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Found 36 results
  1. Content Article
    During the pandemic, approximately 4.1 million people across the UK were identified as clinically extremely vulnerable (CEV) to Covid-19, and asked to shield for their own protection. This decision, made in the light of an unprecedented pandemic, would separate those with autoimmune inflammatory conditions, such as rheumatoid arthritis, from the rest of society for their own protection. This report by the charity Versus Arthritis presents qualitative research led by Dr Charlotte Sharp, a consultant rheumatologist, Lynn Laidlaw who has an autoimmune rheumatic disease and had to shield, and patient contributor Joyce Fox from the Centre for Epidemiology at the University of Manchester. It highlights the stories of people who lived through shielding and details the impact on their daily lives, their physical and mental wellbeing, their work, and their relationships with their families and the rest of society.
  2. Content Article
    During the first waves of the Covid-19 pandemic, the UK shielding policy was introduced with the intention to protect people at the highest risk of harm from Covid-19 infection. This study in the journal Public Health aimed to describe intervention effects in Wales at one year. The authors retrospectively compared linked demographic and clinical data for cohorts of people identified for shielding from 23 March to 21 May 2020 with the rest of the population. The largest clinical categories in the shielded cohort were severe respiratory condition (35.5%), immunosuppressive therapy (25.9%) and cancer (18.6%). The study found that: Deaths and healthcare utilisation were higher amongst shielded people than the general population, as would be expected in the sicker population. Differences in testing rates, deprivation and pre-existing health are potential confounders, but lack of clear impact on infection rates raises questions about the success of shielding and indicates that further research is required to fully evaluate this national policy intervention.
  3. News Article
    Thousands of people who are at extreme risk from the coronavirus and live in tier 4 areas have been told to stay indoors at all times unless they are exercising or have medical appointments. The Department of Health and Social Care (DHSC) issued new advice on Monday warning people classed as “clinically extremely vulnerable” to stay home, in a bid to protect them from the new, more infectious strain of COVID-19. Those affected have been told not to leave their homes even if they cannot work remotely. The government said residents could be eligible for statutory sick pay, employment support allowance, or universal credit as well as the coronavirus job retention scheme. The DHSC said the high-risk group should stay at home as much as possible. Children who have been advised to shield should not attend school, the department added. Read full story Source: The Independent, 21 December 2020
  4. News Article
    Lockdown had a major impact on the UK's mental health, including increased rates of suicidal thoughts, according to new research. The study, led by the University of Glasgow, examined the effects of COVID-19 during the height of the pandemic. Certain groups are said to be particularly at risk, including young people and women. This publication is the most detailed examination of how the UK's adult population coped during the first weeks of lockdown, when people were given strict orders to stay home. Researchers say public health measures, like lockdowns, are necessary to protect the general population, but warn they may have a "profound and long-lasting" effect on mental health and will extend beyond those who have been affected by the virus. The study, published in the British Journal of Psychiatry, looked at three blocks of time between March 31 and May 11. Just over 3,000 adults in the UK were surveyed and a range of mental health factors were considered, including depression, loneliness, suicide attempts and self-harm. The study found suicidal thoughts increased from 8% to 10% and they were highest among young adults (18-29 years), rising from 12.5% to 14%. The researchers say that, even though those are relatively small rises, they are significant because of the short period of time they happened over. "The majority of people did not report any suicidal thoughts, but this creeping rise over a very short period of time is a concern," says Prof Rory O'Connor, chair in health psychology at the University of Glasgow's Institute of Health and Wellbeing. Read full story Source: BBC News, 21 October 2020
  5. News Article
    Hundreds of thousands of vulnerable people living in coronavirus hotspots could be told to "shield" this winter as infections continue to rise. Ministers are expected to outline a three-tier local lockdown system next week, which may see those most at risk if they catch COVID-19 being told to stay at home for a month. A decision on shielding has not been finalised and may be delayed because of fears for the mental health of those told to avoid seeing other people. Around 2.2 million people in England deemed "clinically extremely vulnerable" were asked to shield at the height of the coronavirus pandemic before the scheme was "paused" at the end of July. Sky News understands that the level of self-isolation required in each area will vary depending on the restrictions in place there. It is thought the advice will be clinically led, with GPs helping guide what people should do bearing in mind possible negative effects on mental health. This compares with the more blanket advice on shielding last time around. Read full story Source: Sky News, 9 October 2020
