New advice to be issued for 2.2 million people who shielded during lockdown

13 October 2020, 13:56 | Updated: 13 October 2020, 14:15

More than two million people who shielded during the peak of the pandemic will be given new advice on what to do depending on the Covid alert level in their area.

The Government said none of the alert levels in place in England will automatically trigger a warning for those who shielded before to shield again and stay home at all times.

It follows concerns that those on the shielded list became extremely isolated, with some too fearful to leave their homes for several months.

In the future, those living in the highest risk areas (known as Tier 3 or Covid alert level three) could be advised to adopt formal shielding if necessary, but they would receive a letter setting out the precautions they should take.

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In more general guidance for all those who shielded in the first wave, the Government has said:

- For Covid alert level medium (Tier 1): People should strictly observe social distancing, meet others outside where possible, limit unnecessary journeys on public transport and work from home where possible. People should still go to work and children should still attend school. This is on top of restrictions for everyone to only meet in groups of up to six people.

- For Covid alert level high (Tier 2): People should reduce the number of different people met outside, avoid travel except for essential journeys, work from home where possible and reduce the number of shopping trips made or go at quieter times of the day. People can still go to work if they cannot work from home and children should still attend school. This is on top of restrictions for everyone to not meet other households indoors, unless part of a support bubble, and to only meet in groups of up to six people outdoors.

- For Covid alert level very high (Tier 3): People should work from home, in general stay at home as much as possible, and avoid all but essential travel. People should also significantly reduce shopping trips, and if possible use online delivery or ask people in their household, support bubble or volunteers to collect food and medicines. People in these areas are encouraged to still go outside for exercise, and can still go to school and to work if they cannot work from home.

The Government said all those who shielded previously are already helped by wider protection measures not previously in place when shielding was originally introduced in March, such as the rule of six and face coverings.

Letters will be sent to those affected by the new guidance.

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Deputy chief medical officer for England Dr Jenny Harries said: "Over the last few weeks, we've seen a sharp increase in the prevalence of the virus across the country and we know those who are clinically extremely vulnerable are looking for practical advice on how they can carry on their lives while the virus remains in our communities.

"The new system will provide clarity on how best those in this group can keep themselves as safe as possible depending on the rates of transmission in their local area.

"Whilst advisory, I would urge all those affected to follow the guidance wherever they can and to continue to access health services for their medical conditions.

"We will continue to monitor the evidence closely and fine-tune this approach to make sure everyone in this group is clear about the safest way to go about their daily lives, particularly over the coming winter months."

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Shielding, which was paused at the end of July, aimed to protect those at greatest risk of severe illness and death from Covid-19.

Clinically extremely vulnerable people include those who have had an organ transplant, people with cancer who are undergoing active chemotherapy and those with lung cancer undergoing radical radiotherapy.

People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of their treatment are also included, as are those with cancer who are having immunotherapy or other targeted treatments.

Other conditions included are severe respiratory illnesses including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD).

Dr Harries has since said that most children do not need to be included on the list.

Health and Social Care Secretary Matt Hancock said: "With coronavirus rates continuing to increase, now is the time to take action and ensure we protect the most vulnerable in our society.

"Today's announcement will mean every person most at risk from serious outcomes from the virus will have specific advice targeted to local levels, which they can follow to keep themselves as safe as possible, while ensuring they can also keep as much normality in their lives as possible."

The new guidance says shielding would only be reintroduced for short periods of time if at all.

It says: "In the future, the Government will only reintroduce formal shielding advice in the very worst affected local areas and for a limited period of time.

"This will only apply to some, but not all, very high alert level areas and will be based on advice from the chief medical officer.

"The Government will write to you separately to inform you if you are advised to shield.

"You are not advised to follow formal shielding advice again unless you receive a new shielding notification advising you to do so."

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The move has been criticised by charities, who have said more support is needed for the “extremely clinically vulnerable”.

Gemma Peters, Chief Executive of Blood Cancer UK, said: “It is completely unacceptable that even in areas where the alert level is very high, the Government expects people with blood cancer who cannot work from home to carry on travelling into work.

“It is a ludicrous situation where the Government guidance is telling people with blood cancer to stay away from shops because they’re too dangerous, and in the same breath that it is fine for them to spend many hours in shops if they happen to work in them. In the same areas people with blood cancer are being told to avoid all but essential travel, the Government is saying it is fine for them to continue working in busy places like cafes, restaurants and schools. Even if the infection rate became so high that shielding was reintroduced, all the Government is offering people with blood cancer is that they may be entitled to statutory sick pay. Statutory sick pay is nowhere near enough to support a family, and so even in these areas we would be likely to see people with blood cancer forced to choose between their health and finances.

“This does not make any sense, and the Government needs to urgently revise this guidance and give financial support to people with blood cancer who cannot work from home. If not, we will see thousands of them being unnecessarily exposed to a very high risk to their health, and this is an injustice that will disproportionately affect people who are less well-off.

“This guidance also fails to offer specific mental health support. The mental health toll of the pandemic on people who have been shielding has been great, and so it is extremely disappointing that, six months on, there is no extra mental health support for people who are vulnerable to the coronavirus.”

Sarah MacFadyen, Head of Policy at Asthma UK and the British Lung Foundation, said: “For the 500,000 people with lung conditions who have previously been shielding and have been anxiously waiting for this news, the lack of detail and timelines as well as the news that those in ‘exceptionally high risk’ areas may still be advised to adopt formal shielding in the future, will be devastating.

“We need urgent clarity from the government as to exactly how and when people with severe lung disease, will be able to access this tailored guidance, particularly those in high and very high alert areas. Crucially, we need answers now for those people who cannot work from home to know how their income will be protected if they are advised not to go into work. More than six months on, people are still being asked to make the impossible choice between health and financial security.

“We are told again today that people who are defined as clinically extremely vulnerable are at very high risk of severe illness from COVID-19.  

"Yet it’s not clear how they will be able to access the support they need to be able to feed themselves and get access to vital medicines, particularly if help is not coming from local authorities or they are not eligible for benefits.”