Guidance for the clinically extremely vulnerable (the shielding group)
Some people with long-term lung conditions are at extremely high risk of severe illness from coronavirus. These people belong to a group described as ‘clinically extremely vulnerable (CEV)’, formerly known as the ‘shielding group’.
On this page:
- What should people who are clinically extremely vulnerable (CEV) do?
- What is the guidance for CEV people across the UK?
- When can I get the coronavirus vaccine?
- Going into work if I'm clinically extremely vulnerable
- Children going into school
- What support can I get?
- How at risk am I of becoming seriously ill with coronavirus?
- Help if I'm feeling worried
- Who should be in the clinically extremely vulnerable group?
If you are in the CEV group and think you have developed symptoms of coronavirus, such as a fever or new continuous cough or a loss or changed sense of normal small or taste, get advice from the NHS 111 online service or call NHS 111. Do this as soon as you get symptoms.
What should people in this group do?
We should all be doing what we can to prevent the spread of coronavirus to help protect ourselves and others. This includes:
- following the government guidance for where you live or work
- keeping your distance from anyone outside your household
- washing your hands often, using soap and warm water, or alcohol-based hand sanitiser
If you’re clinically extremely vulnerable, you should follow the government guidance stringently as you may be at risk of severe illness if you catch coronavirus.
It’s important you keep active and find ways to boost your mood, as this will help you stay fit and well.
During the winter months, the NHS recommends taking a daily vitamin D supplement, as this helps to keep your bones healthy. You might have heard that in England, people on the shielded patient list will be offered a free winter supply of vitamin D. If you live in England and are clinically extremely vulnerable, you’ll be sent a letter offering you the supplements. These will be delivered free of charge to your home. For some conditions, for example sarcoidosis, you shouldn’t take a vitamin D supplement unless it’s specifically recommended for you by your specialist. If you are in any doubt if you should be taking a supplement or not, speak to your health care professional for their advice. You can read more on:
- how to take vitamin D supplements safely on the government website, and
- opt-in to receive your free supply of vitamin D on the NHS website.
Get a free flu vaccine
This year, if you live in any part of the UK and are on the shielded patients list, you and your whole household can get the flu vaccine for free.
Flu can be a serious illness, especially if you’re living with a lung condition. Read more about keeping well in the winter and why you should get the flu vaccine this year.
Unlike at the start of the pandemic, advice for people in the shielding group might differ, depending on how affected the area you live or work in is. Below, we explain the new guidance and restrictions across the 4 nations and what it might mean for people in the shielding group.
England has now entered a national lockdown and shielding for the clinically extremely vulnerable has been reintroduced. The shielding advice isn’t as strict as during the first national lockdown, and people in this group can still go outside for exercise or for medical purposes.
The advice for everyone is to stay at home, except for essential purposes. You can read more about the advice for everyone during the national lockdown on the government website.
For people who are clinically extremely vulnerable, it’s especially important you follow the guidance as you are at greater risk of becoming severely ill if you were to catch the virus. Everyone in this category will receive a letter, detailing the new guidance set out for them. You can also read the government’s detailed advice for people who are CEV on their website.
Scotland has entered a national lockdown. The advice for everyone is to stay at home, except for an essential reason. You can read more about the stay at home guidance for Scotland on the government website.
Everyone who is clinically extremely vulnerable will receive a letter from the Chief Medical Officer, which sets out the advice for this group. You can still go outside, for exercise, essential shopping or medicines, but you should minimise contact with people outside your household. You shouldn’t take public transport and you should continue to work from home. If you cannot work from home, you shouldn’t go into work and your letter from the CMO will act as a fit note for as long as lockdown restrictions are in place.
All of Wales has been placed under a level 4 alert – very high risk. The general advice for everyone is to stay at home where possible, except for certain reasons.
While formal shielding has not been reintroduced, people who are clinically extremely vulnerable are advised not to go into work, if they cannot work from home. All people on the shielded patient list will receive a letter from the Welsh government detailing the updated guidance they should follow.
Read more about the guidance for people living in Wales.
Additional restrictions have been put in place in Northern Ireland to reduce the spread of coronavirus. People who are clinically extremely vulnerable are advised to be particularly careful in following the advice on social distancing, face coverings and hand hygiene.
Formal shielding hasn’t been reintroduced, and people in this group are encouraged to go outside for exercise. The Chief Medical Officer will write to CEV people to advise of the updated guidance for them. Anyone who cannot attend work due to this advice will be eligible for Statutory Sick Pay, and can use the CMO letter as evidence for their employer as was the case when shielding was introduced at the at the start of the pandemic. More advice and support can be found here.
The order people will be offered the vaccine is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI). The main criteria used to decide how soon you get a vaccine is your age. This is because the older you are, the higher your risk of becoming seriously ill or dying from COVID-19.
People who are clinically extremely vulnerable and under the age of 70 will be in priority group 4.
There isn’t a set timescale for when all the priority groups will be vaccinated. The NHS has begun vaccinating people in priority group 4, but it may be a little while until you’re invited for yours. When you will get your vaccine is dependent on various factors, like capacity in the NHS and the amount of people in your local area who fall into the priority group. The advice for everyone is to wait until you’re invited and not to contact the NHS.
