Covid: The extra rules to follow during English lockdown if you're clinically extremely vulnerable

Advice for the extremely clinically vulnerable has been extended. Credit: PA

New guidance for people in England at high risk of coronavirus - known as clinically extremely vulnerable - has been announced by the government ahead of the second lockdown beginning on Thursday. The advice outlines extra precautions people in this group should take on top of the national restrictions.

Who is clinically extremely vulnerable?

If you're at high risk of coronavirus, you should have received a letter from the NHS when people were originally asked to shield earlier in the year.

People at high risk include those who:

  • have had an organ transplant

  • are having chemotherapy or antibody treatment for cancer, including immunotherapy

  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer

  • are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)

  • have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)

  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking

  • immunosuppressant medicine

  • have been told by a doctor they have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)

  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)

  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)

  • have a serious heart condition and are pregnant

What are the extra rules for the clinically extremely vulnerable?

  • Going out and socialising

People who are clinically extremely vulnerable are "strongly advised" to stay at home at all times and should only go outdoors for exercise or to attend health appointments, unless told not to by their doctor. They should avoid all but essential travel.

People can exercise with those they live with or in their support bubble.

  • Working

People in this group are advised they should work from home. If they can't, they shouldn't go to work.

Packages of support are available to those financially impacted by the rules, which include Statutory Sick Pay, Employment and Support Allowance, Universal Credit or the Coronavirus Job Retention Scheme.

People in the same household who are not clinically extremely vulnerable can still attend work, so long as they follow the new national restrictions.

  • School

Most children who were originally told to shield are no longer considered extremely vulnerable - due to evidence showing a very low risk of children becoming very unwell from Covid-19.

It means most children should continue going to school. Concerned parents are advised to contact their child's GP or hospital clinician to check whether they should still be considered clinically extremely vulnerable.

If a child remains clinically extremely vulnerable, they should not go to school.

Children who live with someone who is clinically extremely vulnerable, but aren’t themselves, should still attend school.

Support for the clinically extremely vulnerable

People can request help through this link on the government website, including asking for priority access to supermarket delivery slots and to inform their council they need support.

The clinically extremely vulnerable should not be confused with the 'clinically vulnerable', who are still at increased risk to coronavirus, but less so than the extremely vulnerable.

The clinically vulnerable are being advised to "be especially careful" to follow the new restrictions and to minimise their contacts with others.

Those who are clinically vulnerable:

  • are 70 or older

  • have a lung condition that's not severe (such as asthma, COPD, emphysema or bronchitis)

  • have heart disease (such as heart failure)

  • have diabetes

  • have chronic kidney disease

  • have liver disease (such as hepatitis)

  • have a condition affecting the brain or nerves (such as Parkinson's disease, motor neurone disease, multiple sclerosis or cerebral palsy)

  • have a condition that means they have a high risk of getting infections

  • are taking medicine that can affect the immune system (such as low doses of steroids)

  • are very obese (a BMI of 40 or above)

  • are pregnant