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As the UK continues to ease lockdown measures related to the coronavirus pandemic, it is important to understand that COVID-19 still presents a serious threat. This is particularly true for the 2.2 million extremely vulnerable people across England who have been shielding during the pandemic.

What is shielding?

Shielding was introduced as a means of protecting individuals who, at the start of the coronavirus pandemic, were considered to be extremely vulnerable. The purpose of shielding was to minimise all contact for people at a high risk of contracting COVID-19. People who were deemed extremely vulnerable included:

• Solid organ transplant recipients
• People with certain cancers
• People with severe respiratory conditions, such as cystic fibrosis, severe asthma or severe chronic obstructive pulmonary disease
• People with rare diseases that significantly increase the risk of infections, such as severe combined immunodeficiency or homozygous sickle cell
• People on immunosuppression therapies sufficient to significantly increase the risk of infection
• Pregnant women with significant heart disease, congenital or acquired

Additional individuals may have been classified as extremely vulnerable based on the judgment or assessment of GPs and hospital clinicians.

Many of these individuals have been shielding since March. At that time, they were advised to self-isolate and avoid leaving their homes for at least 12 weeks. Further shielding guidelines included not attending any gatherings with family or friends, even in private spaces.

While gathering, vulnerable people still must adhere to social distancing guidelines and follow the same rules already in place for the general population.

The next steps

The government has announced that restrictions will be relaxed for these individuals starting 6th July. As such, they will be permitted to gather in groups of up to six people outdoors in order to spend time with people from another household. While gathering, vulnerable people still must adhere to social distancing guidelines and follow the same rules already in place for the general population.

Starting 1st August, the government plans to further relax lockdown measures and related guidance to the point that extremely vulnerable people will no longer be advised to shield.

Vulnerable individuals should understand that they still must be careful and cautious as lockdown policies are lessened, but the government hopes that such changes will allow them to enjoy more activities, such as shopping or visiting places of worship. Beginning 1st August, vulnerable individuals who are not able to work remotely will also be able to return to work as long as their workplace meets COVID Secure guidelines.

The government’s timing for the two levels of change taking place less than one month apart is intended to allow for a gradual return to normal life for people who have been shielding, while also providing health experts with a chance to observe the situation. During the time between 6th July and 1st August, the government will closely monitor any effects of relaxed lockdown measures, such as changes in hospitalisation or intensive care rates.

The shielding package put in place to provide support for extremely vulnerable individuals will remain available through the end of July. After that time, people who have been shielding may continue to access NHS services as needed. Assistance may be rendered differently at this time. Extremely vulnerable people will continue to have priority for supermarket delivery slots, and will still have access to assistance with shopping, medication, phone calls and transport to medical appointments.

Remain cautious, stay informed

All individuals who are on the Shielded Patient List can expect to receive correspondence from the government in the future that will provide updated information regarding shielding advice and available support.

While extremely vulnerable people will be allowed more flexibility in their daily lives moving forward, the government recommends that these individuals continue to spend as much time at home as possible. They should also remain extremely careful about proper handwashing and ensure minimal contact with others outside of their household.

The NHS has acknowledged that shielding may have adverse effects on the mental health of vulnerable individuals. As such, it has recommended that anyone in need of urgent mental support access these resources.

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