What is shielding? What are the benefits? What are the risks?
Shielding is a measure to protect extremely vulnerable people from coming into contact with coronavirus, by minimising all interaction between them and others. The benefit is that, by following the extremely stringent process of avoiding contact with others, this will minimise the chance of catching COVID-19. However, this is a very challenging ask of people because of the negative physical, psychological and social consequences of isolating themselves for such a long period of time.
Who should be shielded?
Those people who are at the clinically highest risk of severe morbidity and mortality of COVID-19. It does not include all people eligible for the flu vaccine, only a very specific sub-set considered to be at highest risk of severe illness and hospitalisation from COVID-19. It does not include those who may be vulnerable, at risk, or needing support for other reasons. Groups of people at clinically highest risk are:
1. Solid organ transplant recipients
2. People with specific cancers
· People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
· 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
3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD. This includes those long-term home Oxygen for chronic respiratory conditions.
4. People with rare diseases, including all forms of Interstitial Lung Disease/Sarcoidosis, and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
5. People on immunosuppression therapies sufficient to significantly increase risk of infection
6. People who are pregnant with significant heart disease, congenital or acquired
Who agreed this list?
The 4 UK Chief Medical Officers following expert advice.