With COVID-19 restrictions being tightened across the country there are fears that millions of clinically vulnerable people will be forced to shield again while receiving less support than they did before.
Millions of people who were particularly vulnerable to COVID-19 due to having prior health conditions were told to ‘shield’ at the start of the pandemic.
This meant they needed to limit their contact with almost all people and restrict their life above and beyond the restrictions in place at the time.
Shielding officially came to an end on in late July but for places like Leicester that were put under local lockdown in the summer, the advice was only ended on 4 October.
The government changed the advice on shielding on Tuesday recommending people in Tier 3 lockdowns stay at home as much as possible, but insisted it did not need to be fully reintroduced despite a rise in coronavirus cases across the country.
Shielding comes with its own problems a recent poll found at least 80% of people were concerned about the loneliness of older people who have a long-term health condition.
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Some 59% of adults feared they would not be able to see family and friends at Christmas.
Dr David Strain, Senior Clinical Lecturer, University of Exeter, criticised the vague new advice and lack of support for people who needed to shield, saying it “flies in the face” of the recent alarm expressed by health officials.
Another leading professor warned there would be “profound” consequences because of the government’s inaction.
Dr Stephen Griffin, associate professor at the School of Medicine, University of Leeds, said there was a balance between the fallouts of shielding and the need to protect people from COVID-19, but current advice was not enough to save them.
What are the current shielding guidelines?
The advice published on Tuesday did not recommend all shielders would need to go back to protect themselves as much as possible, but did offers some enhanced advice above and beyond current measures.
The advice was broken down into the government’s new tier system, with Tier 1 being the lightest and Tier 3 being almost back to full shielding.
The government said currently they would send letters to all those affected by the latest guidance.
The new guidelines apply on top of the current national rules and enhanced measures in the higher tiers, they are:
For those in Tier 1 they should follow all current social distancing guidelines, only meet people outdoors, limit unnecessary journeys on public transport and work from home where possible.
For those who live in an area under Tier 2 they should reduce the number of people they meet, avoid travel as much as possible and reduce the number of shopping trips they make on top of all the wider guidelines already in place.
For those living under Tier 3 measures, they should stay at home as much as possible, reduce shopping trips and use online delivery if available or get someone else to do it for you, on top of all the wider guidelines already in place.
For all three tiers, the government advises people to still go to work or school if they cannot work from home.
The government said none of the alert levels in place in England will automatically trigger a warning to shield again – where people were told to stay home at all times.
Watch: How will England's three-tier local lockdown system work?
Deputy chief medical officer for England Dr Jenny Harries said: “The new system will provide clarity on how best those in this group can keep themselves as safe as possible depending on the rates of transmission in their local area.”
She added the guidelines were only advisory but encouraged everyone who needed to shield to follow them.
What do the experts say?
The new guidelines have been generally criticised by experts and charities that support shielding people for their underlying health conditions, but many have acknowledged it is a very difficult situation.
Dr Strain said: “If the UK’s top doctors believe that more is required for the general population, surely as a bare minimum those at the greatest risk from adverse outcomes should be offered protection.”
He said telling people who need to shield to follow the basic mask wearing and rule of six guidelines would be enough was a “distortion of the truth.”
He added there was a reluctance in government to support the physical and mental health of those who needed to isolate themselves from society.
Dr Griffin said the psychological and societal cost of shielding was “not to be underestimated.”
He added: “Balanced with this is the need to protect the vulnerable from COVID, which made it somewhat unclear as to why the programme was paused in August when the virus remained in circulation.
“Following this, whilst some shielders have been able to maintain this practice at least in part, many have had to return to normal practices, accepting a considerable level of risk as the nation unlocked over the summer.”
Sarah MacFadyen, Head of Policy at Asthma UK and the British Lung Foundation, said: “For the 500,000 people with lung conditions who have previously been shielding and have been anxiously waiting for this news, the lack of detail and timelines as well as the news that those in ‘exceptionally high risk’ areas may still be advised to adopt formal shielding in the future, will be devastating.
She said the government had to provide details for those who could not work from home in high risk areas about how to support their income.
She accused the government of making it clear that clinically vulnerable were at risk from COVID-19 but did not provide any information about the support they might receive.
Gemma Peters, chief executive of Blood Cancer UK mirrored Ms MacFadyen’s demand for more information about those who could not work from home, calling the lack of advice “unacceptable”.
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