thoroughly. If you are using your own utensils, remember to use a separate tea towel for drying these.
- We understand that it will be difficult for some people to separate themselves from others at home. You should do your very best to follow this guidance and everyone in your household should regularly wash their hands, avoid touching their face, and clean frequently touched surfaces.
What should I do if I’m caring for someone who is extremely vulnerable?
If you are caring for someone who is extremely vulnerable due to 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.
- Only care that is essential should be provided
- Wash your hands on arrival and often, using soap and water for at least 20 seconds or use hand sanitiser.
- 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 are 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
- Find out about different sources of support that could be used and accessing 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.