  6. News Article
    Having flu and COVID-19 together significantly increases your risk of death, say government scientists who are urging all those at risk of getting or transmitting flu to get the vaccine in the coming weeks and months. The evidence for the double whammy is currently limited and comes mostly from a study with small numbers – 58 people – carried out in the UK during the early phase of the pandemic. “As I understand it, it’s 43% of those with co-infection died compared with 26.9% of those who tested positive for Covid only,” said England’s deputy chief medical officer, Prof Jonathan Van-Tam. These were people who had been hospitalised and had been tested for both viruses, he said, and so were very ill – but the rate of death from Covid alone in the study between January and April was similar to the known rate of Covid hospital mortality generally of around 25% or 26%. "I think it is the relative difference in size of those rates that’s rather more important than the absolute rate,” he said. The study may have been small and they would be doing further studies this season, but the findings tallied with other work that has been done, he said. “If you get both, you are in some serious trouble, and the people who are most likely to get both of these infections may be the very people who can least afford to in terms of their own immune system, or their risk for serious outcomes. So please protect yourself against flu, this year,” says said Prof Yvonne Doyle, medical director of Public Health England The government has bought 30,000,000 doses of flu vaccine, which is more than ever before. They will arrive in batches, so the elderly – over 65 – and those with medical conditions will be called for immunisation first. Relatives of those who are on the shielding list will also be called up. The letters will begin to go out this week. Because of the threat of Covid and the risk that people with flu could be infected if admitted to hospital, all those aged 50-64 will be offered flu vaccination, but not straight away. They should wait to be called by their GP. Read full story Source: The Guardian, 22 September 2020
  7. News Article
    Millions of people who are at risk of serious illness from COVID-19 could be asked to start shielding again if infection rates continue to rise, according to reports. Officials are planning to send out letters telling the most vulnerable either to stay at home or to follow advice specifically tailored to their health conditions. The Daily Telegraph reports that the new programme will initially target those living in areas with dangerous levels of coronavirus but went on to quote an anonymous official as saying it could be applied to the whole of England if necessary. If so, it could affect up to 4.5 million people – more than double the number who were asked to shield at the start of the lockdown in March. The new shielding scheme is reportedly based on a "stratified risk model" which would target individuals based on factors such as their underlying health conditions, age, sex and weight. Read full story Source: 13 September 2020
  8. News Article
    Sarah Spoor and her two adult sons have spent the past 14 months shielding in a one-bedroom apartment, with no garden, in west London. Her youngest sleeps in the bedroom, his brother has a pull-out bed in the kitchen, while Spoor takes the living room in another fold-out bed. All three have complex medical conditions that leave them vulnerable to Covid, and despite the strain of living in such close quarters, they don’t feel safe leaving home any time soon. “If we catch it, we die; it’s that simple. In the 14 months, I have probably been out about four times, and that’s usually in some dire emergency,” said Spoor, who provides round-the-clock care for her sons, 20 and 24, after their medical team decided it was too risky for their usual carers to continue visiting. The family has yet to be vaccinated as their medical conditions, which include type 1 diabetes, adrenal insufficiency, pernicious anemia and thyroid failure, mean they are likely to experience a severe reaction leading to hospital admission, and they are concerned about the risk of catching Covid in hospital when cases are still prevalent. Spoor is not alone in fearing a return to life after lockdown, with disability charity Scope estimating 75% of disabled people plan to continue shielding until after their second vaccine dose, and some for longer. “I think there is a potential long-term impact that groups of people become squirrelled away and it’s potentially easy for governments and local authorities to forget about them,” said James Taylor, executive director of strategy and social change at Scope. “We’re really worried that, in the long-term, lots of the rights that disabled people have fought for, the visibility, the recognition of disabled people as equal, that all falling away and going backwards.” Read full story Source: The Guardian, 19 April 2021
