MILLIONS at high risk of Covid are set to receive shielding letters as the second national lockdown begins.
Around two million deemed clinically extremely vulnerable will be told to “stay at home at all times”.
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They have been advised not to go into work, and stay away from supermarkets.
But, the Department of Health is encouraging people in the highest risk group to continue to go outside to exercise, and attend all necessary medical appointments – either scheduled or emergency.
During the first national lockdown concerns were raised that the blanket “stay at home” message for those shielding was “isolating” and increased the risk of mental health issues.
The new guidance, while still strict, is designed to be “softer”, while protecting those at greatest risk.
The group includes people with specific cancers, those people who have had organ transplant ops, people with severe asthma and lung conditions as well as pregnant women with significant heart problems.
They are all deemed to be at higher risk of death, or serious complications if they catch Covid.
Patients in this group will have previously received a letter from their GP or local hospital advising them that they should shield.
New letters are expected to be sent out in the coming days, outlining the specific ‘dos and don’ts’.
Some may have already received a letter with the new updated guidance to cover the four weeks of lockdown, until December 2.
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.
Boris Johnson has repeated vowed the national measures will end on December 2 – after which time we will return to local lockdowns based on the tiered system.
Like last time the clinically extremely vulnerable group will have priority access to supermarket delivery slots, so they don’t have to leave the house to get food.
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.
Government guidance states that if you need additional assistance while shielding then your local council could be able to help.
Those who are new to the shielding list can register with the new online service, where they will be able to request additional support.
Those on the shielding list have bee advised to not go to supermarkets or the pharmacy and the online service will help you to get access to priority supermarket deliveries, as well as putting you in touch with someone who can advise you on the local services in your area.
If you haven’t received a letter and you think you should be added to the list then you should discuss this with your GP or your specialist.
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.
Who should shield?
You are automatically deemed “extremely clinically 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
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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.