Shielding advice for very high-risk groups

Who is advised to shield, and what should you do if you are shielding?

The coronavirus outbreak is a rapidly developing situation and the most up-to-date information for people in the UK can be found on the NHS website.

The UK Government and devolved administrations have released guidelines for people who would be at very high risk if they caught coronavirus because they have a severe respiratory condition, including severe asthma.

The UK government has called this the clinically extremely vulnerable group.

Most people with asthma who are in the clinically extremely vulnerable group have already been contacted by letter or text message. You may also be contacted about shielding in future if your diagnosis changes and you become part of the very high-risk group, or if you are added to the very high-risk group by your doctor.

The four governments use slightly different criteria to define the shielding group. Please contact your doctor or hospital clinician to discuss your concerns if you think you may need to shield and haven't received a letter.  

The advice for people in the shielding group remains unchanged. You are advised to stay at home at all times and avoid all non-essential face-to-face contact until the end of June. On 11 May, the UK government’s recovery strategy introduced more support for those in the shielding group, and those helping them, such as care workers.

Current advice from governments across the UK is that:

If you have already received a letter or text message, you should follow the shielding advice.

If you have not been contacted and you're concerned, you should discuss your concerns with your GP or hospital doctor. In the meantime, the NHS says you may wish to follow the shielding guidance.

  • In England, you should register with the Government for shielding support, even if you don't feel you need it. You can do this online, or by calling 0800 028 8327, the UK Government's dedicated helpline. 
  • In Northern Ireland, a freephone helpline is available for people shielding, on 0808 802 0020. You can also get in touch by email on covid19@adviceni.net or text ACTION to 81025.
  • In Scotland, you can register for support by texting 07860 064525 and quoting your CHI number, which is the 10-digit number that should be at the top of your shielding letter. You find the contact information about your local assistance centre on the NHS inform website.
  • In Wales, you do not need to register and can find information about what support is available on the Welsh Government’s website.

Who should be shielding?

The decision to shield is a deeply personal one, and it’s your choice whether you choose to shield or not. If you decide not to shield, the NHS recommends discussing your decision with your GP or hospital clinician.​

In England, the NHS now say that you would be in the shielding group for asthma if ALL THREE of these things apply to you:

  • You have asthma, AND
  • You are taking certain extra controller medicines as well as a preventer inhaler (for example, you are taking Montelukast, salmeterol or formoterol, or you are on a combination inhaler like Seretide, Fostair, Symbicort, Flutiform, Fobumix, DuoResp Spiromax, Combisal, Sereflo, Sirdupla, Aloflute, AirFluSal, Relvar Ellipta, Fusacomb or Stalpex), AND
  • You are taking continuous or frequent oral steroids.

The British Thoracic Society also says that you are at very high risk if:

  • You are taking a biologic therapy for severe asthma.

Across the four nations, the criteria for shielding are very slightly different.

Read more about criteria in ScotlandWales or Northern Ireland.

We will update this advice if anything changes and we will continue to push for the right people to be identified and contacted, and the right support for people with asthma who need to shield. We will also monitor how all guidance is being implemented to ensure people with asthma are sufficiently protected and supported.

What if I don't get a letter?

If you think that you are at high risk from coronavirus, but have not been contacted, it may be because your GP or hospital clinician is still working through their patient lists or have judged, on the basis of the guidance, that you do not fall into the extremely clinically vulnerable group. If you are still concerned, you should discuss this with your GP or hospital clinician.

There is no cut-off point for being added to the shielding group – you can be added any time, if you have one of the conditions in the agreed clinical list described above.

You may feel frustrated if you think you should be shielding, but your GP or your specialist does not agree. You can make the personal decision to shield, but you won't be eligible for government support. You can get support from the mutual aid network or your local council and you should talk to your employer. This ACAS advice for employees who want to shield may be useful when talking to your employer.

The government advises shielding only if you fall into the at-risk groups defined on this page. Think about the extra benefit you will get from shielding as opposed to social distancing and weigh it against the impact on your mental and physical wellbeing of the significant loss of social contact and staying at home for a long time.

What to do if you are shielding

  • Stay at home at all times and avoid any face-to-face contact with others until the end of June. The UK Government said on 11th May that they would be "likely" to advise people in this group to stay shielded beyond this date, but dates are not yet confirmed.
  • Get food, medicines and other essential items delivered, and ask the person delivering them to leave them at the door. You can ask friends and neighbours to help with this, or use delivery services.
  • Contact the UK government or devolved administrations to tell them if you need extra services. If you need to, you can also get support from the NHS volunteer responders in England (and equivalent groups in the rest of the UK) or a local mutual aid network. 
  • If you need to, you can also get support from the NHS volunteer responders or a local mutual aid network.
  • Use phone or online services to contact your GP or other services if needed.
  • Inside your home, minimise all non-essential contact with other people you live with.
  • People who provide essential support for you, such as healthcare or support with your daily needs or social care, can still come to your home. But if they have symptoms of COVID-19, they should not come. You should make a plan for how your care needs will be met if your carer becomes ill.
  • If you get symptoms of COVID-19, which means a fever, a new continuous cough, or a change in your sense of smell (anosmia), use the NHS 111 online coronavirus service or call 111 as soon as you get symptoms. Do not wait for your symptoms to get worse.
  • If someone else lives with you, they do not have to follow the shielding guidance. They should follow the social distancing guidance very closely and do what they can to support you with shielding.
  • There is more information for people who live with you in the government shielding guidance and we strongly suggest you read it and apply it as much as you can.

