The UK government has now issued guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19. These new shielding measures will apply nationally for 4 weeks up to 2 December. At the end of the period, the government has outlined that it intends to return to a regional approach and will issue further guidance at the time.

People who are defined as clinically extremely vulnerable are at very high risk of severe illness from COVID-19 are identified in 2 different ways. You may be identified as clinically extremely vulnerable if:

• You have one or more of the conditions listed below, or
• Your hospital clinician or GP has added you to the shielded patients list because, based on their clinical judgement, they deem you to be at higher risk of serious illness if you catch the virus.

If you do not fall into either of these categories and have not been informed that you are on the shielded patients list, you need to follow the new national restrictions from 5 November.

Adults with the following conditions are automatically deemed clinically extremely vulnerable:

• solid organ transplant recipients
• those 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
• those with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
• those with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
• those 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. GPs and hospital clinicians have been provided with guidance to support these decisions

*these are new conditions that have been added to the list recently.