Advice for people at high risk from coronavirus (shielding)
If you’re at high risk (clinically extremely vulnerable) from coronavirus (COVID-19), you were advised to take extra steps to protect yourself until 1 August 2020. This was called shielding.
In England, the risk of getting coronavirus is now low enough that you’re no longer advised to shield but there are still things you can do to protect yourself and others. You can also still get some support.
Information:
This advice is for people who have received a letter from the NHS saying they’re at high risk from coronavirus.
If you’re not sure if you’re at high risk, see Annex 1 – who’s at higher risk from coronavirus – below and Annex 2 Pregnancy and coronavirus if applicable
If you live in an area with an outbreak
If you live, work or study in an area where there is a coronavirus outbreak, the advice for you may be different.
See areas with local restrictions on GOV.UK
Work and school
Children who were shielding can go back to school when their school reopens.
If you were shielding, work from home if possible. Your employer should support you to do this.
If you cannot work from home and are concerned about having to go to work, talk to your employer. Employers should make sure suitable arrangements are in place so you can go to work.
Information:
More information and advice about work
You can also get advice from Acas. Call the Acas helpline on
0300 123 1100
(Monday to Friday, 8am to 6pm).
Going out and meeting people
You can meet other people and go out to places like shops and restaurants. You can also have visitors in your home.
You should follow the same social distancing advice as everyone else.
Do
try to stay at least 2 metres (3 steps) away from anyone you do not live with (or anyone not in your support bubble)
if you meet people outdoors, only meet in groups of up to 6 people and try to stay at least 2 metres away from each other
if you meet people indoors (including in your home), only meet 1 other household at a time and try to stay at least 2 metres away from each other
wash your hands with soap and water often – do this for at least 20 seconds
use hand sanitiser gel if soap and water are not available
wash your hands as soon as you get home
wear something that covers your nose and mouth in places where it’s hard to stay away from other people, such as on public transport, in shops and in hospitals
Don’t
do not touch your eyes, nose or mouth if your hands are not clean
do not share or pass things to people you do not live with, including food and drinks
Support bubbles
If you live alone or you’re a single parent who lives alone with your children, you can meet with 1 other household without staying 2 metres away from them. This is called a support bubble.
Find out more about meeting people from outside your household on GOV.UK.
Help and support
You’re no longer able to get free food parcels, but you can get help with food and medicine deliveries from an NHS volunteer.
Call
0808 196 3646 (open 8 am to 8pm) to get help from NHS Volunteer Responders.
You can also continue to get priority supermarket delivery slots.
Information:
More information and advice
Annex 1 – Who is at Higher Risk from Coronavirus?
Who’s at higher risk from coronavirus
Coronavirus (COVID-19) can make anyone seriously ill. But for some people, the risk is higher.
There are 2 levels of higher risk:
high risk (clinically extremely vulnerable)
moderate risk (clinically vulnerable)
Important
The lists below may not include everyone who’s at higher risk from coronavirus and may change as we learn more about the virus.
People at high risk (clinically extremely vulnerable)
People at high risk from coronavirus include people who:
have had an organ transplant
are having chemotherapy or antibody treatment for cancer, including immunotherapy
are having an intense course of radiotherapy (radical radiotherapy) for lung cancer
are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)
have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine
have been told by a doctor they have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)
have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)
are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)
have a serious heart condition and are pregnant
Information:
If you’re at high risk from coronavirus, you should have received a letter from the NHS.
Speak to your GP or hospital care team if you have not been contacted and think you should have been.
What to do if you’re at high risk
If you’re at high risk from coronavirus, you were advised to take extra steps to protect yourself until 1 August 2020. This was called shielding.
In England, you’re no longer advised to shield. But there are still things you can do to protect yourself and others. You can also still get some support.
See what to do if you’re at high risk from coronavirus.
People at moderate risk (clinically vulnerable)
People at moderate risk from coronavirus include people who:
are 70 or older
have a lung condition that’s not severe (such as asthma, COPD, emphysema or bronchitis)
have heart disease (such as heart failure)
have diabetes
have chronic kidney disease
have liver disease (such as hepatitis)
have a condition affecting the brain or nerves (such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy)
have a condition that means they have a high risk of getting infections
are taking medicine that can affect the immune system (such as low doses of steroids)
are very obese (a BMI of 40 or above)
are pregnant – see advice about pregnancy and coronavirus
What to do if you’re at moderate risk
If you’re at moderate risk from coronavirus, you can go out to work (if you cannot work from home) and for things like getting food or exercising. But you should try to stay at home as much as possible.
It’s very important you follow the general advice on social distancing. This includes trying to stay at least 2 metres (3 steps) away from anyone you do not live with or anyone not in your support bubble.
What is a support bubble?
Unlike people at high risk, you will not get a letter from the NHS.
Information:
Get help and support
If you’re at a higher risk from coronavirus, you can get help from an NHS volunteer with things like getting food, medicines and other things you need.
Call 0808 196 3646
(open 8am to 8pm) to get help from NHS Volunteer Responders.
Other things that can affect your risk
A report by Public Health England found that other things might also mean you are more likely to get seriously ill from coronavirus.
These include:
your age – your risk increases as you get older
being a man
where in the country you live – the risk is higher in poorer areas
being from a Black, Asian or minority ethnic background
being born outside of the UK or Ireland
living in a care home
having certain jobs, such as nurse, taxi driver and security guard
See the full report on disparities in the risk and outcomes of COVID-19 on GOV.UK.
