Social distancing, self-isolation and shielding

If you develop symptoms of coronavirus, you should self-isolate and order a test as soon as possible by visiting www.nhs.uk/coronavirus or calling 119.

You and members of your household will need to self-isolate until your test results come back. 

If you have been identified as someone who is extremely vulnerable and develop symptoms you should seek clinical advice using the NHS 111 online coronavirus service or call NHS 111. Do this as soon as you get symptoms.

If you test positive for coronavirus, you will need to self-isolate for 7 days from the point at which you first developed symptoms. If after 7 days you still have symptoms, other than a cough or loss of taste and smell, you should continue to self-isolate. You do not need to continue to self-isolate if, after 7 days, you still have a cough or loss of taste and smell as these can last for several weeks after the infection has passed.

If you live with other people, all other household members must stay at home for 14 days from when you started having symptoms, unless they also develop symptoms of coronavirus. If they develop symptoms of coronavirus, then they should also book a test right away. If the results come back positive then they should isolate for 7 days from the start of their symptoms. After 7 days they will be able to return to normal, so long as they are feeling better. If their results come back negative then they must continue the isolation of 14 days with the rest of the household.

If you test positive for coronavirus, the NHS test and trace service will contact you by text message, email or phone call and ask you to share details of your recent interactions, including people you have recently had direct contact with.

You can find out more about how the track and trace service works here.

If your test comes back negative, then you are at low-risk of having coronavirus. Other members of your household will no longer need to self-isolate and if you feel well you can also stop self-isolating. However, if you still feel unwell it is better to stay inside as you may have another virus, such as a cold or the flu, so you should try not to be around other people.

If you have been in recent contact with someone who has received a positive coronavirus test result, you may be contacted by the NHS test and trace service and told to self-isolate for 14 days. Members of your household will not need to self-isolate with you unless you develop symptoms of coronavirus yourself.

Read more about how the test and trace service works here. 

After people have completed their period of self-isolation, they should continue to follow Government advice on social distancing. This means only leaving the house in line with Government guidance and staying two metres away from people outside of your household. 

If you or anyone in your household develops symptoms of coronavirus after your first period of self-isolation, or if you are contacted by the test and trace service, then you must start a new period of self-isolation. 

If you have received a letter from the NHS or your GP, then the first thing you should do is register at the Government’s dedicated website or call 0800 028 8327.

You should register even if you don’t need support with daily tasks and getting supplies as this lets the government know that you’re being supported and have received your letter.

The guidance for people who are shielding has changed since letters were sent out. New letters with up to date advice and information will be issued in the coming weeks, but the key points of the guidance are now:

• You can go outside to an open space with members of your household or with one person outside of your household. Take care to minimise contact with others by staying 2 metres away from people. 
• Only let those who provide essential care into your home.
• Avoid contact with other people in your home as much as possible - stay at least 2 metres (3 steps) away and minimise time in shared spaces.
• If you need the GP or other essential services, use telephone or online services. Do not put off getting medical help. 
• Your hospital or clinic will contact you if they need to make any changes to your care or treatment. You should contact them directly if you have any specific questions about an appointment.
• Regularly wash your hands with soap and water for at least 20 seconds.
• If you need urgent medical attention relating to your current medical condition, contact your specialist hospital care team directly.
• If you develop symptoms of the coronavirus then you should call 111 immediately.

Being asked to shield may feel overwhelming and you might be worried about how you’ll cope. To help you prepare for this, you may wish to:

• speak to your carers or others who help you in the house and plan what happens if they become unwell. You can find more information here.  
• ask someone else to pick up food and prescriptions. This could be a carer, family member, friend, trusted neighbour or a local community group. If you don’t have anyone who can help, the Government should include information about how they can help support you when registering online or over the phone. Many pharmacies are also offering a home delivery service or are being given additional help to provide support, so you should speak to your pharmacy about other options.
• keep in touch with your friends and family via phone, internet and social media
• prepare a hospital bag, including a list of the medicines you’re taking – in case you need to go into hospital.

Most people have now received a letter. However, central records don’t capture everyone and so GPs and hospital clinicians have been asked to help identify and contact people who meet the criteria. It may take some time for letters to reach people who have been identified this way.

If you haven’t received the letter but feel that you should have, then you should contact your GP/clinician to discuss this and follow the social distancing guidance in the meantime.

Don’t worry, information is being added to the database all the time and there may be a delay between you being added to the database and being recognised by the website or support phone line. You should retry in a couple of days.

Members of your household who aren’t extremely vulnerable don’t need to shield and can leave the house for limited purposes such as getting food and medicine. But to help you stay safe, they should reduce their contact outside the home.

To reduce the risk of spreading the virus at home, you should:

• Minimise the time spent with others in shared spaces (kitchen, bathroom and sitting areas)
• Try to keep 2 metre distance from others and sleep in different beds, if possible
• Use separate towels and clean the bathroom after every use
• If possible, have meals in your own space and ensure all kitchenware is cleaned thoroughly

Some households have made the decision to shield together as it’s easier for them to live more comfortably if the whole household follow the shielding guidance. We strongly advise you to register for government support via the telephone number of webpage provided in the letter.

