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COVID-19 coronavirus: what is shielding and who needs it?

In the last week, the pace of change of advice about COVID-19 - commonly just called coronavirus - has ramped up. About 1.5 million people across the country will be getting, or have received, a letter asking them to stay at home for 12 weeks - a strategy called 'shielding'. But who's in this 'highest-risk' group and what's the difference between the advice for them and for the rest of us?

Use Patient's coronavirus checker tool if you have any symptoms of fever or a new cough. Until you have used the tool and been advised what action to take, please stay at home and avoid contact with other people.

As the number of cases in the UK continues to grow rapidly, the risk increases for all of us. It's for this reason that we should all be practising strict social distancing, regardless of age or whether we have any health problems.

Editor's note

This article was updated on 9th and 29th May 2020 following updated guidance from the Royal College of GPs and NHS consultants to add patients who were previously included in the 'at risk' category rather than the shielded category.

And make no mistake - while coronavirus is much less likely to kill young healthy people than older ones, even the fittest of us could die. These measures are for our own protection, as well as to reduce the risk of our NHS being completely overwhelmed.

Higher, highest

Some people are at higher risk of life-threatening complications than others. This includes anyone who's invited for an NHS flu vaccine every year (apart from young, healthy children who all get the invitation).

Everyone in this category should be avoiding any unnecessary social interaction. That means no socialising with friends you don't live with; no visits to supermarkets or hotels (pubs, restaurants and bars should already be closed) and no travelling by public transport. In fact, you should avoid leaving the house wherever possible except to get a breath of fresh air while nobody else is around.

But there are degrees of risk:

  • While increasing age brings increasing risk as your immune system wanes, over-80s are at significantly higher risk than healthy people in their 70s.
  • Among high-risk groups, there are some people whose immune systems would struggle the most to fight off infection. These are the groups being asked to stay at home.

Are you eligible for a free NHS flu vaccination?

You may be entitled to a free NHS flu vaccination from your GP or local pharmacist. Find out if you are eligible today.

Find out more

The you-must-stay-at-home group

The groups being contacted to ask them to stay at home are:

Editor's note

  • People who have had a 'solid organ' transplant (kidney, liver, intestines, heart, lung and pancreas).
  • Pregnant women who also have significant heart disease.
  • People with certain cancers:
    • Anyone currently having chemotherapy or radical radiotherapy for lung cancer.
    • People having any treatment for blood or bone marrow cancers - leukaemia, lymphoma, myeloma, etc.
    • Anyone having immunotherapy or other ongoing antibody treatments for cancer.
    • People having 'targeted' cancer treatment - PARP inhibitors or protein kinase inhibitors (your team can confirm if you're on this treatment - if you're not sure, assume you are taking it until you've spoken with them).
    • People who have had a bone marrow or stem cell transplant in the last six months, or who are still taking medication to suppress their immune system.
  • People with rare diseases that significantly affect their risk of infection (such as severe combined immunodeficiency, or SCID).
  • People with sickle cell disease (not sickle cell trait).
  • Anyone with cystic fibrosis.
  • People with severe asthma or COPD.
  • People taking medication that damps down (suppresses) their immune system significantly. There are many examples of these medicines, but they include:
    • Azathioprine
    • Mycophenolate (both types)
    • Ciclosporin
    • Sirolimus
    • Tacrolimus
  • People who have had a splenectomy (spleen removal). This group was added, according to the NHS England Director of Primary Care, in April. However, not all NHS guidance has been updated to reflect this.
  • People with end stage kidney disease receiving dialysis (these patients must still attend their dialysis appointments).
  • People with with interstitial lung disease, bronchiectasis and pulmonary hypertension.
  • Anyone else identified by their GP or hospital team as being at very high risk (you may receive a letter slightly later - if in doubt, please stay at home for the next week at least).

What should I be doing?

The message for highest-risk groups is clear:

  • Stay at home for at least 12 weeks from mid March.
  • You should not leave the house for shopping or leisure, including going for a walk.
  • Wash your hands regularly for at least 20 seconds.
  • If you live with someone who is shielding with you, you can have contact with them inside the house as long as they do not have any symptoms.
  • If you live with other people who leave the house at all, you should:
    • Minimise the time you spend with them.
    • Keep at least 3 steps (2 metres) from them.
    • Avoid using the kitchen when they are there and keep your own separate crockery and cutlery.
    • Have your meals in your room where possible.
    • Use separate towels and if possible a separate bathroom from them.
  • If you have carers coming in to provide essential services, they can continue to do so. However, they will need to practise strict hygiene.

What support will I get?


You will need to make sure your medication is collected or delivered to you. To help with this:

  • If your pharmacy or a friend/relative delivers your medication, this should continue.
  • If you don't have access to online GP services so you can order repeat prescriptions online, your practice should help arrange this. At Patient Access, you can order your medication yourself or nominate a family member or carer to order medications on your behalf.
  • If your pharmacy closes for any reason, you can simply nominate a new one if you're registered with Patient Access.

Food and supplies

The government is making plans to ensure food parcels are delivered to people having to stay home by about 27th March. They will also be mobilising volunteers around the country to make offers of shopping, etc. If friends or family are already shopping for you, they should continue to do so.

Tragically, there have been cases of vile people scamming older, vulnerable people by offering to shop for them and then stealing. Make sure you know who's doing your shopping and never hand over a credit card (or money in advance).

Do make sure people leave deliveries on your doorstep - you should never be face to face to take them.

What about hospital and GP appointments?

Please don't attend any appointments without checking with your team. Where possible, they will be making arrangements for you to have a phone or video appointment.

If you need urgent blood tests or treatment, your team will be looking at arrangements to minimise your chance of becoming infected.

What if I'm unwell?

If you develop a fever or a new cough, use the Patient Access coronavirus checker to find out what to do. If you get these symptoms and don't have access to the internet, ring the NHS on 111.

If you have an urgent question about other medical conditions, please contact your GP or specialist team.

Help from NHS volunteers

Many people who have to stay home for their own protection can now access help from the 750,000 NHS volunteers who have signed up to help. The services NHS volunteers can offer include:

  • Collecting and delivering shopping and other essential supplies.
  • Delivering medicines from pharmacies.
  • Driving patients to appointments.
  • Bringing them home from hospital.
  • Making regular phone calls to check on people isolating at home.
  • Transporting medical supplies and equipment for the NHS.

People who are eligible for help include:

  • Anyone who has been advised to self-isolate and shield themselves.
  • Over-70s who have underlying health conditions such as heart disease, diabetes, COPD, liver or kidney problems, or nervous system conditions such as Parkinson’s disease or multiple sclerosis.
  • People who are self-isolating who GPs consider especially vulnerable.

If you think you may be eligible, please contact your GP practice (or social care provider if you have one). They can refer you to this service.

Editor's note

This article was updated on 9th and 29th May following updates in NHS guidance.

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