Publication - Advice and guidance

Coronavirus (COVID-19): shielding advice and support

Details of shielding advice to help people make informed decisions and access support services during the coronavirus pandemic.

Coronavirus (COVID-19): shielding advice and support
Highest risk group

Highest risk group

Some groups of people are at the highest risk of severe illness from coronavirus.

If you are in this group you will receive a letter from the Chief Medical Officer. Contact your GP or specialist care provider, if you fall into one of these groups and have not received a letter.

Grouping How would I know if I am in this group?
Solid organ transplant recipients

People who have had a transplant of heart, lung, stomach or other part of intestine, liver and kidney. This is because of the medication taken to stop rejection of the transplanted organ.

People with specific cancers
  • People with cancer who are undergoing active chemotherapy. Or people who have had radical radiotherapy for lung cancer.
  • People with cancers of the blood or bone marrow who are at any stage of treatment. This includes cancers such as leukaemia, lymphoma or myeloma.
  • People with cancer who are having immunotherapy or other continuing antibody treatments.
  • People with cancer who are having specialised treatments that can affect the immune system. This includes protein kinase inhibitors or PARP inhibitors.
  • People who have had bone marrow or stem cell transplants in the last 6 months. Or people who are still taking immunosuppression drugs.
People with severe respiratory conditions
  • People with cystic fibrosis.
  • People who are on home oxygen for a lung condition.
  • People with severe asthma and on regular inhalers and long-term steroid tablets. For example, Prednisolone or regular injections to control your asthma.
  • People with severe COPD. This usually means being on several different inhaler medications in the last year. As well as a steroid inhaler, this must include two long acting preventers. For example, Long Acting Beta Agonists and Long Acting Anti-Muscarinic Antagonists. Severe COPD means that:
    • You are too breathless to walk 100 yards
    • You have 2 or more lung infections a year or
    • You need oxygen to help with your breathing
People with rare diseases including all forms if interstitial lung disease / sarcoidosis

This includes inborn errors of metabolism that significantly increase the risk of infections. For example, SCID and homozygous sickle cell disease.

There are many conditions classed as a rare disease. Not everyone with a rare disease will be in the shielding group

Your clinician will know if you should be in the highest risk group and will add you to the list if needed. Once added you will receive a letter.

People on immunosuppression therapies that significantly increase risk of infection. Or people who have had their spleens removed

Immunosuppressive therapy helps to stop rejection of a bone marrow or organ transplant. It can also treat conditions in which the immune system is overactive. For example, autoimmune diseases and allergies.

In some cases these treatments may put people into the shielding group. Your clinician can determine if your medications put you in this group.

  • People on high dose corticosteroids (equal to Prednisolone 20mg or more) for 4 weeks or more.
  • People on specific single therapies, e.g. Cyclophosphamide. These medications are usually prescribed by specialists in hospitals.
  • People on lower dose of corticosteroids in combination with other disease modifying medication.
  • People on disease modifying medications who also have other chronic medical conditions.
  • People who take some medication and are otherwise healthy may not need to be in the shielding group. This includes single Disease Modifying medications (DMARD). It also includes Biologic medications such as Methotrexate, Azathioprine, Ciclosporin, Leflunomide plus others. Discuss this with your specialist or GP if you are not sure.
People who are pregnant with significant heart disease, congenital or acquired If you are being followed up by a specialist heart clinic during your pregnancy.

People who are receiving renal dialysis treatment

People receiving and people starting renal dialysis.

How we identified people

Clinicians helped us identify the people who need to be on the shielding list. This might be someone who does not have one of the conditions listed above.

Not everyone who has an annual flu vaccine for medical reasons will receive a letter.

How we are using your data

To identify people, we have used GP practice, local health board or national data. This is so we could write to you. All data is securely stored. This information has been shared appropriately within the NHS in Scotland. It did not include medical records.

We notify GPs and health boards about who is on the list. This is so that they can provide further advice to their patients.

When we were asking people to shield, we shared only contact details with local authorities and our partner retailers. This allowed them to provide support to help people access groceries and medication.

We will keep your contact details in case we need to contact you again. This action is only taken due to the current coronavirus outbreak. No details of medical conditions or health records are being shared. You can request to be removed from the list by asking your GP or specialist care provider.

First published: 25 Nov 2020 Last updated: 25 Nov 2020 -