  9. News Article
    Today marks the last day that about four million of the most clinically vulnerable people in England and Wales are advised to shield at home. Letters have been sent out to the group in the last few weeks. They are still being advised to keep social contacts at low levels, work from home where possible and stay at a distance from other people. The change comes amid falling Covid cases and hospital admissions. According to NHS Digital, there are 3.8 million shielded patients in England and 130,000 in Wales. Scotland and Northern Ireland are expected to lift their restrictions later in April. People affected by shielding included Rob Smith, from Hull, who has muscular dystrophy. Shielding for more than a year has been a "nightmare", he told BBC Breakfast. "Where I was able to go out, I didn't feel I wanted to. I didn't feel confident to face people again," he said. "I've always been sociable.... It's had a massive impact." Mr Smith now says he feels anxious about the future and believes for many people who have been shielding, it will "take time to get used to being out there again". He is also wary of the risk of mixing with others again. Read full story Source: BBC News, 31 March 2021
  10. News Article
    More than 3.7 million vulnerable people in England will no longer have to shield from the coronavirus from 1 April. It comes as the numbers of COVID-19 cases and hospital admissions have declined for the past couple of weeks. Letters will be sent out to this group in the next two weeks. In them, people will still be advised to keep social contacts at low levels, work from home where possible and stay at a distance from other people. Since 5 January, they have been asked to stay at home as much as possible to reduce their risk of being exposed to the virus. But at a Downing Street press conference, Health Secretary Matt Hancock confirmed shielding guidance, which had been extended to 31 March for all those who are clinically extremely vulnerable, would end on 1 April. England's deputy chief medical officer Dr Jenny Harries recommended the change based on the latest scientific evidence and advice. Read full story Source: BBC News, 17 March 2021
  11. News Article
    There is to be a large expansion of the number of people being asked to shield in England. An extra 1.7 million people are expected to be added to the 2.3 million already on the list. Half of the group have not yet been vaccinated so will now be prioritised urgently by their local GPs. It comes after a new model was developed that takes into account extra factors rather than just health. This calculation includes things such as ethnicity, deprivation (by postcode) and weight to work out a person's risk of becoming seriously ill if they were to catch Covid. It also looks at age, underlying health issues and prescribed medications. Prof Andrew Hayward, a member of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), which has been involved in the modelling, said it considered a "combination of factors" such as age, ethnicity and chronic illness and put them together to reach a score. He told BBC Radio 4's PM programme that this score could "more or less order people in the population according to their level of risk" and "identify those at the top of that range to say, 'you should be prioritised for vaccine and you have a level of risk that is similar to those on the shielding list'". Read full story Source: BBC News, 16 February 2021
  12. News Article
    With the first phase of the UK’s vaccination programme now fully under way, the government’s self-congratulatory tone suggests all clinically vulnerable groups are soon in line for protection. There’s certainly reason to be positive: millions of people are on their way to safety. But look a little closer and many high-risk people are struggling to access the vaccine. When the vaccine was first introduced last year, the Joint Committee on Vaccination and Immunisation (JCVI) put shielders – or the “clinically extremely vulnerable” (CEV) – as low as sixth on the priority list, behind older people with no underlying health conditions. It resulted in the baffling situation where a marathon-running 65-year-old was given priority for the vaccine over a 20-year-old with lung disease who needs oxygen support. The government U-turned after pressure, moving CEV people up to fourth spot behind healthy over-75s. These are complex calculations, but there are still fears some will miss out. Some young disabled people who don’t meet the government’s narrow criteria of CEV and are worried they won’t be prioritised at all. Shielders – many of whom are of working age and live with children – also have extra risk factors compared with older people. As the British Medical Association said this month, we need a more sophisticated vaccine delivery that takes into account circumstantial factors such as race, health inequality and employment. I’ve received many messages from shielders who are terrified of being forced out to work, or of schools reopening before they get their vaccine. There are also those with learning disabilities to consider. Currently, only older people with a learning disability, those who have Down’s syndrome or people who are judged as having a severe learning disability are on the priority list. This means that people with a mild or moderate learning disability aren’t prioritised at all. This is despite the fact all people with learning disabilities have a death rate six times higher than the general population. Young adults with a learning disability are 30 times more likely to die of Covid than young adults in the general population. Read full story Source: The Guardian, 3 February 2021
