New support measures were revealed for those in the clinically extremely vulnerable category – also known as ‘shielders’ – hours before England went into lockdown.

Charities supporting the vulnerable accused the government of causing “untold amounts of stress” on these groups, with leaders saying they were “frustrated” by the last-minute updates and that many people had been left “bewildered and anxious”, PA reported.

Tracey Loftis, head of policy and public affairs at Versus Arthritis, said: “Without advance notice, people do not have time to plan and adapt their lives for the new rules. This can affect jobs and caring responsibilities, leaving people feeling isolated and confused.”

Meanwhile Professor Mark Woolhouse, an expert in infectious disease epidemiology at the University of Edinburgh, said the new guidance “feels like an afterthought” and “should have been made weeks ago”. 

While the recognition of extra protection to the most vulnerable is welcome, he said, “we have to ask why the need to protect the vulnerable has not been at the forefront of the response over the past few weeks”.

So what do shielders need to know this time around?

New groups added to the extremely clinically vulnerable list

People with chronic kidney disease (stage 5) or undergoing dialysis, as well as adults with Down’s syndrome, have been added to the clinically extremely vulnerable list after evidence found they’re at higher risk from Covid-19 than the general population.

This means those with the following conditions now fall into the clinically extremely vulnerable group:

• solid organ transplant recipients
• people with specific cancers:
• people with cancer who are undergoing active chemotherapy
• people with lung cancer who are undergoing radical radiotherapy
• 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 that 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 chronic obstructive pulmonary disease (COPD)
• people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell)
• people on immunosuppression therapies sufficient to significantly increase risk of infection
• adults with Down’s syndrome
• adults on dialysis or with chronic kidney disease (Stage 5)
• women who are pregnant with significant heart disease, congenital or acquired
• other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs.

Letters will be going out later this week to all those identified as clinically extremely vulnerable, providing them with further detail on the updated guidance and on how to access the support available.

What’s the advice for these people?

Many shielders have been continuing to do so since the first lockdown over fears for their safety, despite the official period ending on August 1.

For those who haven’t, the new guidance advises to stay at home as much as possible, except to go outdoors to exercise or attend health appointments. But they can exercise with those they live with or in their support bubble.

They are urged to avoid all non-essential travel, but should continue to travel to hospital and GP appointments unless told otherwise by their doctor.

They are “strongly advised” not to go to any shops or to pharmacies.

The message is clear that if people cannot work from home, they should not attend work. These people may be eligible for Statutory Sick Pay, Employment and Support Allowance, Universal Credit or the Coronavirus Job Retention Scheme during this period of national measures, reads the government advice.

The formal shielding notification can act as evidence for your employer or the Department for Work and Pensions (DWP) that you should not work outside of your home for the period stated in the letter, adds the guidance.

What about vulnerable kids?

Most children originally on the shielded patient list can still attend school, according to the guidance. But if parents are unsure or worried, they are urged to contact their child’s GP or hospital clinician to check whether they should still be considered clinically extremely vulnerable.

If a GP or clinician has advised that a child should remain on the shielded patient list, they should not attend school.

Deputy chief medical officer for England, Dr Jenny Harries, said: “Our guidance for this group of individuals has always been advisory, but I would strongly urge all those who are clinically extremely vulnerable to take these extra precautions to keep themselves as safe as possible.”

What’s the advice for people living in the same household as a shielder?

Those living in a household with someone who is clinically extremely vulnerable are advised to carry on as normal, attending work and school as per the latest regulations. Most people are urged to work from home where they can.

People who are vulnerable have been urged to try to stay 2 metres away from other people within their household, especially if they display symptoms of the virus or have been advised to self-isolate.

However charities have warned that this isn’t practical advice, especially for those living in smaller, shared spaces.

What support is available?

Aside from the financial benefits people can apply for if they can’t attend work, there are a few other ways to get support.

Shielders will be able to use an online service to request priority access to supermarket delivery slots, and to inform their council they need help. 

The government will be providing £32 million to upper tier councils in England which will be used to provide support, such as access to food and signposting to local support of befriending services.

NHS Volunteer Responders will also be on hand once again to help with a regular, friendly phone call, and transport to and from medical appointments. You can call 0808 196 3646 between 8am and 8pm to arrange support or visit NHS Volunteer Responders.

What about those who aren’t extremely clinically vulnerable?

Those with more general underlying health conditions or who are 70 years old or over may still be more vulnerable to Covid-19 than the general population, so are also advised to stay at home as much as possible, to carefully follow the rules and minimise contact with others.