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Where are we with shielding the most vulnerable?

Unlocking lockdown for the clinically vulnerable

After the strict guidelines of shielding the most vulnerable during lockdown, government advice across the UK became much lighter, suggesting that everyone could make their own decisions about going out – and stopping deliveries of emergency supplies as a result.

England

Following the announcement of the three-tier Covid alert system on 12 October, the government refreshed its advice for the clinically extremely vulnerable. You can read the full advice on the government website, but here is a summary of its key points.

The guidelines explain that because extra measures have been introduced since lockdown – the rule of 6, use of face coverings and Covid-secure workplaces – there is currently no need for very restrictive shielding advice.

Instead the guidance aims at balancing protection against the coronavirus with the need to maintain harmful effects on social and mental well-being. And it will change according to where the person lives or wants to travel.

Formal shielding is being avoided as much as possible. The current guidance says formal shielding will only be introduced for some cases, in the very worst affected local areas, and then only for a limited time. Anyone who should shield at this point should get a letter from the government.

The best thing to do now, says the guidance, is follow the local alert advice, as this will reflect the Covid alert level. You can check the level of alert in any area on the central government website. If an area is upgraded to a higher risk level (or downgraded) there will be plenty of publicity at a local level, and instructions about how behaviour is expected to change.

Socialising inside and outside the home

The standard guidelines apply for all – social distancing, hand washing and avoiding touching your face.

People don’t need to maintain social distancing within their home with members of their household or support bubble. Any other visitors should stay 2m away. Keeping the space well ventilated while visitors are present is recommended.

The rule of six applies in all areas for meeting inside and outside. If an area is moved into a high alert category, then people can’t meet indoors in any number, unless they are members of one household and/or their support bubble. People in very high risk areas will be advised to limit their interactions even further.

Meeting people outdoors is a preferable option at every level of risk.

Going to shops and pharmacies

Face coverings are the order of the day in shops and pharmacies.

The NHS Volunteer Responders programme is available to help support those who need it. Volunteers can collect and deliver shopping, medication and other essential supplies. Call 0808 196 3636 between 8am and 8pm, 7 days a week to self-refer or visit www.nhsvolunteerresponders.org.uk for further information.

Care and support at home

The government acknowledges the need for continuing care and support, whatever the Covid alert level or the area.

Any carers or visitors helping with everyday needs can continue to visit, following social distancing guidance where close personal contact isn’t required.

Paid carers will be conforming to the guidance they have been given regarding issues such as PPE and distancing.

If you or other family members provide unpaid care, visit the guidance for those who provide unpaid care to friends or family.

Getting medical help

There’s been quite a bit of concern that people aren’t visiting GPs or hospitals for ongoing care for health issues other than Covid. There are other ways to talk to medical professionals though, such as online consultations and repeat medication ordering. The government is keen that people should continue to seek support from the NHS for their existing health conditions. To find out more visit www.nhs.uk/health-at-home, or download the NHS App. Anyone with an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.

The effects of isolation in lockdown, especially for those who live alone, are now being seen in a significant rise in those worrying about their mental health. For those who feel anxious or depressed, the guidance recommends visiting the Every Mind Matters website as a first step. If you or someone you care for are experiencing a mental health crisis, then you are advised to make contact with a local health professional immediately.

Travel

Many people categorised as vulnerable will need to attend appointments and will probably need some sort of transport to get there other than the recommended walking or cycling.

Car sharing is seen as a safer option to public transport because it involves fewer social contacts. Even then it’s recommended that people only share cars with members of their household or support bubble. No more than 6 people at a time, with the windows open, everyone to wear face coverings, and the vehicle to be cleaned between journeys with standard products.

Anyone who wants to travel out of their area should check the alert level of the area they are visiting, and follow the guidance for the higher alert level, whether that be home or away.

Scotland

In Scotland the government is asking those who have been shielding to follow the same guidance as everyone else in Scotland, and not to start shielding again unless their healthcare providers advises them to do so.

Wales

Those defined as vulnerable are also advised to take the same precautions as the rest of the population in Wales both at home and when out and about. The Welsh government says that if the advice changes, it will be communicated through local radio and television, and those who are on the shielding list will receive a letter.

Northern Ireland

In Northern Ireland shielding is described as ‘paused’ while the risk of catching Covid-19 has reduced. As with the other governments, people are advised to talk to their GPs with any concerns, and various mental health support organisations are signposted.

 

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