  13. News Article
    The entire Covid shielding programme has been “closed” for good in an announcement slipped out at night during a Cabinet reshuffle. Clinically extremely vulnerable people will “not be advised to shield again” in future despite fears of a huge winter wave, said the statement uploaded to the government website last week. Furious charities today raised fears disabled and immunosuppressed people will be “cast adrift” - while others will feel “yet again forgotten by the government”. Some 3.8million vulnerable people were advised to shield during England’s third lockdown, going outside only for exercise or health appointments. That guidance was paused on 1 April and on July 19 people were told they could follow the same rules as the rest of the population. But the ‘Shielded Patient List’ was retained for future use and ex-shielders were given special tips, such as only meeting vaccinated people. Last night, however, the government announced there will no longer be “centralised guidance” for clinically extremely vulnerable people. Read full story Source: Mirror, 16 September 2021
  14. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Clive talks to us about the important role of digital technologies in tackling the big issues healthcare faces, the need for digital tools and records to be joined-up and interoperable, and how his experiences as a carer have shaped how he sees patient safety.
  15. News Article
    Up-to-date registers of clinically vulnerable patients must be created to ensure that those who are most at risk during Covid-19 and any future pandemics are protected and can access the support they need, a report from the All-Party Parliamentary Group (APPG) on Vulnerable Groups to Pandemics has recommended. The report considered vulnerable people’s experiences during the pandemic and makes 16 recommendations on what the government and the health service can do better to plan and prioritise extremely vulnerable patients during further Covid-19 outbreaks and future pandemics. These tackle the format and content of information and guidance; access to medical services such as mental health support to help people deal with anxiety, fear, and isolation; provision of practical support such as food and finance when isolating; and the need for more research into how medical conditions make people more vulnerable to a threat and vaccines less protective. At the launch of the report representatives of charities and patient groups described how the pandemic had left clinically vulnerable people feeling anxious, afraid, lonely, trapped, and desperate. They also described the “not on the list” scenario many had had to contend with, meaning they could not access priority services such as testing or support to isolate. There were still patients whose doctors recognised that they should be on the list fighting to get their condition recognised, said Susan Walsh, chief executive of Immunodeficiency UK. This means that, under the government’s Living with Covid plans, they will no longer be able to access free testing. Lord Mendelsohn, co-chair of the APPG on Vulnerable Groups to Pandemics, said, “We should be more willing to allow the medical practitioners responsible for these patients to be able to overhaul computerised systems and find ways to make that happen.” Read full story Source: BMJ, 28 February 2022
  16. News Article
    The UK must urgently procure stocks of a drug that can boost vulnerable people’s protection against Covid, experts have urged in a letter to The Times. Evusheld, made by AstraZeneca, was licensed by the UK regulator the Medicines and Healthcare products Regulatory Agency in March. Some people with immune system problems, such as blood cancer patients or organ transplant patients do not get sufficient protection from vaccinations and many are continuing to shield. Campaigners believe that offering Evusheld to those people could allow them to resume normal life. Evusheld is being used in countries including the United States and Israel but the UK government has yet to ask AstraZeneca for supplies. In a letter published in The Times, Gemma Peters, chief executive of Blood Cancer UK, and Lord Mendelsohn, co-chairman of the All-Party Parliamentary Group on Vulnerable Groups to Pandemics, say that this represents a failure of a promise made at the start of the pandemic that the government would “do everything in its power to protect the vulnerable”. They write: “People who are immunocompromised are still dying from Covid at much higher rates than the rest of the population. They cannot afford to wait. They deserve better.” Read full story (paywalled) Source: The Times, 6 July 2022
  17. News Article
