The prime minister has revealed a raft of new measures designed to curb the rate of Covid-19 infection in the UK.
People have been told to work from home if they can; pubs, bars and restaurants in England and Scotland are subject to a 10pm curfew; and the number of people able to attend weddings has halved from 30 people to 15.
But what happens for those who were shielding earlier this year? From August 1, the guidance to shield, and the support provided, was scrapped entirely in England. But news of rising cases is likely to concern them.
Speaking in the Commons on Tuesday, Boris Johnson said: “I want to speak directly to those who were shielding early in the pandemic and may be anxious about being at greater risk.
“Following advice from our senior clinicians, our guidance continues to be that you do not need to shield – except in local lockdown areas – and we will keep this under constant review.”
The prime minister’s announcement comes after the UK government’s chief medical and scientific advisors warned there could be 50,000 Covid-19 cases a day in the UK by mid-October with a daily death toll of 200 or more by mid-November if the current growth in the rate of infection is not halted.
What do those on the shielding list need to know?
In some areas subject to local lockdowns, the advice is not to shield. In Bolton and Greater Manchester, for example, the government’s guidance states people who are clinically extremely vulnerable do not need to shield, but should continue to take precautions.
In Leicester, the picture is different: people who are clinically extremely vulnerable are urged to shield until the 5 October. After this time, shielding will be paused. It’s best to check your local authority’s website for further guidance on shielding in your area – and follow the public health guidance stated there.
HuffPost UK understands that, to date, the clinical advice has been that there should not be a set threshold for reintroducing shielding. The key epidemiological indicator for this decision is the incidence rate, not R rate or other metrics, although these are also taken into account.
People who were shielding earlier this year were told to stop on August 1 and encouraged to return to work or school. Shielders are still able to get support from NHS volunteer responders – if they need prescriptions or shopping picking up – and priority delivery at supermarkets. But they no longer receive free food parcels, medicine deliveries or basic care from the National Shielding Service.
There are concerns over the lack of guidance and clarity for those who are most vulnerable to the effects of the virus.
At the time of writing, the government’s official guidance on shielding had been last updated on September 4, and said: “The government is advising that you do not need to shield at the moment. This is because the rates of transmission of coronavirus (Covid-19) in the community have fallen significantly.”
What do the experts say?
Professor Paul Hunter, an expert in medicine at the University of East Anglia, said it’s “disappointing” vulnerable citizens have been omitted from the conversation over the past few weeks.
“Given it’s now almost certain we will see big increases in the epidemic over the next two to three months, we really need to focus on how better to identify, protect and support our more vulnerable citizens,” he said. “This has been a big omission in the public debate over recent weeks.”
Dr Dominic Pimenta, a hospital doctor and chairman of healthcare workers’ charity Heroes, echoed Prof Hunter’s comments, and said the new measures are welcome, but the guidance around shielding should be clearer.
“The current local lockdown areas affect 13 million people, and the government guidance is unclear what services will be provided to those shielding in that area, advising [them] to contact their local authority for further guidance,” he says.
“While some services continue nationally ... there is deep uncertainty, particularly for those attending workplaces, at what point they will be asked to shield again, and crucially, supported to do so.”
He said the lack of guidance and support for this group is “shameful”.
Is there any financial support available?
As of August 1, when shielding ended nationally, people in this group were no longer eligible for Statutory Sick Pay (SSP) on the basis of being advised to shield by the government.
For those who live or work in an area where shielding has been introduced as part of the local lockdown measures and they have been notified to shield, if they are unable to work as a result, SSP is available.
While those who can afford to shield will most likely do so, those who cannot will be forced to “make a choice between their livelihoods and their health”, says Dr Pimenta, who authored a book on the pandemic called Duty Of Care.
“Whatever the national strategy will turn out to be, it’s an immutable fact that cases will continue to rise for at least another fortnight after these measures come in, increasing the risk in the community, particularly for those who cannot afford to protect themselves,” he says.
Phillip Anderson, head of policy at the MS Society, adds: “It is simply not right that some are already being forced to choose between their health and their job and we want to see a financial support package introduced where it’s not safe for them to go into work.”
Dr Pimenta says there needs to be guidance issued now, so people can plan for the coming weeks and months. “Far better to err on the side of safety, and end the confusion now nationally, so both employers and those on the shielding list can plan for what is going to be a difficult winter for us all,” he says.
“This meaningless delay in guidance serves only to disproportionately affect those who are both physically and economically the most vulnerable in our society – a dire injustice.”
What needs to happen now?
Anderson has called for action. “Yet again we have a major statement from the prime minister where he was largely silent on vulnerable people,” he said. “With estimated cases higher than when the shielding programme was paused, this is a huge disappointment.”
He said there needs to be an “urgent plan to protect vulnerable people”, and for people to know under what circumstances shielding could be brought back and what support will be offered.
The general public is now being told to work from home, where possible, he points out. Does this mean it’s safe for people who are vulnerable to go to their workplaces if they can’t work from home? “We want to know if it’s safe for vulnerable people to go into workplaces at all,” he added.
A Department of Health and Social Care spokesperson told HuffPost UK: “Shielding for the clinically extremely vulnerable has been paused since the start of August in most of the country - our advice for them is the same as for the rest of the population.
“Shielding is still advised in specific areas of the country where prevalence of the virus is higher. Local authority support is available to those shielding in these areas.
“We keep all aspects of our response to the pandemic under review and in line with the advice of our scientific and medical experts.”