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People shielding to be advised they don’t need to stay home amid lockdown changes

Written by on 13 October 2020

The 2.2 million mainly elderly people on the shielding list in England are to be sent letters telling them they do not need to stay in their homes to keep safe.

Instead, they will be given advice linked to the COVID alert level for their postcode, ranging from “meet others outside where possible” for Tier 1 areas, to “ask people in your household, support bubble or volunteers to collect food and medicines” for those whose homes are in Tier 3.

The deputy chief medical officer for England, Dr Jenny Harries, said: “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.”

The new advice also shows officials are making plans for even tighter restrictions within the Tier 3 areas that have the most worrying levels of coronavirus transmission.

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They are warning that “prescribed areas” might be established in the future, with vulnerable people who live there being told to shield by staying indoors as they did during the national lockdown.

Dr Harries stressed the letters being sent out would contain guidance, not compulsory instructions.

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Dr Jenny Harries said the letters would offer guidance, not instructions

“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,” she said.

The shielding group is defined by medics as those who are clinically extremely vulnerable, based on age, ethnicity, gender, and individual clinical needs.

In April, those on the list were advised to stay in their homes, but officials found many interpreted the guidance as an instruction and some did not go outside for several months.

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The new advice, said to be based on mitigating factors including the rule of six and mask-wearing, encourages people to continue to work and take outdoor exercise.

The letters will give what is being described as common sense “soft” advice in addition to the national restrictions.

For most of England, under the medium COVID alert level, the advice includes: “Strictly observe social distancing, meet others outside where possible, limit unnecessary journeys on public transport and work from home where possible, but you can 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 Tier 2 areas, under the high alert level: “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.

“You can still go to work if you cannot work from home because all workplaces should be COVID secure, and children should still attend school.”

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And for the highest alert level, currently only applied to the Liverpool City region: “Work from home, in general stay at home as much as possible, and avoid all but essential travel.

“You should also significantly reduce shopping trips, and if possible use online delivery or ask people in your 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.”

Officials say the individuals on the shielding list is constantly changing, but most of the 90,000 children told to shield in the spring have now been removed from the list as the risk they face has been re-evaluated.

It’s understood that Scotland, Wales and Northern Ireland will adopt a similar approach.

Those with the following conditions fall into the clinically extremely vulnerable group:

  • Solid organ transplant recipients
  • People 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 six months or who are still taking immunosuppression drugs
  • People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
  • People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (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
  • Other people who have also been classed as clinically extremely vulnerable