Annex 2 – Pregnancy and coronavirus
If you’re pregnant, you may be unsure how coronavirus (COVID-19) could affect you, your baby and your pregnancy care.
It’s important to tell your midwife or maternity team if you have symptoms of coronavirus. You should also ask them for help with any other concerns as you usually would.
Pregnancy and your risk
There’s no evidence that pregnant women are more likely to get seriously ill from coronavirus.
But pregnant women have been included in the list of people at moderate risk (clinically vulnerable) as a precaution.
This is because pregnant women can sometimes be more at risk from viruses like flu.
It’s not clear if this happens with coronavirus. But because it’s a new virus, it’s safer to include pregnant women in the moderate-risk group.
It may be possible for you to pass coronavirus to your baby before they are born. But when this has happened, the babies have got better.
There’s no evidence coronavirus causes miscarriage or affects how your baby develops in pregnancy.
Information:
For more information about things that can increase your risk of getting seriously ill from coronavirus, see who’s at higher risk from coronavirus.
What to do if you’re pregnant
If you’re pregnant, it’s important you:
wash your hands regularly
stay at home as much as possible and follow the advice on social distancing, such as staying at least 2 metres (3 steps) away from other people
stay away from anyone who has symptoms of coronavirus
You still need to go to all of your pregnancy (antenatal) scans and appointments unless you’re told not to.
Appointments and scans
You’ll still have regular appointments and scans while you’re pregnant. But there may be some changes.
You may find that:
midwife appointments are now online, by phone or by video call
if you need to have a scan you may have to go on your own
you may be asked to wear a mask or gown when you’re in a hospital or clinic
some appointments may be cancelled or rescheduled – if an appointment is cancelled, it will be rescheduled, or you’ll be able to rebook it
This is to help keep everyone safe and stop the spread of coronavirus.
Speak to your midwife or maternity team for more information.
Important
If you’re well, it’s really important you go to all your appointments and scans for the health of you and your baby.
Hospitals and clinics are making sure it’s safe for pregnant women to go to appointments.
Non-urgent advice: Call your midwife or maternity team if:
you’ve missed an appointment and need to book another one
you have any questions about your care or appointments
you do not know when your next appointment is
you have symptoms of coronavirus
If you get symptoms of coronavirus
If you get any symptoms of coronavirus (a high temperature, a new, continuous cough or a loss or change to your sense of smell or taste):
What is a support bubble?
Important
If you’re worried about your symptoms or not sure what to do, get advice from the NHS 111 online coronavirus service.
If you have any other symptoms
If you have any other symptoms, or anything else you’re worried about, you should still get medical help as you usually would.
You can still have GP appointments or speak to your midwife or maternity team if you have any questions.
Urgent advice: Call your midwife or maternity team immediately if:
your baby is moving less than usual
you cannot feel your baby moving
there is a change to your baby’s usual pattern of movements
you have any bleeding from your vagina
you’re feeling very anxious or worried
you have a headache that does not go away
you get shortness of breath when resting or lying down
Do not wait until the next day – call immediately, even if it’s the middle of the night.
If you do not have a midwife or maternity team call a GP or use the NHS 111 online service. Only call 111 if you cannot get help online.
Labour and birth
It’s really important you have a midwife with you when you give birth to keep you and your baby safe.
If you and your baby are well, you may be able to give birth at home, in a midwifery-led unit or in a birth centre.
If you’ve had any complications during your pregnancy you may be advised to give birth in a unit led by a doctor (obstetrician).
There may also be some changes to what usually happens where you plan to give birth, because of coronavirus.
Speak to your midwife or maternity team for more information.
You can also read more about signs that labour has begun.
Birth partners
Having a birth partner is important for your safety and wellbeing during labour and birth.
You’ll be able to have a birth partner during labour and the birth if they do not have symptoms of coronavirus. But there may be limits on how long they can stay after the birth.
If your birth partner has symptoms, they may not be able to come with you. You might want to have a backup birth partner just in case.
If you have coronavirus and go into labour
If you have symptoms of coronavirus and go into labour, you’ll be advised to give birth in a unit led by a doctor (obstetrician). This is so the team can look after you and your baby more closely.
You’ll be cared for in an area within the maternity unit that’s just for women with coronavirus.
You may see the midwives and maternity team wearing aprons, masks or eye protection. These things are to keep you, your baby and the staff caring for you safe, and to stop the spread of infection.
Having coronavirus should not have any impact on whether you have a vaginal or caesarean birth.
Your maternity team has been advised on how to keep you and your baby safe. They will make sure you get the best care and respect your birth choices as closely as possible.
After the birth
After your baby is born, you should be able to have skin-to-skin contact unless your baby is unwell and needs care in the neonatal unit.
You’ll also be encouraged to breastfeed. There’s no evidence coronavirus can be passed on to your baby in breast milk, so the benefits of breastfeeding and the protection it offers outweigh any risks.
As well as enjoying this time with your newborn baby, it’s important to be aware of any signs they might be unwell. At the moment it can be hard to know what to do – but trust your instincts and get medical help if you think your baby needs it.
For example, it’s common for babies to get newborn jaundice. Jaundice is usually harmless, but it’s important to be able to recognise the symptoms and to get medical help if your baby has them.
If you have any questions or need help
If you have any questions or concerns at any time, speak to your midwife or maternity team.
If you need help with day-to-day things, you can also call the NHS Volunteer Responders on 0808 196 3646.
They can help you with things like:
doing shopping
picking up prescriptions
taking you to appointments or hospital
