Coronavirus and COVID-19

What is social shielding and who needs to do this?

Some people, including children, 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’.

Shielding is a way to protect people who are extremely vulnerable from coming into contact with coronavirus by minimising interaction between them and other people. The UK government and devolved administrations have published advice for people who are at very high risk of severe illness from coronavirus

As lockdown restrictions ease, there may be different guidance in your area if there is a localised outbreak. For up to date advice in your area, check your local council or local newspaper website. In England, you can check this government page on local restrictions.

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.​

We will update this information if shielding is reinstated across the UK. We are working with the NHS and professional bodies to make sure people with long-term lung conditions get the best advice and support.

If you are in the shielding 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.

How long do I have to shield for?

  • In England, Scotland and Northern Ireland, shielding was paused on 1 August.
  • In Wales, shielding was paused on 16 August.

The list of people in the clinically extremely vulnerable group remains in place and people in this group should follow the advice specific to them. The government will monitor the virus continuously and if it spreads too much, might advise the group to shield again. Some people may still need to shield, if they’ve been told by their GP they need to do so.

What should people in this group do?

People in the shielding group should keep up-to-date with current advice from the government. There is different advice around the UK in England, Scotland, Wales and Northern Ireland, and it is kept under review.

Shielding guidance has now been paused. People in the shielding group can instead follow strict social distancing, rather than full shielding measures. The governments have said the change in advice is based on evidence that the risk of catching COVID-19 is now lower than when shielding was first introduced. People in the shielding group should have received a letter outlining these changes. The government will monitor the virus continuously and if it spreads too much, might advise to shield again. Some people may need to continue to shield, if they’ve been told by their GP they need to do so.

You should still be cautious, as you may be at risk of severe illness if you do catch coronavirus. It’s advised you try and limit the number of people you meet, shops you visit and non-essential journeys you make.

The decision to go outside is yours. The best ways to protect yourself if you do go outside are to: 

  • ideally spend time in open areas
  • keep your distance from other people
  • do not share or exchange personal belongings (such as cups) with other people
  • only spend as long as you feel comfortable outside. 

To help you to get used to being outside more you may want to try short trips outside or spend time in the company of friends, family or neighbours. If you would prefer not to go outside, try spending time with the windows open, to let in fresh air and get some natural sunlight. 

Can I now go back to work?

You should continue to work from home if you can. But, if you can't work from home, you can go back into work, on the basis your workplace is COVID-safe. Your employer should support you to return to work safely.

The governments in England, Northern Ireland, Scotland and Wales have produced guidance on returning to work safely and how a workplace can become COVID-safe.

For more information on returning to work, take a look at the ACAS website.

Children and school staff

Children who have been shielding will return to school, college or nursey when they reopen.

For more detail on children shielding returning to school, nursery or college, take a look at this webpage from our sister charity, Asthma UK.

What support can I get now shielding has been paused?

England

People who have been shielding in England will no longer receive food boxes and medicine deliveries from the National Shielding Service. However, the NHS Volunteer Responders can continue to help with food and prescription deliveries if you need it. You will still be eligible for priority supermarket slots if you registered by 17 July.

Scotland

In Scotland, lots of shielding support will remain open. The national COVID-19 helpline will remain open Monday to Friday, 9am to 5pm. The number for this helpline is 0800 111 4000. People who have been shielding in Scotland will continue to get updates from the SMS Shielding Service. The Scottish government is also developing a service that will tell you your risk of being exposed to the virus in your local area. For more information on Scotland’s COVID forecasting service, visit the government’s website

Read more about the continued support for people in the shielding group in Scotland.

Northern Ireland

People shielding in Northern Ireland who registered for food boxes will no longer receive them. 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:

Wales

People in the shielding group in Wales won’t receive any more food boxes from the government. However, they can still benefit from priority supermarket delivery slots. The volunteer medicine delivery scheme will also be available until the end of September.

I feel anxious about shielding being paused

We know for some people the ending of shielding will be welcome news. But others will be understandably feeling anxious about it. This relaxation allows people who have been shielding to see more people, enjoy the summer and be more active – this is important as we all move towards normality, and for this group to boost their physical and mental fitness.

We encourage anyone with concerns or who is feeling anxious about going outside to contact their health care professional. 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. You can also get support from these organisations:

For more information on understanding your COVID-19 risk, go to our sister charity website, Asthma UK. While the content is aimed at people with asthma, there is information on risk factors and making decisions that is relevant to all people with lung conditions.

Who is regarded as extremely vulnerable (the shielding group)?

People are regarded as extremely vulnerable if they are at very high risk of severe illness as a result of coronavirus (COVID-19), and may need be admitted to hospital. People with a range of long-term lung conditions are in this group if their condition is severe. 

