Shielding is back and extremely vulnerable and elderly people in England have been urged to stay at home at all times from tomorrow.
Except for exercise and medical appointments, people who are at a high risk of dying if they catch Covid-19 should remain at home and not meet up with others.
The Department of Health today toughened up its advice for the shielding group, who will once again face life behind closed doors as the country shuts down.
Officials’ move comes less than a month after they said they wouldn’t bring shielding back but would instead switch to ‘soft advice’ for the high-risk groups.
Dr Jenny Harries, one of England’s deputy chief medical officers, told reporters in October that the Department was worried people had taken the advice too seriously the first time and stopped almost every aspect of their lives, in some cases unnecessarily, which had wrought havoc on people’s mental health.
But today’s update said people classed as clinically extremely vulnerable are now ‘strongly advised to stay at home at all times, unless for exercise or doctors’ appointments’.
People in the high-risk group include people having cancer treatment, people who have had organ transplants, those with severe lung conditions like cystic fibrosis or COPD, people with kidney disease and pregnant women with heart disease.
Everyone over the age of 70 is included in a slightly lower risk group known as ‘clinically vulnerable’ and face less specific advice to ‘stay at home as much as possible, to carefully follow the rules and minimise contact with others’. In general they are not believed to be entitled to the same Government support.
During the UK’s first wave of coronavirus, people deemed to be clinically extremely vulnerable in England were advised to take extra precautions, also known as shielding. Pictured: The family of a self-isolating nurse meet through a window to reduce the risk of passing on the coronavirus
Dr Jenny Harries said the guidance was ‘advisory’ and not an actual rule or law
Dr Jenny Harries said today: ‘We have previously said that where the conditions of transmission of the infection alters significantly we would alert patients in relative regions.
‘With the prevalence of the virus continuing to increase across England and in places across the world, it’s right that we adjust our advice for the clinically extremely vulnerable accordingly so they can feel as safe as possible over the coming few weeks.
‘Our guidance for this group of individuals has always been advisory, but I would strongly urge all those who are clinically extremely vulnerable to take these extra precautions to keep themselves as safe as possible.’
Shielding people will again be able to get priority access to supermarket delivery slots so they don’t have to go to the supermarket to get food.
They will also be able to get access to NHS volunteers to deliver medicines, drive them to or from medical appointments, or just phone them to keep them company.
The Department of Health also said it would give an extra £32million to county councils this month that they will be able to use to support shielding residents.
There are 31 upper tier councils in England suggesting they will get an average of £1million each, although this is likely to be weighted according to populations.
Current definitions of clinically extremely vulnerable people suggest there are 2.3million people who will be advised to go back into shielding.
Everyone who is on the list will receive a letter in the coming week, the Government said, outlining the new guidance and giving advice on how to get help.
Almost all of the 90,000 children on the shielding list in March will be left off this because scientists have realised that the risk of them getting sick with Covid-19 is vanishingly small and deaths are almost non-existent in under-20s.
WHO IS ON THE SHIELDING LIST?
People who are considered ‘clinically extremely vulnerable’ should all receive an official letter warning them.
There are thought to be around 2.3million people on the list, including:
- Organ transplant recipients;
- People having chemotherapy for cancer;
- Lung cancer patients receiving radical radiotherapy;
- People with blood or bone marrow cancer such as leukaemia;
- Cancer patients receiving immunotherapy or other therapies that affect the immune system;
- Bone marrow or stem cell transplant recipients who had the procedure during the last six months or are still taking immunosuppressant drugs;
- People with debilitating lung conditions including cystic fibrosis, bad asthma or severe COPD;
- Those with rare condition that increase the risk of infection, such as homozygous sickle cell disease;
- Patients having immunosuppressant therapies that raise infection risk;
- Pregnant women with significant heart disease;
- Others who have been individually judged extremely vulnerable by doctors;
- Adults with Down’s syndrome;
- People with stage 5 kidney disease.
New additions to the shielding list include adults with Down’s syndrome, of whom there are around 40,000 in the UK, and those with late-stage kidney disease; around 63,000 people. Officials said those groups are at higher-than-average risk.
