Many more people asked to shield in England

The Department of Health and Social Care (DHSC) and Public Health England (PHE) have issued revised guidance on shielding – the protection in place for people who are clinically extremely vulnerable to becoming severely ill with Covid-19.

This news comes as the DHSC has identified new technology that can help clinicians in England to identify, for the first time, a new group of people who may be at a higher risk of becoming severely ill with Covid-19. Up to 1.7 million people in England have now been identified to be clinically extremely vulnerable, in addition to the 2.3 million people already on the shielding list.

This research, commissioned by England’s Chief Medical Officer Chris Whitty and funded by the National Institute of Health Research (NIHR), has found that there are several health and personal factors which could mean that a person is at a higher risk of becoming severely ill if they catch Covid-19. The University of Oxford turned this research into a risk-prediction model which has been independently validated by the Office for National Statistics (ONS). NHS Digital then used the new model to develop a population risk assessment which predicts, on a population basis, whether adults with a combination of risk factors may be more at risk than others, enabling them to be flagged to clinicians for priority access to vaccination. 

Those within this group who are over 70 will have already been invited for vaccination and 820,000 adults between 19 and 69 years will now be prioritised for a vaccine. Employers are reminded to continue to encourage all their staff to take the vaccine, including those required to shield, by distributing factual information from reliable sources rather than mandating take-up of the vaccine.

The risk factors identified may include age, ethnicity, body mass index (BMI), as well as certain medical conditions and treatments. Employers should not assume, however, that a member of their workforce will, or will not, automatically be part of this group due to their appearance alone and should base their decisions on medical confirmation – such as a shielding letter provided to the employee. As soon as an individual is listed as potentially clinically extremely vulnerable by the population risk assessment, they will be sent a letter informing them that they are being added to the Shielded Patient List as a precautionary measure, how they have been identified, and outline any additional guidance to support them.

It is important to note that this shielding guidance applies to clinically extremely vulnerable individuals only. Others living in a household with someone who is clinically extremely vulnerable are advised to continue to comply with the national lockdown guidance that came into effect on 5 January 2021. 

Individuals in England who are asked to shield are advised to work from home wherever possible but where remote working is not possible, shielders are still not expected to attend work. Where the latter is concerned, it may be necessary to consider placing affected staff on furlough or on statutory sick pay.