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Coronavirus shielding advice

Shielding is a way of protecting people who are at high risk of becoming severely ill from COVID-19. Coronavirus advice on shielding and protecting the extremely vulnerable is constantly changing in the UK.

    The advice on how to protect yourself across the UK reflects the level of risk in local areas.

    There are slight differences between the 4 nations of the UK. For detailed information see the information further down on this page. In summary:

    • England and Wales: shielding is paused. You should continue to take extra care and follow the general advice. So keep social contacts low, work from home where possible and keep your distance from people.
    • Scotland: some areas of Scotland are at COVID-19 protection level 2, while others are at level 1. The Scottish islands are mostly at protection level 0. You should follow the advice for your area, but continue to take extra care to protect yourself (follow the links below to find your area).
    • Northern Ireland: shielding advice is reviewed on a regular basis and you should continue to take extra care and follow the general advice.

    We update our coronavirus shielding advice with guidance as and when it becomes available. 

    If you've had the COVID-19 vaccine, you should continue to follow the advice on how to protect yourself against the virus.

    What is shielding and protecting the extremely vulnerable?

    Shielding is a way of protecting people who are at high risk of becoming severely ill from COVID-19. At the start of the coronavirus pandemic, people with a weakened immune system Open a glossary item (clinically extremely vulnerable people) were asked to follow strict shielding advice. 

    Current advice is generally less restrictive than at the start of the pandemic. It still focuses on minimising social contact to reduce the chances of catching the virus by people who may be at greater risk.  

    Why is the advice about shielding changing?

    The advice about shielding changes as the number of people with coronavirus changes. So if the number of people with the virus goes down the risk of catching it is lower.

    The governments of the different UK countries have been changing this advice often to reflect the level of risk in a particular area. This is because infection rates vary in different parts of the country, and not everyone will need the same advice.

    More is also known about the virus, and that staying at home without much social contact for long periods can affect your health and wellbeing.

    It is likely that shielding advice will change again as more is known about the virus, its effect on the vulnerable, and as infection rates change.

    Who are more at risk of becoming ill?

    Some people with cancer are more at risk of being seriously ill if they develop the COVID-19 infection. These groups of people include those:

    • having chemotherapy
    • having radical radiotherapy for lung cancer
    • with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
    • having immunotherapy or other continuing antibody treatments for cancer
    • having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
    • who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
    • taking medicine such as high doses of steroids

    COVID-19 Population Risk Assessment

    Some people might be asked to shield because they have been identified through the COVID-19 Population Risk Assessment as being at high risk of serious illness if they catch the virus.

    Individual risk and circumstances

    Individual risk

    It is important to follow the guidance for your part of the UK. But also, to be aware of your individual risk. Speak to the team caring for you if you are unsure about your individual risk.

    Your individual risk depends on a number of factors including:

    • your type of cancer
    • the treatment you are having
    • any other health issues you have
    • your age
    • your ethnicity
    • where you live
    Your doctor may give you shielding advice that is based on your individual circumstances and which may differ from that of your local area.

    Circumstances

    The decision to protect yourself from coronavirus with shielding measures is your personal choice and depends on your circumstances. For example, there are some people who, because of their cancer, may have a limited time to live. And so they may decide not to fully follow the shielding measures.

    Current guidance

    There are slight differences in the advice for each UK country. Below is a summary of the current advice for extremely vulnerable people in England, Wales, Scotland and Northern Ireland.

    Shielding is paused in England. If you are clinically extremely vulnerable you should follow the rules that are in place for everyone, but take extra care to protect yourself from getting the coronavirus. Ask the team caring for you if you are uncertain as to what you should do. The general advice to protect yourself is: 

    • keep social contacts to a minimum
    • meet outside where possible
    • work from home where possible
    • keep your distance from people, that is at least 2 metres 
    • wash your hands regularly with soap and water for 20 seconds, or use hand sanitiser if you can't wash them
    • avoid touching your face and wear a face covering
    • clean surfaces regularly and avoid touching surfaces others have touched
    • ensure any enclosed areas are well ventilated
    • think about whether you and those you are meeting have been vaccinated with the COVID-19 vaccine – you might want to wait at least 21 days after your second dose before being in close contact with others

    Shielding is paused in Wales. If you are clinically extremely vulnerable you should follow the rules that are in place for everyone, but take extra care to protect yourself from getting the coronavirus. Ask the team caring for you if you are uncertain as to what you should do. The general advice to protect yourself is:

    • keep social contacts to a minimum
    • work from home where possible
    • wash your hands regularly with soap and water for 20 seconds, or use hand sanitiser if you can't wash them
    • keep your distance from people, that is at least 2 metres 
    • avoid touching your face and wear a face covering
    • clean surfaces regularly and avoid touching surfaces others have touched
    • ensure any enclosed areas are well ventilated

    Some areas of Scotland are at COVID-19 protection level 2, while others are at level 1. The Scottish islands are mostly at protection level 0. You should follow the advice for your area.