Shielding and employment

If you have a shielding letter, your employers should be supporting you in shielding. If you can work from home in your job, it’s fine for you to continue working while shielding, as long as you are well. If you can’t work from home, you shouldn’t be working while shielding.

The Government advice is that employers must support vulnerable and at-risk workers to protect themselves. The Asthma UK Helpline nurses are unlikely to be able to advise about specific employment situations, but there is helpful guidance from ACAS about coronavirus and employment issues

The shielding advice also applies to key workers. For example, there is some useful information in the NHS Employers' guidance.

Shielding and school

From 1 June 2020, it is expected that nurseries in England may reopen and children in certain year groups may be allowed back to school.

For more detail on this, read the latest government information on coronavirus and schools.

The reopening of schools is underpinned by the government’s latest understanding of the science, with evidence showing that younger children are less likely to become unwell if they catch coronavirus.

Asthma UK understands parents may be worried about sending their child with asthma back to school.  

Staff and children in the clinically extremely vulnerable (high risk) group have been advised to shield. People in this group will not be expected to go to school or college.

Staff and children in the clinically vulnerable (moderate risk) group are thought to be at higher risk of severe illness from coronavirus. This includes adults and children with asthma. Staff in this category have been advised to work from home where possible. If working from home is not an option, they should move to the safest on-site roles, where possible, so they can stay 2 metres from others.

Young children have consistently been shown to have very low risk of serious illness from coronavirus. But if your child has asthma and you are worried about them going back to school, the current government advice is to call your GP.

Find out how to avoid a back to school asthma attack.

A child or member of staff who lives with someone who is clinically vulnerable (but not clinically extremely vulnerable), including those who are pregnant, can go back to school.

If a child or member of staff lives with someone who is shielding, then they should only return to school if “stringent social distancing” can be maintained, according to government advice. They should not attend school if they can’t maintain social distancing rules. Instead, they should be supported to learn or work at home. It’s up to you to decide whether your child can maintain social distancing during the school day. It’s likely that younger children will find social distancing difficult.

If a child or staff member has coronavirus symptoms, or is self-isolating because of coronavirus symptoms in their household, they should not go to school.

If your child is not going to attend school or college, let the school or college know, so they can continue supporting your child as well as they can. Parents will not be fined for not sending their children to school or college at this time.

Once more children and young people start returning to school, staff and pupils in all settings will be eligible for testing if they become ill with coronavirus symptoms. Members of their household will also be eligible for testing.

Find out how to get tested for coronavirus

Supporting your wellbeing while shielding

It’s really important to look after yourself while you are shielding. It is a long time to stay at home without contact with others, and it can be hard to cope with.

Get some fresh air

If you have a garden, you can go into it as long as you stay 2 metres away from other people. Otherwise, spend time with the windows open to let in some fresh air. You could try arranging things so you can see a nice view, if you have one.

Try to keep active

Do whatever physical activity you can manage. This might be some yoga or an exercise video at home, or in your garden if you have one. If you aren’t able to do much exercise, try to break up the time you spend sitting down by walking around at home. There are also chair-based exercises you can do to help you keep moving.

Look after your physical health

Eat healthy meals, drink enough water, and try not to increase how much alcohol you drink. If you smoke, now is a great time to give up, as smoking raises the risk from coronavirus. Find out how to quit smoking

Stay social

It’s really important to keep in touch with friends and family. You can send texts or emails, call people on the phone or use video chat to stay in touch with people who are important to you.

Get support

NHS volunteer responders can do things like helping you with shopping, getting prescriptions or just checking in to see how you're doing. 

You can request support online or by calling 0808 196 3646.

You can also reach out to friends and family to support you with tasks like these while you're shielding. 

Look after your mental health

Lots of people are feeling anxious or struggling with their mental health at the moment. The Mental Health Foundation has produced a great list of tips to look after your mental health.

Ideas include:

  • Making sure you’re looking after yourself, so you feel more able to cope with whatever happens.
  • Watch out for bad habits like increasing your alcohol consumption. Try to make sure you are getting some exercise.
  • Only looking at reliable sources of information, like the NHS and the websites for UK Government and devolved administrations. 

 Last updated on: Tuesday 26th May

We hope you have found this content useful

 

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