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Extremely Vulnerable 'Shielders'

This guidance is for those who are at very high risk of severe illness from coronavirus because of an underlying health condition.

What is meant by 'extremely vulnerable'?

People falling into this extremely vulnerable group include:

  1. Solid organ transplant recipients.

  2. 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
  3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD.

  4. People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell).

  5. People on immunosuppression therapies sufficient to significantly increase risk of infection.

  6. Women who are pregnant with significant heart disease, congenital or acquired.

Shielding is for your personal protection. It is your choice to decide whether to follow these measures. 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. You are advised to call your GP or specialist to discuss this.

The NHS in England is directly contacting people with these conditions to provide further advice.

This group has been the most carefully protected of all and the advice is still to be extremely careful about who these people come into contact with. 

From 6th July people in this group:

  • no longer need to socially distance from people they live with
  • may now, if they wish, meet in a group of up to 6 people outdoors, including people from different households whilst maintaining strict social distancing. 
  • May also, if they wish, form a ‘support bubble’ with one other household. All those in a support bubble will be able to spend time together inside each other’s homes, including overnight, without needing to socially distance. 

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. 

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 an extremely vulnerable person develops symptoms of coronavirus:

Seek clinical advice as soon as you get symptoms using the NHS 111 online coronavirus service or call NHS111 if you don’t have internet access. If you are seriously ill, call 999 . Do not visit the GP, pharmacy, urgent care centre or a hospital. 

Prepare a single hospital bag. This should include an emergency contact's name and telephone number, a list of the medications you take (including dose and frequency), any information on your planned care appointments and things you would need for an overnight stay (snacks, pyjamas, toothbrush, medication and so on). If you have an advanced care plan, please include that.

For more information look at the full government guidance on shielding for the extremely vulnerable

From 1st August, the government plans to pause shielding unless the transmission of COVID-19 in the community starts to rise significantly.

This means:

  • the government will no longer be advising you to shield
  • the support from the National Shielding Service of free food parcels, medicine deliveries and care will stop
  • NHS Volunteer Responders will carry on delivering the food you buy, prescriptions and essential items to you if you need it
  • you will still be eligible for priority supermarket slots (if you have registered by 17 July)