You can read more about the coronavirus vaccine in our dedicated FAQ page.
Wherever you live in the UK, you should work from home if you can. If you cannot work from home and are in the clinically extremely vulnerable group you are advised to not go into work.
You might be eligible to be furloughed, have Statutory Sickness Pay (SSP) or Employment Support Allowance (ESA) – we would encourage you to talk to your employer to discuss your options. The letter you receive from the government can be used as evidence. Read more about the support that’s available to you.
If you live with someone who is clinically extremely vulnerable but you still need to go into work, take a look at this guidance from the Cystic Fibrosis Trust. It gives tips on things you should do when you come in from home.
Think about how you’re getting to and from work. If you have to use public transport, consider travelling outside of peak hours to avoid the amount of people you come into contact with.
If you’re concerned about your health and safety in the workplace, you should speak with your employer in the first instance. If you can’t find a resolution, you should contact your trade union, Health and Safety Executive or get advice from ACAS.
Schools in England and Scotland are operating as online learning only, except for children of keyworkers. Schools in Wales and Northern Ireland are opening in a phased return, depending on the child’s age.
Evidence has shown there is a very low risk of children becoming seriously ill from COVID-19, even if they have an existing health condition. Most children who were originally identified as clinically extremely vulnerable have been removed from the shielded patient list, and no longer need to follow the advice for this group. But if your child is still considered to be clinically extremely vulnerable and their school is open, you should consider the guidance for CEV children for where you live and discuss with their hospital clinician whether they should be going into school. If you’re unsure if your child still falls into the CEV category, speak to your GP or hospital clinician.
During the national lockdown it’s important you get the care you need to keep you safe and well.
If you don’t have someone you can rely on to go shopping for you, you can register for support on the government website. This can help you:
- request access to a priority supermarket delivery slot
- tell your council if you need support, especially if you are unable to arrange this yourself or with the help of friends, family or other support networks
If you’re clinically extremely vulnerable, you’re advised to not go to the pharmacy to collect any medicines, and should instead ask family or friends to do this for you. If this isn’t possible, and your pharmacy are unable to arrange for a volunteer, you’ll be eligible for free medicines delivery. If you fall into this category, please contact your pharmacy and tell them you’re CEV and need your medicines to be delivered. They will arrange this free of charge.
The NHS Volunteer Responders service is there to support to people who need it in England. They can help you by:
- collecting food, medicine and other essential supplies
- providing regular phone calls with their ‘check in and chat’ service
- helping you get to medical appointments
You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health care professional for an online consultation. Visit the NHS Health at Home website for more information, or download the NHS app. If you struggle using technology, or would just like to become more digitally confident, take a look at our technology for lung health hub.
In Scotland, the national COVID-19 helpline is open Monday to Friday, 9am to 5pm. The number for this helpline is 0800 111 4000. People who have been shielding in Scotland can continue to get updates from the SMS Shielding Service.
Read more about the continued support for people in the shielding group in Scotland.
Details of the support that’s available to you will be in the letter you’ve been sent by the government. If you’re struggling and need support, you can contact the COVID-19 Community Helpline:
- phone: 0808 802 0020, or
- text: ACTION to 81025, or
- email: [email protected]
People in the shielding group in Wales can still benefit from priority supermarket delivery slots if they don’t feel comfortable going to the shops. If you need help getting your medicines you should speak to your pharmacy.
If you need support and don’t have anyone to help you, you should speak to your local council. Local councils have a list of people who are on the shielded patient list in their area and will be able to help arrange support where you need it.
Different factors affect your risk of becoming seriously ill with coronavirus. Having a long-term lung condition is one of them. But it isn’t the only factor that increases your risk. Age is the biggest risk factor, with those aged 80 and older at a greater risk of becoming seriously ill with coronavirus.
Everyone is different, and your own level of risk depends on different factors. This makes it difficult to give blanket advice about the level of risk from having a lung condition.
We know you might be feeling anxious about what the next few months might look like. If you have concerns, contact your GP. We will continue to make sure the voices of our supporters are heard, so everyone gets the support they need.
If you’re feeling low, please take a look at our information on dealing with your mental health while living with a lung condition. The government has also created guidance for people to help look after their mental wellbeing during the COVID-19 pandemic.
You can also get support from these organisations:
- Mental Health Foundation
- Every Mind Matters
- Let’s Talk Loneliness
- Clear Your Head (Scotland)
To understand more about your COVID-19 risk, including advice on how you can reduce the risk of catching the virus, take a look at this webpage.
What to read next:
- What is coronavirus?
- What if I have symptoms of coronavirus?
- What should people with a lung condition do now?
- How can I cope with staying at home?
- What’s the difference between self-isolation, social distancing and social shielding?
Last updated: Tuesday 19 January 2021
Help us continue the fight for people with a lung condition against COVID-19
Generous donations from people like you, mean our charity Helpline and website can continue being there for people with a lung condition when they need us most!
The ongoing fight against COVID-19 means people with lung conditions will continue to need the help and support that your donations allow us to provide.