Extremely Vulnerable Patient Group and Shielding FAQs

Updated guidance for people who are clinically extremely vulnerable (shielding). You will have seen updated guidance for this group which came into effect on Monday 1 st June. In summary:

  • Patients should continue to shield until at least the 30 June can now spend a short period of time outdoors each day with members of their household, still maintaining 2m distance from others.
  • If you live alone, you can meet one other person from a different household (ideally the same person each time) while maintaining strict social distancing.
  • Other aspects remain the same. Apart from going outside once per day, you should continue to avoid all non-essential face to face contact, including shopping or going to pharmacies.
  • The support package remains unchanged.

The next review will be on 15th June

This is the list of people on the government website that have been advised to ‘shield’ for the next 12 weeks from coronavirus: See also Extremely Vulnerable V High Risk – Patient Guidance

Most are fairly clear – the asthma/COPD is open to some interpretation – there is more info on asthma.org.uk

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.


The current high risk groups are adults and children who are taking:

  • Any biologic therapy, also called a mAb (Xolair/omalizumab, Nucala/mepolizumab, Cinqaero/reslizumab, Fasenra/benralizumab)
  • Steroid tablets or liquid every day
  • Antibiotic tablets or liquid for asthma every week (e.g. azithromycin)
  • Tiotropium
  • A combination inhaler that also contains a long-acting bronchodilator (e.g. Seretide, Fostair, Symbicort) at a high daily steroid dose
  • An inhaler with a high daily steroid dose AND you are taking Montelukast


Or, if:

  • you have been admitted to hospital for their asthma in the last 12 months
  • you have ever been admitted to an intensive care unit for their asthma

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.

Shielding means…..

  • Stay at home at all times and avoid any face-to-face contact with others for at least 12 weeks
  • Get food, medicines and other essential items delivered, and have the person delivering them leave them at the door. Public services and charities are gearing up to help people who have to stay at home. From Tuesday 24th March they may be able to register for extra services from Government.
  • Use phone or online services to contact GP or other services if needed.
  • Inside your home, minimise all non-essential contact with other people you live with.
  • People who provide essential support, such as healthcare or support with daily needs or social care, can still come to the home. But if they have symptoms of COVID-19, they should not come. You should make a plan for how your care needs will be met if your carer becomes ill.
  • If you get symptoms of COVID-19, which means a fever or a new continuous cough, use the NHS 111 online coronavirus service or call 111 as soon as you get symptoms. Do not wait for your symptoms to get worse.
  • If someone else lives with you, they do not have to follow the shielding guidance. They should follow the social distancing guidance very closely and do what they can to support you with shielding.



This information is correct as at 02.04.2020