It can be challenging to understand what guidance you should be following as restrictions put in place during COVID-19 are eased. Below are a series of frequently asked questions relating to shielding…
What guidance should I be following from 6 July?
- Those who have received a shielding patient letter remain in the ‘clinically extremely vulnerable’ category and should continue to follow the updated guidance for the clinically extremely vulnerable. If the rate of infection does not rise this guidance will be updated on 1 August.
Why have you changed the advice for those classed as clinically extremely vulnerable? What is the evidence base for this decision?
- Each step towards relaxing the shielding guidance should be taken carefully. People in this group are still at risk of severe illness if they catch coronavirus and should continue to take precautions, but as the risk of catching coronavirus is now sufficiently low, the Government believes that the time is now right to further relax the advice.
- The latest epidemiological data from the ONS COVID-19 Infection Survey shows that the chance of encountering coronavirus in the community has continued to decline. Four weeks ago, on average only one person in 500 had the virus. Last week it was even lower at less than one in 1700. In addition, a test and trace system is now in place, including within schools, and there are robust measures in place to manage potential areas of higher risk.
Will these changes be reassessed before 1 August?
- The latest scientific evidence shows that the chance of encountering coronavirus in the community has continued to decline. If this trend continues as expected, the risk levels to those shielding will be low enough for the guidance to be further relaxed from 1 August.
- The government regularly monitors this position and if the rates of infection in the community rise, then it may be necessary to advise that more restrictive measures should be taken for people at highest risk from COVID-19 to keep themselves safe.
I’m worried about catching coronavirus – am I still at significant risk?
- Clinically extremely vulnerable people are still at risk of severe illness if they catch coronavirus and should continue to take precautions, even as the levels of coronavirus in the community continue to decline according to the latest epidemiological data from the ONS COVID-19 Infection Survey.
- People should continue to socially distance as much as possible and always robustly practice good, frequent hand washing.
Are you planning on telling us to ‘shield’ again in the future?
- The latest scientific evidence shows that the chance of encountering coronavirus in the community has continued to decline. The government regularly monitors this position and if the rates of infection in the community rise, then it may be necessary to advise that more restrictive measures should be taken.
- The guidance for the clinically extremely vulnerable is advisory.
How will people know that they should start shielding again?
- Those who have received a shielding patient letter remain in the clinically extremely vulnerable category and should continue to follow the guidance on ‘shielding and protecting people who are Clinically Extremely Vulnerable’. This guidance will continue to be updated to reflect the most recent advice from the government.
- If there is a significant change to the advice, the Government will write to all patients who are clinically extremely vulnerable setting out any changes to advice before they are made.
Is it possible that some regions may have to return to shielding in the future?
- The NHS currently manages a national Shielded Patient List in England. The variation in R across the country has been quite limited to date, so a national approach continues to be appropriate. The government regularly monitors this position and will continue to be led by the scientific evidence.
Why is the advice for England different to the advice for other parts of the UK?
- As far as possible the conditions that means someone is advised to shield have been consistent between the four UK nations. Each country has slightly different health systems and ways of recording health data, so small differences may arise in implementation.
- Each administration has been working to a slightly different timeline on updating their shielding guidance based on when measures were first introduced.
- Chief Medical Officers will be monitoring any changes in cases or R rates in each nation and could change their advice depending on how the risk levels change in each nation.
Is my name being kept on a shielding list? Why?
- The NHS will continue to maintain the Shielded Patient List allowing us to maintain targeted advice and support to those who are most vulnerable and to change advice and support if incidence was to rise significantly.
Does my whole household have to shield with me until 1 August?
- In line with the current public health advice, those living with clinically extremely vulnerable people are not advised to shield themselves. They should support those shielding and carefully follow the guidance on staying alert and safe (social distancing).
- The Government has also published guidance to help them understand how to protect the person who is shielding. The guidance for the clinically extremely vulnerable continues to be advisory.
Can I see my family and friends?
- From 6 July, guidance for extremely clinically vulnerable people will change to advise that those shielding may wish to spend time outdoors in a group of up to 6 people, including people they do not live with, if they choose to do so. If you do go out, you should take extra care to minimise contact with others by maintaining social distancing. This can be in a public outdoor space, or in a private garden, uncovered yard or terrace.