    Level 2

    The advice for clinically extremely vulnerable people on mainland Scotland and Skye under level 2 restrictions is:

    Contact with others

    • reduce the number of people or households you have face-to-face contact with
    • avoid areas which allow physical distancing of only 1 metre

    Shopping

    • strictly follow the shopping guidelines for the general population

    If you cannot work from home

    • you should have a workplace risk assessments and your employer should make any changes needed to your workplace to protect you
    • speak to your employer to ensure all appropriate protections are in place (most workplaces can be made safe)

    School/college/formal childcare

    • follow the advice to the general population

    People who live with someone on the shielding list

    • follow the advice to the general population

    Level 1

    The advice for clinically extremely vulnerable people in the Scottish islands under level 1 restrictions is:

    Contact with others

    • follow the advice to the general population

    Shopping

    • strictly follow the shopping guidelines for the general population

    If you cannot work from home

    • you should have a workplace risk assessments and your employer should make any changes needed to your workplace to protect you
    • speak to your employer to ensure all appropriate protections are in place (most workplaces can be made safe)

    School/college/formal childcare

    • follow the advice to the general population

    People who live with someone on the shielding list

    • follow the advice to the general population

    Level 0

    Contact with others

    • follow the advice to the general population

    Shopping

    • strictly follow the shopping guidelines for the general population

    If you cannot work from home

    • you should have a workplace risk assessments and your employer should make any changes needed to your workplace to protect you
    • speak to your employer to ensure all appropriate protections are in place (most workplaces can be made safe)

    School/college/formal childcare

    • follow the advice to the general population

    People who live with someone on the shielding list

    • follow the advice to the general population

    Shielding advice is reviewed on a regular basis in Northern Ireland. If you are clinically extremely vulnerable you should follow the rules that are in place for everyone, but take extra care to protect yourself from getting the coronavirus. Ask the team caring for you if you are uncertain as to what you should do. The general advice to protect yourself is:

    The general advice for clinically extremely vulnerable people is:

    • keep social contacts to a minimum

    • work from home where possible

    • wash your hands regularly with soap and water for 20 seconds, or use hand sanitiser if you can't wash them

    • keep your distance from people, that is at least 2 metres 

    • avoid touching your face and wear a face covering

    • clean surfaces regularly and avoid touching surfaces others have touched

    • ensure any enclosed areas are well ventilated

    • exercise outside but maintain social distancing

    I’m shielding and living with other people, what should we do?

    Anyone who lives with you should reduce their contact outside their home where possible. But they do not have to practice the same shielding measures. They should practice social distancing (see below).

    • Spend as little time as possible with other people that you live with in shared spaces, such as the kitchen or living room. Keep these areas well ventilated.
    • Try to keep 2 metres (3 steps) away from people you live with. Sleep in a different bed where possible.
    • Use separate towels to other people in your house.
    • Use a separate bathroom if possible. If you need to share a toilet and bathroom, this should be cleaned after you use them.
    • Everyone should wash their hands regularly, avoid touching their face and clean frequently touched surfaces.
    • Depending on your situation, it could be very difficult to stay separate from others at home. Do what you can. It is important that you feel you can support each other through this.

    Care and support

    Visits for essential support

    You can continue to have visits from anyone who helps you with essential support. For example, healthcare staff or carers. All essential visitors should wash their hands with soap and water for at least 20 seconds when they arrive at your home and often during the visit.

    Getting help from the NHS

    It is important that you continue to contact the NHS and other health providers for support with your existing health conditions and any new health problems.

    There is a range of  NHS services which you can access from home. It includes ordering repeat prescriptions or contacting health professionals for an online appointment.

    You can also download the NHS App.

    Help with shopping and medicines

    Many local authorities have schemes to help with things like shopping and getting medicines. There might also be a local volunteer scheme in your area. Contact your local council to find out more or check your local authority's website.

    NHS Volunteer Responders

    In England the NHS Volunteer Responders can:

    • collect shopping, medicines and other important items
    • contact you with a friendly phone call
    • help you get to medical appointments by giving you a lift

    Help with shopping and medicine is also available in the other UK countries.

    If you feel worried about shielding

    It is understandable that you might feel anxious about changes to the shielding advice. The decision about whether you shield or not is yours and will depend on your circumstances and how comfortable you feel about it. If you're feeling anxious, it can help to talk through your worries with your family.

    The team caring for you can also talk to you about your individual risk.

    Travelling to hospital

    Many hospital appointments are changing to telephone or video appointments. But there might be situations when you need to see your team for a face-to-face appointment or attend the hospital for treatment. There are some practical tips that can help you feel more safe:

    • Try to avoid public transport and go by car where possible. Ask a friend or family member to drive you if you can't drive. They won't be able to go into the appointment with you and will need to wait in the car for you.
    • Try to practise social distancing with the person driving you if they are not part of your ‘support bubble’ or extended household group. Sit as far away as possible from them.
    • Wear a face covering.
    • Avoid touching your mouth, nose and eyes.
    • Wash your hands where possible or use a hand sanitiser gel before, during and after the journey.

    Hospital transport

    Your hospital might be able to provide hospital transport if you are unable to travel by yourself or find someone to drive you. The transport service will have safety and cleaning procedures in place to try to protect you from coronavirus. Talk to your medical team or contact the transport service at your hospital for more information.