There has been a lot of confusion about who is considered particularly 'vulnerable' to coronavirus. This article summarises the advice. In short, there are two groups, and only the most vulnerable or 'extremely vulnerable' have been advised to remain fully at home. This does not include, for instance, all people over the age of 70.

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'Clinically extremely vulnerable' patients

Some patients have been identified as particularly vulnerable to coronavirus. For these 'clinically extremely vulnerable' patients, there is a significantly greater risk of very serious consequences, if they catch coronavirus.

People in this group have been advised to 'shield' themselves, which typically involves remaining fully at home. In some parts of the UK, this advice has now been withdrawn and people in the 'clinically extremely vulnerable' group are no longer advised to 'shield'. However, if infection rates go up again in future, the advice to 'shield' may be brought back into force.

The exact definition of this group varies very slightly between England, Scotland, Wales and Northern Ireland. The summary below is broadly applicable throughout the UK.

The clinically extremely vulnerable group includes patients with the following conditions or undergoing the following treatments:

  • Solid organ transplant recipients
  • 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
  • People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD
  • People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
  • People on immunosuppression therapies sufficient to significantly increase risk of infection
  • Women who are pregnant with significant heart disease, congenital or acquired.

If you are in this group, the advice to shield yourself is advice, not a legal requirement.

'Vulnerable' patients

Some people are considered 'vulnerable' but not in the 'highest risk' or 'clinically extremely vulnerable' group outlined above. If this includes you, you have not been asked to 'shield' yourself at any time, but you are advised to follow social distancing rules carefully.

This group includes people with the following characteristics or illnesses:

  • aged 70 or older (regardless of medical conditions)
  • under 70 with an underlying health condition listed below (i.e. for adults this usually anyone instructed to get a flu jab as an adult each year on medical grounds):
    • chronic (long-term) respiratory diseases, such as asthma, chronic obstructive
    • pulmonary disease (COPD), emphysema or bronchitis
    • chronic heart disease, such as heart failure
    • chronic kidney disease
    • chronic liver disease, such as hepatitis
    • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
    • diabetes
    • problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
    • a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or  chemotherapy
    • being seriously overweight (a BMI of 40 or above)
    • those who are pregnant.

Guidance on shielding in different parts of the UK

England

People who are clinically extremely vulnerable are advised to follow social distancing guidance particularly carefully, and work from home if possible, and if their workplace is not COVID-safe. Advice to 'shield' may be restored in future if infection rates increase, but it does not currently apply.

If you live in an area where a local lockdown is imposed and the advice to 'shield' is restored, you will receive a letter from the NHS to tell you.

Full official guidance

Scotland

People who are clinically extremely vulnerable are advised to follow social distancing guidance particularly carefully, and work from home if possible, and if their workplace is not COVID-safe. Advice to 'shield' may be restored in future if infection rates increase, but it does not currently apply.

You are advised to follow guidance from your medical team or doctor, who can advise if there is a reason why sticking to regular social distancing rules might not be appropriate for you, based on your individual medical circumstances.

Guidance 

Wales

People who are shielding are advised that they may leave their homes for exercise, and to meet others outdoors. Social distancing should be maintained at all times.

Social distancing with members of your own household is not necessary.

Households that contain only one adult may also form an extended household with one other household.

Guidance

Northern Ireland

People who are clinically extremely vulnerable are advised to follow social distancing guidance particularly carefully, and work from home if possible, and if their workplace is not COVID-safe. Advice to 'shield' may be restored in future if infection rates increase, but it does not currently apply.

Guidance

Updated: August 10th 2020.