    Patients with rheumatic conditions who shielded during the pandemic feel "left behind", according to new research. The University of the West of England (UWE) in Bristol conducted a study with patients about their experiences of shielding during the pandemic and how it continued to affect them. Researchers interviewed 15 rheumatology patients from the Bristol area. Pamela Richards, who suffers with arthritis, said the pandemic has been "a massive blow" to the way she lives. "I have never experienced anything like shielding, it heightened a sense of anxiety in me," said Ms Richards. "How do I get food? I cannot leave the house. How can I see friends? I was not allowed to." Ms Richards, who shielded for nearly two years during the pandemic, said that life has not returned to normal, despite no longer being advised to shield. "It is a new normal, which is about being on high alert and managing risk every day," she said. Researcher Christine Silverthorne said: "Many are still dealing with lasting physical and mental effects both from the experience of shielding and as a consequence of delays to their healthcare and treatment". Read full story Source: BBC News, 6 March 2023
  18. News Article
    Time is running out for hundreds of thousands of vulnerable people who are facing another winter shielding from Covid, campaigners have said. They are calling on the government to buy a drug called Evusheld to provide some protection against the virus. The government says it is not clear how long that protection will last when up against the Omicron variant. But patients, charities and health experts argue the protection offered is better than nothing. There are around 500,000 people in the UK with suppressed immune systems. That means their bodies struggle to produce antibodies, so the existing vaccines offer them little or no protection, leaving them very vulnerable to Covid. Blanche Hampton has lupus, a condition where her immune system has turned against her. The drugs she takes to control the lupus also suppress her immune system, meaning her body has no defences against Covid. Blanche has been shielding for two and a half years, but she believes Evusheld offers a chance for at least some kind of existence outside of her small flat in Inverkip, west of Glasgow. "Evusheld would give me a layer of protection, that is better than nothing. Because that's what I have currently - nothing." And Blanche, like many people who find themselves in the same situation, says she feels abandoned. Read full story Source: BBC News, 17 October 2022
  19. News Article
    Doctors who have been shielding during the covid-19 pandemic have said they are worried for their safety when they return to work. From 1 August those who are at high risk of serious illness if they contract covid-19 will no longer be advised to shield in England, Scotland, and Northern Ireland.123 But doctors who have been shielding during the pandemic have expressed concerns about their safety when they return to work, and say they feel forgotten by their employers. Read full story (paywalled) Source: BMJ, 21 July 2020
  20. News Article
    The 2.2 million people who have been self-isolating in England during the pandemic will no longer need to shield from 1 August. From 6 July, they will be able to meet up outdoors, in a group, with up to five others and form 'support bubbles' with other households. The measures can be eased because infection rates are falling, the government says. Among the list of people who should be shielding are solid organ transplant recipients, cancer patients undergoing chemotherapy, pregnant women with heart disease and people with severe respiratory conditions such as cystic fibrosis and severe asthma. The government says it has worked with clinicians, GPs, charities, the voluntary sector and patient groups on the changes, but some charities are criticising the relaxing of the advice, saying many of the people they support do not feel it is safe to stop shielding. Read full story Source: BBC News, 23 June 2020
  21. News Article
    Some extremely vulnerable people have been told they have been removed from shielding lists via text message, without the knowledge of their GP. This has caused confusion, with charities demanding clearer guidance for this group as lockdown eases. GPs say they should be notified when their patients are added or removed from the lists. Shielding has now been extended until the end of June and is under constant review, the government says. Around 2.2 million people in the UK are staying at home to protect themselves from the virus because they were told they were at high risk of being seriously ill with COVID-19. But 40 healthcare charities say the lack of a clear plan for their future is causing anxiety and potentially putting their health at risk. Read full story Source: BBC News, 30 May 2020
  22. News Article
    An emergency unit at a Norwich hospital has reduced ward admissions and is helping shield urgent non-COVID-19 patients. The older people’s emergency department (Oped) – a special unit at the Norfolk and Norwich university hospital – is providing emergency care for patients over 80. Launched in 2017, the unit, just down the corridor from A&E, has six beds, two in side rooms and no waiting room. Normally, it admits patients identified as frail and usually with multiple conditions that need a lot of care (such as cognitive impairment, incontinence or reduced mobility). They are brought straight in by ambulance or trolley from other parts of the hospital and seen by a consultant geriatrician within two hours. A team of nurses with experience in both emergency care and care of the elderly, pharmacists