Although the Government can only offer direct help to people who have been advised to shield, registering allows you to access additional support – for example home shopping delivery slots and food packages.

You should also speak to family, friends and trusted neighbours that don’t live with you about how they can offer additional support in the coming months.

This is a personal decision, but if you get support for essential tasks – perhaps they help you to get out of bed, move around your house, clean, prepare food, take your medication, or get dressed – then we suggest that you carry on letting carers come in and support you as they usually do.

Don’t be afraid to ask health and care workers how they’re going to maintain good hand hygiene whilst in your home.

If someone usually does the shopping or picks up essential supplies for you, then they can continue to do this. Leave a list on the doorstep or let them know over the telephone. When they’re back from getting these supplies, they should leave the shopping on the front doorstep, knock on the door and step back 2 metres while you safely receive it.

If you’re unable to carry or lift the shopping, then you could consider opening the door and then going into another room to keep your distance. What’s important is that you keep a distance of 2 metres at all times. If someone you don’t know is coming into your house then you may wish to ask to see their identification.

If the person who cares for you feels unwell or has symptoms of coronavirus, they should not carry on providing any care or support and you need to make alternative arrangements.

Perhaps you can identify another family member, friend, trusted neighbour or local community support group to step in and help. If those options aren't available or appropriate for you, it would be a good idea to also contact your local council and local charities to see how they could help.

If someone usually pops in to see how you are doing and have a chat, you should now keep in regular contact over the phone, through email or video calls. Not face-to-face.

While the Government’s guidance is in place to protect those who are at greater risk, being asked to shield can still have an impact on your healt - both physically and mentally. Seeing restrictions eased for the rest of the population while you are being asked to mainly stay at home can make it even harder. 

You may feel sad, angry, frustrated, lonely and anxious – all of which are completely normal in these circumstances. 

In addition, you may feel more inactive than before or be more inclined to not eat as well due to a lack of motivation.

We have some tips on managing your physical and mental wellbeing while you stay at home here.

For planned GP appointments, where possible these should be provided over the phone, email or online. If they need to see you in person they will contact you and arrange a visit to the surgery or visit your home.

For planned hospital appointments, hospitals have been advised to review ongoing care. It’s possible that some appointments will be cancelled or postponed, you should be contacted if this is the case.

Any changes to your care plan should be discussed with your GP or clinician.

You may be worried about everything going on, feel vulnerable or just want to do all you can to avoid catching coronavirus. That’s totally understandable. And while it’s your choice, the guidance suggests you should only shield if it’s absolutely necessary.

Everyone else is being instructed to follow the social distancing guidance. Beyond that it is up to you to decide on the steps you want to take.

This is something you may wish to discuss with your family and/or your GP or specialist but please be aware that the dedicated support line is only currently available to those who have received letters.

If you want to do more than only social distancing, you might want to think about limiting your social contact by asking family, neighbour or friend to collect your shopping and any prescriptions or exercise at home rather than outdoors.

For further advice on how to manage please see our Coronavirus hub which includes information on a range of things, including staying at home and shopping. 

We understand that being asked to shield can be overwhelming and that the longer you are asked to stay inside, the harder it may become. 

Whilst we encourage all those who have been identified as extremely vulnerable to follow the advice on shielding, you do not have to shield and you cannot be fine or sanctioned for not doing so. 

Some people, particularly if they are receiving end of life care, may decide that it’s not the right choice for them and choose to follow guidance in place for the general population instead. 

This is a difficult and deeply personal decision and we would encourage anyone considering this to speak with their GP or specialist and your family. It’s important that everyone knows your wishes. If you do choose to not follow the shielding guidance, you should continue to follow social distancing and hand washing measures.

NHS England have asked GPs to review the list of people who were considered clinically extremely vulnerable and in some cases this has led to some individuals being removed from the list of those that need to shield.

Your GP or clinician should have had a discussion with you before you were notified but this hasn’t happened on all occasions.

If you have received communication and you are not sure what it means you should contact your GP or clinician.

You are still eligible for support from the NHS Volunteer Responders and if you have a regular supermarket delivery slot these will continue.

Having been advised to shield and not leave your home for a long period of time the prospect of going outside even for restricted purposes may feel daunting.

You may decide that you would still like to shield and that is completely fine too.

If you do go outside you should think about the following measures to keep yourself safe:

• Stay 2 metres away from others at all time, this includes those in your household where possible.
  
• If you are seeing someone from outside your household this should be the same person each time.
• Avoid busy places where possible and try to go outside at times when there will be fewer people around, such as in the morning.
• Keep the amount of time you leave your house and see others to a minimum.
• Practise good hygiene and hand washing practices.
  
• Make sure that other measures to protect yourself outside are followed such as wearing sun cream when appropriate and staying hydrated.