In a more specific breakdown of rules, extremely vulnerable people have been advised not to socialise or exercise with people outside of their household bubbles – lone adults will still be allowed to form a support bubble with one other home.
Extremely vulnerable people who can’t work from home should not go to work, the guidance said, but people they live with can follow general national advice.
Likewise, children who live with an extremely vulnerable person can still go to school as normal. Schools will continue to open as usual throughout the lockdown.
Ministers advise people not to take any ‘non-essential’ travel outside, going only to hospital or medical appointments or to exercise near home. ‘They are strongly advised not to go to any shops or to pharmacies,’ the advice said.
In the lower-level clinically vulnerable group, which includes everyone over the age of 70 and people with diabetes, heart disease, asthma or kidney or liver disease, as well as pregnant women and obese people.
Those people are advised more gently to strictly follow lockdown rules and to only go out if necessary to exercise, to buy food or for medical reasons.
The return to a full shielding programme was unexpected after the Government last month made a conscious effort to change its tone on messaging for at-risk groups.
As the country moved to its local lockdown measures, officials said people would be sent tailored advice depending on the situation in their area.
The Government announced on October 13 that it was switching to ‘soft advice’.
Officials said some followed the advice too literally the first time and saw it as rules not suggestions, and that it had devastating impacts on people’s mental health. They said that this time advice would be offer on how people can best protect themselves, and they would be able to choose how strictly to follow it.
Local authorities were still able to appeal for full shielding to be brought back if the situation is desperate, but none of the three alert levels trigger it automatically.
The new, tougher guidance will come into effect from midnight tonight provided MPs vote in favour of the month-long lockdown this afternoon.
It is expected to pass the test in the Commons but many MPs are furious with the measures, which they say are unnecessarily strict.
Theresa May led an Tory assault on the plan today when she accused the Government of mangling figures to force the policy through.
The former PM delivered a damning assessment of Boris Johnson’s handling of the situation, saying a controversial claim that deaths could hit 4,000 a day by next month was ‘wrong before it was even used’.
Boris Johnson (pictured right today) is expected to win a vote on a second lockdown that is due to come into force from midnight. But Theresa May (left) delivered a damning assessment of Boris Johnson’s handling of the situation, saying a controversial claim that deaths could hit 4,000 a day by next month was ‘wrong before it was even used’
She said Mr Johnson – who scuttled out of the Commons as she started speaking – must open up to more scrutiny, warning that the extraordinary national restrictions coming into force at midnight will ‘shatter livelihoods’.
WHAT ARE THE LOCKDOWN 2.0 RULES?
Stay at home at all times except for food shopping, medical purposes, individual exercise or work if you can’t work from home;
Non-essential shops must close, as well as restaurants and bars. Takeaways can stay open;
Holidays are banned. International travel is allowed for work or if someone is returning from a pre-lockdown trip;
Gyms, leisure centres, cinemas, hairdressers and beauty salons must close;
Construction and manufacturing can continue, as can other ‘essential’ industries that cannot be done from home.
The intervention came after the premier begged rebellious Conservative MPs to trust him, insisting he cannot ‘risk British lives’ by avoiding action.
Kicking off the stormy debate, the PM said he never thought he would be imposing such draconian measures – including ordering people to stay at home and shutting non-essential retail, bars and restaurants for a month.
But Mr Johnson said he had been ‘confronted’ with the prospect of the NHS ‘collapsing’ under the weight of coronavirus patients, and had looked at the grim experience of European countries suffering another peak.
‘I’m not prepared to take the risk with the lives of the British people,’ he said.
However, in her stinging rebuke to the government, Mrs May said: ‘It appears the decision to go towards this lockdown was partly, mainly, to some extent based on the prediction of 4,000 deaths a day.
‘Yet if you look at the trajectory showing in that graph that went to 4,000 deaths a day, we would have reached 1,000 deaths a day by the end of October.
‘The average in the last week of October was 259, by my calculations. Each of those deaths is a sadness and our thoughts are with the families, but it’s not 1,000 deaths a day.
‘So the prediction was wrong before it was even used. And this leads to a problem for the Government – for many people it looks as if the figures are chosen to support the policy rather than the policy being based on the figures.’