The Government is advising those who are at increased risk of severe illness from COVID-19 to be particularly stringent in following social distancing measures.

This group includes those who are:

  • aged 70 or older (regardless of medical conditions)
  • under 70 with an underlying health condition listed below (i.e. anyone instructed to get a flu jab as an adult each year on medical grounds):
    • chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
    • chronic heart disease, such as heart failure
    • chronic kidney disease
    • chronic liver disease, such as hepatitis
    • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
    • diabetes
    • problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
    • a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
    • being seriously overweight (a body mass index (BMI) of 40 or above)
  • those who are pregnant

There are some clinical conditions which put people at even higher risk of severe illness from COVID-19. Specific guidance has been set out by the Government on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19. People falling into this group are those who may be at particular risk due to complex health problems including:

  • Solid organ transplant recipients.
  • People with specific cancers:
    • people with cancer who are undergoing active chemotherapy or 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.

The NHS in England is directly contacting people with these conditions to provide further advice. They should receive letters by Sunday 29th March 2020. Shielding is a practice used to protect extremely vulnerable people from coming into contact with coronavirus. People in this category are strongly advised to practice shielding by staying at home at all times and avoiding any face-to-face contact for a period of at least 12 weeks from the day they receive their letter. Please note that this period of time could change.

While the rest of a vulnerable person’s household are not required to adopt these protective shielding measures for themselves, the Government expects them to do what they can to support the vulnerable person in shielding and to stringently follow guidance on social distancing, including:

  • 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 in the household and encourage the vulnerable person to sleep in a different bed where possible. If possible, the vulnerable person should use a separate bathroom from the rest of the household. Make sure the vulnerable person uses separate towels from the other people in the house, both for drying themselves after bathing or showering and for hand-hygiene purposes.
  • If the vulnerable person does share a toilet and bathroom with others, it is important that they are cleaned after use every time (for example, wiping surfaces which people have come into contact with). Another tip is to consider drawing up a rota for bathing, with the vulnerable person using the facilities first.
  • If the vulnerable person shares a kitchen with others, others should avoid using it while they are present. If possible, meals should be taken to individual rooms to eat. If there is one, use a dishwasher to clean and dry the family’s used crockery and cutlery. If this is not possible, wash them using usual washing up liquid and warm water and dry them thoroughly. If the vulnerable person is using their own utensils, remember to use a separate tea towel for drying these.
  • The Government understands that it will be difficult for some people to separate themselves from others at home. Households should do their very best to follow this guidance and everyone in the household should regularly wash their hands, avoid touching their face, and clean frequently touched surfaces.

If the rest of the household stringently follow advice on social distancing and minimise the risk of spreading the virus within the home by following the advice above, there is no need for them to also shield alongside the vulnerable person.