- Additionally, those who are shielding will be able to create a ‘support bubble’ with one other household, as long as one of the households in the ‘bubble’ is a single adult household (either an adult living alone or with dependent children under 18). All those in a ‘support bubble’ can spend time together inside each other’s homes, including overnight, without needing to maintain social distancing.
Can I exercise outside? If so, how often and for how long?
- Yes, from 1 June the shielding guidance was updated to advise that those classed as clinically extremely vulnerable may wish to spend time outdoors, including for exercise. From 6 July, this can be in a group of up to 6 people (including people they don’t live with).
- There is no advised limit to how often and how long to spend outside, that is up to you, but you should follow social distancing guidelines and always robustly practise good, frequent hand washing.
Can I drive to exercise?
- From 6 July the advice for those classed as clinically extremely vulnerable remains that you no longer need to maintain social distancing with people in your household or support bubble (where applicable). Therefore, you can drive to an outdoor location alone or with members of your household or support bubble.
Can I let people into my house now?
- If you are not in a ‘support bubble’ with another household, you must not meet other people indoors, including in their home or your home, except for specific circumstances set out here.
- Any essential carers or visitors who support you with your everyday needs can continue to visit unless they have any of the symptoms of COVID-19 (a new continuous cough, a high temperature, or a loss of, or change in, their normal sense of taste or smell). Essential carers coming to your home should follow advice on good hygiene: wash their hands with soap and water for at least 20 seconds on arrival to your house and often while they are there (or use hand sanitiser), avoid touching their face, catch any coughs or sneezes in a tissue (or their sleeve), and put used tissues immediately in the bin and wash their hands afterwards. They should maintain social distancing where close or personal contact is not required and where this is possible.
From 6 July, who can I ‘bubble’ with?
- From 6 July, those who are shielding will be able to create a ‘support bubble’ with one other household, as long as one of the households in the bubble is a single adult household (either an adult living alone or with depending children under 18). Support bubbles must be exclusive – you should only form a bubble with one household and they should only be in a bubble with you.
What can you do in a ‘support bubble’?
- Forming a support bubble with another household means you can meet – indoors or out – without needing to maintain social distancing. You can also stay overnight as if you lived with that household. This means you can have closer contact with those in your support bubble, which should help provide additional support to those who need it. You should continue to adhere to social distancing guidelines in full with other households.
- The risk of infection rises with the number of people in a bubble and the number of interactions you have with people you do not live with, so it’s important to take measures to try and protect against this. This means that support bubbles must be exclusive – you should only form a bubble with one household, and they should only be in a bubble with you.
- You must not gather indoors or stay overnight with anyone outside of this bubble and should not change your bubble. If you are in a single adult household, you may also want to consider the size of the household you choose to make a bubble with, and where possible, choose a small household. Everyone in a support bubble should isolate when one member of the bubble becomes symptomatic or tests positive for coronavirus.
Can I ‘bubble’ with another shielding household?
- Yes, all single adult households can bubble with one other household, including households containing other people who are shielding. Similarly, shielding people living in a household can bubble with any single adult household.
Is bubbling safe?
- There are key principles for how you can form a support bubble safely. These are critical to keeping you – and your friends and family – safe and saving lives:
- support bubbles must be exclusive – you should not change who is in your bubble or have close contact with anyone else you do not live with. This is critical to keeping you, and your family and friends, safe
- if you or someone in your support bubble is showing coronavirus symptoms, or otherwise self-isolating, everyone in your support bubble should stay home. If you or a member of your support bubble is contacted as part of the test and trace programme, the individual contacted should stay at home. If the individual becomes symptomatic, everyone in the support bubble should then isolate
Does this mean I can go shopping/to the pharmacy?
- The current advice to those who are clinically extremely vulnerable is to not spend time in any other buildings or covered areas apart from your own home (apart from if you are in a ‘support bubble’ from 6 July).
- This will change from 1 August, when guidance for this group will be brought in line with that for the clinically vulnerable group. In practice, that means that you should stay home as much as possible, but you can go outside, including to the shops, providing you take particular care to maintain social distancing.
- Anybody who is shielding, or self-isolating can seek support from the NHS Volunteer Responders for help with shopping or medication. Simply call NHS Volunteer Responders on 0808 196 3646 (8am to 8pm) to arrange this