Covid-19 High Risk Patients

The guidance for patients identified as clinically at high risk of complications of COVID-19 has changed and a new letter will shortly be sent to all patients by central NHS an example of which can be seen using the link below:

Shielding Letter Copy

What is the current guidance?

Over the course of the last three months, you have been identified as someone who is clinically extremely vulnerable due to an underlying disease or health condition that may put you at risk of severe illness if you catch Coronavirus (also known as COVID-19). This remains the case and you are advised to follow the shielding guidance rigorously.

You were advised to ‘shield’ to protect yourself during the peak of the epidemic in England when you were more likely to come into contact with the virus in your daily life. The initial shielding guidance advised that you should stay at home at all times and strictly avoid nonessential face-to-face contact.

On 1 June the shielding guidance was slightly relaxed, and we suggested that you may wish to spend some time outdoors away from your home once a day. This change was based on scientific evidence that the initial peak of the pandemic had passed in the UK and, in general, the likelihood of meeting someone in the community with infection had significantly reduced. Like all our guidance to those who are clinically extremely vulnerable, this was advisory. The current guidance can be found online at GOV.UK.

What is changing?

Throughout the epidemic we have been clear on the need to balance the risk of the disease to those who are clinically extremely vulnerable with the benefits of gradually returning to normal life. We know that the shielding guidance has been challenging to follow and that it will take time to adjust.

The latest scientific evidence shows that the prevalence of disease across all English regions has continued to decline. If this trend continues as we expect it to, the Government will further relax its shielding advice in two stages on 6 July and 1 August.

From 6 July:

  • you may, if you wish, meet in a group of up to 6 people outdoors, including people from different households, while maintaining strict social distancing;
  • you no longer need to observe social distancing with other members of your household;
  • in line with the wider guidance for single adult households (either an adult living alone or with dependent children under 18) in the general population, you may from this date, if you wish, also 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. This is a small advisory change that brings those affected a step nearer others in their communities. However, all the other current shielding advice will remain unchanged at this time.

From 1 August the advice to ‘shield’ will be paused. From this date, the Government is advising you to adopt strict social distancing rather than full shielding measures. Strict social distancing means you may wish to go out to more places and see more people but you should take particular care to minimise contact with others outside your household or support bubble.

In practice, this means from 1 August you are advised that you no longer need to shield. This means that from 1 August:

  • you can go to work, if you cannot work from home, as long as the business is COVID-safe;
  • children who are clinically extremely vulnerable can return to their education settings if they are eligible and in line with their peers. Where possible children should practise frequent hand washing and social distancing;
  • you can go outside to buy food, to places of worship and for exercise but you should maintain strict social distancing; and
  • you should remain cautious as you are still at risk of severe illness if you catch Coronavirus, so the advice is to stay at home where possible and, if you do go out, follow strict social distancing.

More detailed guidance will appear on GOV.UK when the changes come into effect on 6 July and 1 August.

Will the position be reviewed?

After 1 August we will continue to keep your name on the Shielded Patient List. We will monitor the virus continuously over coming months and if it spreads too much, we may need to advise you to shield again.

We have committed to reviewing the advice to those who are clinically extremely vulnerable at every review point of the wider social distancing measures. Should the scientific evidence require the Government to tighten the advice for clinically extremely vulnerable people, this will be communicated to you quickly and clearly.

Why is the guidance changing?

The Government’s guidance to those most at risk of severe illness if they catch Coronavirus has always been advisory and based on the balance of risk to this group at a time when the transmission of Coronavirus has been highest in our communities. We recognise everyone will feel differently about their own risk and have different priorities – our ambition has been to help and support you in looking after yourself through a very challenging period.

All Government decisions on shielding advice are led by the latest scientific evidence. The latest evidence shows that the chance of encountering Coronavirus in the community has continued to decline. Four weeks ago, around one person in 500 had the virus. Last week it was even lower with less than one in 1,700 people having the virus. As a result, we believe that the time is now right to relax our advice to those shielding further, but we understand that it might take a while to get back to routine daily life again.