Shielding, social distancing and self-isolation

The Government and scientific experts have used data from the first wave of the pandemic to develop a tool to assess individuals and their risk of becoming seriously ill from coronavirus.

If you've received a letter or email letting you know you're considered high risk, it means a range of individual and health-related factors mean you're more likely to become seriously ill if you catch coronavirus. 

Anyone that's received this letter or email can get their vaccine as a priority. This means you should be contacted soon about booking a vaccination appointment if you haven't already.

It also means you're advised to follow the guidance we've outlined above for those shielding. This includes the additional support offered to people shielding, such as priority access to online shopping delivery slots. The letter or email you receive should make it clear how you can access this support (there are also more suggestions below). 

IIf you're not able to work from home, you're advised not to go to work and should have a conversation with your employer as to what this means for you. You may be eligible for furlough, Statutory Sick Pay or  Employment Support Allowance.  

These precautions apply to you if you've been contacted because you've been identified as high risk based on a range of factors, your GP or hospital clinician has told you that you're clinically extremely vulnerable or you're in one of the following groups:

• 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 that 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 chronic obstructive pulmonary disease (COPD)
• people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
• people on immunosuppression therapies sufficient to significantly increase risk of infection
• problems with your spleen, for example splenectomy (having your spleen removed)
• adults with Down’s syndrome
• adults on dialysis or with chronic kidney disease (stage 5)
• women who are pregnant with significant heart disease, congenital or acquired.

Yes you can. Under the new government guidance, caring for a vulnerable person is considered one of the essential reasons that you can leave your home.

To help keep you and the person you care for safe there are precautions you can take. Where close contact isn’t necessary you should try to maintain a distance of 2 metres. Throughout your visit take care to wash your hands regularly and wipe down frequently touched surfaces.

However, if you care for someone that's clinically extremely vulnerable and either of you develops coronavirus symptoms, you shouldn't continue to visit, even to provide care. 

Just in case, it's always a good idea to have an alternate plan in place. Is there a friend or another family member that could step in if you become unwell? If you don't have another option, and the care is essential, try and keep distance wherever possible. 

As well as the above guidance, you might want to consider the following

• Maintain social distancing measures with those not in your household or support bubble.
• If someone in your household or support bubble gets symptoms of coronavirus you should try to stay away from them as much as possible and make sure surfaces are regularly cleaned and hand washing is frequent.
• Minimise social interactions with those outside your household or support bubble.
• Wash your hands frequently.
• Wear a face covering whenever you're indoors in areas such as the GP surgery or hospital if you're able to.

You are advised not to go to shops or pharmacies to get supplies. Where possible you can use online shopping options or there are some other options listed below:

• Friends, families and neighbours may be able to pick up supplies for you.
• NHS Volunteer Responders: online here or by calling 0808 196 3646. They may be able to support you in picking up essential supplies, check in and chat options and transport to medical appointments.
• Your local Age UK.
• You can register here to request a priority supermarket delivery slot amongst other support options from your local authority. You will be asked for your NHS number which you should find on communication from the NHS or prescriptions
• If friends or family are not able to collect your prescriptions you should contact your pharmacy who should be able to support you in delivering your medicines

If you already have a priority slot for supermarket delivery then you should keep this.

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 and support bubble will need to self-isolate until your test results come back. 

You may want to let others you've seen in the last 48 hours know you have symptoms and are waiting for a test. They don't need to self-isolate while you wait for your results, but they could take extra care when social distancing.

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 10 days from the point at which you first developed symptoms. If after 10 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 10 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 10 days from when you started having symptoms, or if you have tested positive without having symptoms, 10 days from the date of your test. 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 10 days from the start of their symptoms, even if this means they need to isolate for longer than the original 10 days. After 10 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 10 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 and support bubble 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 10 days. Members of your household will not need to self-isolate with you unless you or they develop symptoms of coronavirus.

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

We know that some people are finding it hard to book a coronavirus test or get one in the first 5 days of developing symptoms. But if you can't book a test and have symptoms, then you and people you live with should follow the rules about self-isolating. 

The Government are constantly monitoring the international rate of infection and have produced a list of countries where the infection rate is low enough for people to travel to. If you travel to a country outside of this list, where the rate of infection is higher, then you will need to self-isolate for 10 days when you get back to the UK.  

The list is constantly being monitored and if the infection rate goes up in countries then the guidelines will change, and you will need to quarantine on your return.  

Check the Government website for more information on travelling abroad. 

After people have completed their period of self-isolation, they should continue to follow Government advice on social distancing. This means following Government guidance, staying two metres away from people (or following the one metre plus rule where this isn’t possible) outside of your household and support bubble, and continuing to take precautions, including washing your hands regularly with soap and warm water for at least 20 seconds.

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.