Extremely vulnerable – shielding

Shielding and protecting people defined on medical grounds

Public Health are strongly advising people with serious underlying health conditions (listed below) to stay at home and not to go out. This is because they are at very high risk of severe illness from coronavirus (COVID-19), and should rigorously follow shielding measures in order to keep themselves safe.  It also includes the extremely clinically vulnerable people living in long-term care facilities, either for the elderly or persons with special needs. If you live in a residential care setting, provide supported living or home care, separate guidance is also available.

People falling into this extremely vulnerable group include:

• solid organ transplant recipients
• people with specific cancers
• people with cancer who are undergoing active chemotherapy
• people with lung cancer who are undergoing radical radiotherapy
• people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• people having immunotherapy or other continuing antibody treatments for cancer
• people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
• people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD
• people with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
• people on immunosuppression therapies sufficient to significantly increase risk of infection
• women who are pregnant with significant heart disease, congenital or acquired

If you have an underlying health condition listed above, you are at very high risk of severe illness as a result of coronavirus (COVID-19) requiring admission to hospital.

If you think you fall into one of the categories of extremely vulnerable people listed above you should discuss your concerns with your  GP or hospital clinician. We understand this is an anxious time and people considered extremely vulnerable will understandably have questions and concerns.

What you need to know

Shielding is a measure to protect extremely vulnerable people by minimising interaction between those who are extremely vulnerable and others. This means that those who are extremely vulnerable should not leave their homes, with the exception that they may exercise outside for up to one hour each day, and within their homes should minimise all non-essential contact with other members of their household. This is to protect those who are at very high risk of severe illness from coronavirus (COVID-19) from coming into contact with the virus.

Only visits from people who provide essential support to you such as healthcare, personal support with your daily needs or social care should continue, but carers and care workers must stay away if they have any of the symptoms of coronavirus (COVID-19).

You may find this guidance on home care provision useful. All people coming to your home should wash their hands with soap and water for at least 20 seconds on arrival to your house and often while they are there.

You should have an alternative list of people who can help you with your care if your main carer becomes unwell. You can also contact your existing care provider for advice on how to access care.

If you have someone else living with you, they are not required to adopt these protective shielding measures for themselves. They should do what they can to support you in shielding and they should stringently follow guidance on social distancing, reducing their contact outside the home. If you care for but don’t actually live with someone who is extremely vulnerable, you should still stringently follow guidance on social distancing.

We strongly advise you to follow the above measures as much as you can and to significantly limit your face-to-face interaction with friends and family if possible.

If you develop symptoms:

• You should seek clinical advice using the online assessmentto determine whether you need to call the COVID 111 helpline
• You must then stay at home (self-isolate) for period of 14 days from the onset of symptoms, regardless of whether the test result is positive or negative
• If the test result is positive, your details will be passed onto the Public Health Contact Tracing Service so any contacts can be followed up and advised

For further details refer to the self-isolation guidance.

This advice is likely to be in place until further notice.

* if one member of your family or household has a new continuous cough or high temperature 
** if you live alone and you have a new continuous cough or high temperature 
*** noting cinemas, theatres, pubs, bars, restaurants and clubs are now all required to close. If you meet others when you are outdoors (for example, on a walk) ensure that you stay at least 2 metres away. 
**** for example via telephone (COVID-19 111 helpline or online) 

Be aware:   These measures have been put in place to protect the Island’s community, and are enforceable by law.   Legislation introduced under the Emergency Powers Act can see penalties of up to £10,000 or three months in prison  for those breaking rules on social distancing and self-isolation.   The Police can also issue on-the-spot fines of up to £250 for those infringing stay-at-home guidelines.