People with severe long-term lung conditions in this group include people with:

People with severe COPD

Current NHS medical records do not hold perfect data to specifically identify how severe your COPD is. To work around this, letters have been sent to people with COPD based on the medications that they are taking. This is because there are good records of prescriptions that people have received. These include:

  • People on what is sometimes called triple therapy. This means taking a long acting beta agonist (LABA) and a long acting muscarinic agonist (LAMA) and an inhaled corticosteroid (ICS) in either November or December 2019. These could be prescribed as either 3 separate medicines or combinations of single and dual or combination medicines or as triple therapy.
  • People who’ve had a prescription for Roflumilast most recently in November 2019 or December 2019. 

But some people who take this sort of medicine may only have mild COPD. And not everyone who has severe COPD is on triple therapy. If you have received a letter and have been prescribed either triple therapy or Roflumilast and think your COPD is not severe, talk to your GP or hospital specialist.

GPs and hospital clinics have identified people with severe COPD who have been missed by the medication approach to add them to the list. This review was informed by NICE’s definition of severe COPD, which includes:

  • Everyone who has severe or very severe airflow obstruction. This is measured using a breathing test called spirometry where you blow out as hard as you can. If the lung damage means that the amount of air you can blow out in 1 second is less than 50% of what it should be, it is classed as severe. Severe or very severe airflow obstruction is sometimes described as GOLD grade 3 or GOLD grade 4.
  • People who have been admitted to hospital in the past because of an acute attack of their lung condition.
  • People who are very limited by breathlessness – this means that even walking normally at your own pace you have to stop after 100 yards or a few minutes on level ground. Health care professionals sometimes use a measure called the MRC score. This scores breathlessness on a scale of 1 to 5. If you have a score of 4 or 5 you should be shielding. 
  • People who have multiple medical problems – many people with COPD have other medical problems, such as heart disease, high blood pressure and diabetes. Each of these may increase an individual’s risk.
  • People who need to use oxygen therapy at home 
  • People who need to use non-invasive ventilation at home – a mask ventilator, sometimes called BiPAP, to support their breathing at night 

Lung cancer and mesothelioma

This applies to people who are undergoing chemotherapy or radiotherapy for their lung cancer or mesothelioma or if they meet any of the criteria that are on the list under COPD.

Severe bronchiectasis

This includes people with bronchiectasis who: 

Tuberculosis

There is currently no evidence that if you have active or latent TB, you're more at risk from COVID-19.

But if your lungs are extensively damaged or inflamed as a result of active TB or past TB, you may be more at risk of developing a chest infection after a coronavirus infection. For example, some people develop severe bronchiectasis after extensive active TB and in that case, you are advised to practise social shielding, following the current guidance on severe bronchiectasis.

It is important not to stop your TB medication if you feel worse, but to seek advice from your local TB team.

Interstitial lung disease, including pulmonary fibrosis 

Everyone with pulmonary fibrosis and other types of interstitial disease is regarded as vulnerable, and should have received a letter from their specialist or GP. Read our detailed information about your care.

Sarcoidosis 

Everyone with sarcoidosis affecting their lungs is regarded as vulnerable, and should have received a letter from their specialist or GP. Read our detailed information about your care

Pulmonary hypertension

People with a diagnosis of pulmonary hypertension are regarded as vulnerable. Please visit PHA UK for more information.

Immunosuppressive drugs 

People on immunosuppressive drugs for any reason should practise social shielding. These include:

  • Prednisolone
  • Methotrexate
  • Azathioprine
  • Mycophenolate Mofetil and Mycophenolate Sodium
  • Cyclosporin
  • Sirolimus
  • Tacrolimus
  • Having in the last 6 months received intravenous Cyclophosphamide, Rituximab or Infliximab

Other lung conditions

The groups listed above cover most lung conditions. If your condition is not included or you are not sure, have a look at these criteria:

If you meet any of these then it is likely your condition makes you especially vulnerable to coronavirus. If you have not received a letter, seek advice from your health care team.

 

What to read next:

Last updated: Monday 17 August 2020

We hope you have found this content useful

We hope you have found this content useful. Our team of health experts is working tirelessly on a daily basis to provide the latest and most up to date health advice concerning coronavirus (COVID-19).

Record numbers of people now need our support. As a charity, we rely on donations from people like you. We do not yet know if we will be eligible for government help. However, our help and advice are only possible thanks to kind donations from people like you.

If you can, and are able, please donate now. Every pound will make a difference.

DONATE NOW

We use your comments to improve our information. We cannot reply to comments left on this form. If you have health concerns or need clinical advice, call our helpline on 03000 030 555 between 9am and 5pm on a weekday or email them.

Last medically reviewed: September 2020. Due for review: September 2020

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.