and physiotherapists are on hand to support patients much more quickly than A&E to get patients out of hospital and back home within the same day wherever possible. For patients who need to stay longer after treatment there is an adjacent ambulatory ward. This unique model is showing results. The proportion of the specialist department’s patients admitted to the hospital is 50% compared with 68% for the same age group of emergency patients coming to the hospital five years ago, when they were treated at the normal A&E. When Oped patients are admitted, their average length of stay is 1.2 days less. “It’s just what we want for old people,” says Dr Sarah Bailey, the department’s lead consultant geriatrician. “We get the experts in straight away because we recognised that’s the best thing for [them]”. During the pandemic, the unit is helping to keep those who do not have coronavirus symptoms, such as those with injuries from falls and some stroke patients, away from the main A&E ward, providing a degree of shielding not normally possible. But for most NHS trusts, providing a separate unit like Oped is not feasible. “Hospitals are working to separate emergency patients with respiratory problems from those with other conditions,” says Dr Jay Banerjee, who leads the Royal College of Emergency Medicine’s work on emergency care for the elderly. “But most just do not have the capacity to also try to separate elderly patients with other conditions from younger patients.” Read full story Source: The Guardian, 27 May 2020
  23. News Article
    NHS England has set up an advisory group to look at how physical and mental health services can be delivered to patients who are most vulnerable to COVID-19 and have been asked to shield themselves from the pandemic. There are now around 2.5 million patients on the list of people considered to be at the highest clinical risk, including solid organ transplant recipients and patients on chemotherapy, who have been told to cut themselves off from society as far as possible. They are going to have to stay that way beyond the end of June, with suggestions that their isolation could continue for many more months hence, and there is significant concern about the impact of this on their ongoing physical and mental health. The NHS has therefore set up an advisory group to examine how care can be provided to these patients. Read full story Source: HSJ, 13 May 2020
  24. News Article
    Tens of thousands of cancer patients have not yet received letters advising them to “shield” themselves from the coronavirus threat, The Times has learnt. Peter Johnson, national clinical director for cancer, has written to charities asking for their help in tracing the missing patients and alerting them to the need to take stringent self-protection measures against infection. His appeal comes as the government increased by one million its estimate of the number of people at greatest risk of severe illness should they contract COVID-19. Its new strategy document stated that it had identified 2.5 million people who were “clinically extremely vulnerable and advised to shield”. At the onset of the lockdown in March, ministers estimated the number at 1.5 million. Professor Johnson’s letter, seen by The Times, states: “We are still receiving reports of cancer patients who believe that they should have received a shielding letter but have not yet received one or have not been added to the national list. It is crucial that those who are clinically extremely vulnerable receive a letter advising them to shield. Read full story Source: The Times, 12 May 2020
  25. News Article
    Significant concerns about the NHS’ refusal to share data with councils have emerged in a letter from a leading council chief executive and clinical commissioning group accountable officer. Steven Pleasant, chief executive of Tameside Metropolitan Borough Council and accountable officer of Tameside and Glossop CCG, said the failures are “becoming increasingly exasperating”, in a letter intended for the Ministry of Housing, Communities and Local Government’s shielding sounding board. Steven said he understands NHS Digital has decided the most recent version of the list cannot be shared with councils even though it is being shared with police, fire, voluntary organisations and companies offering logistical support. “I am sure that you will appreciate that this is counterproductive and frustrating given that local authorities are leading and coordinating the response to the most vulnerable in communities,” he wrote. He also raised concerns about how the NHS’ shielded patients team is passing on to councils information about people needing additional support — for instance, if the recipient’s food parcel stock is running low, requiring the council to step in. Welfare concerns and medication information could also need to be passed on. Mr Pleasant said although his council had asked for this information to be provided via email, staff “have been told by the NHS shielding team that they do not have permission to do this and that details can only be provided verbally over the phone”. “We believe this significantly increases the chances of error and presents significant risk… around incorrect information being captured,” he wrote. Read full story Source: HSJ, 21 April 2020
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