More than two million people who shielded during the peak of the pandemic have been given new advice on what to do depending on the Covid alert level in their area.
The Government said none of the alert levels in place in England will automatically trigger a warning for those who shielded before to shield again and stay home at all times.
It follows concerns that those on the shielded list became extremely isolated, with some too fearful to leave their homes for several months.
In the future, those living in the highest risk areas (known as Tier 3 or Covid alert level three) could be advised to adopt formal shielding if necessary, but they would receive a letter setting out the precautions they should take.
– For Covid alert level medium (Tier 1): People should strictly observe social distancing, meet others outside where possible, limit unnecessary journeys on public transport and work from home where possible. People should still go to work and children should still attend school. This is on top of restrictions for everyone to only meet in groups of up to six people.
– For Covid alert level high (Tier 2): People should reduce the number of different people met outside, avoid travel except for essential journeys, work from home where possible and reduce the number of shopping trips made or go at quieter times of the day. People can still go to work if they cannot work from home and children should still attend school. This is on top of restrictions for everyone to not meet other households indoors, unless part of a support bubble, and to only meet in groups of up to six people outdoors.
– For Covid alert level very high (Tier 3): People should work from home, in general stay at home as much as possible, and avoid all but essential travel. People should also significantly reduce shopping trips, and if possible use online delivery or ask people in their household, support bubble or volunteers to collect food and medicines. People in these areas are encouraged to still go outside for exercise, and can still go to school and to work if they cannot work from home.
The Government said all those who shielded previously are already helped by wider protection measures not previously in place when shielding was originally introduced in March, such as the rule of six and face coverings.
Letters will be sent to those affected by the new guidance.
Deputy chief medical officer for England Dr Jenny Harries said: “Over the last few weeks, we’ve seen a sharp increase in the prevalence of the virus across the country and we know those who are clinically extremely vulnerable are looking for practical advice on how they can carry on their lives while the virus remains in our communities.
“The new system will provide clarity on how best those in this group can keep themselves as safe as possible depending on the rates of transmission in their local area.
“Whilst advisory, I would urge all those affected to follow the guidance wherever they can and to continue to access health services for their medical conditions.
“We will continue to monitor the evidence closely and fine-tune this approach to make sure everyone in this group is clear about the safest way to go about their daily lives, particularly over the coming winter months.”
Clinically extremely vulnerable people include those who have had an organ transplant, people with cancer who are undergoing active chemotherapy and those with lung cancer undergoing radical radiotherapy.
People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of their treatment are also included, as are those with cancer who are having immunotherapy or other targeted treatments.
Other conditions included are severe respiratory illnesses including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD).
Dr Harries has since said that most children do not need to be included on the list.
Health and Social Care Secretary Matt Hancock said: “With coronavirus rates continuing to increase, now is the time to take action and ensure we protect the most vulnerable in our society.
“Today’s announcement will mean every person most at risk from serious outcomes from the virus will have specific advice targeted to local levels, which they can follow to keep themselves as safe as possible, while ensuring they can also keep as much normality in their lives as possible.”
The new guidance says shielding would only be reintroduced for short periods of time if at all.
It says: “In the future, the Government will only reintroduce formal shielding advice in the very worst affected local areas and for a limited period of time.
“This will only apply to some, but not all, very high alert level areas and will be based on advice from the chief medical officer.
“The Government will write to you separately to inform you if you are advised to shield.
“You are not advised to follow formal shielding advice again unless you receive a new shielding notification advising you to do so.”