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.

Contents
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 if they catch coronavirus (COVID-19). If you’re in one of the groups below, the Chief Medical Officer will have sent you a letter letting you know you have been added to the shielding list.

Contact your GP or specialist care provider if you fall into one of the groups below and you have not received a letter.

Read more information about each group, including useful links and phone numbers, below.

Solid organ transplant recipients

 

Who is in this group

You are in this group if you have had a transplant of the kidney, liver, pancreas, islet cell, heart, lung, stomach or other part of intestine. This is because of the immunosuppressant medication taken to stop rejection of your transplanted organ(s).

If you’re waiting for an organ transplant

If you’re planning to receive a liver or kidney transplant from a living donor, both you and your donor will be asked to shield yourselves for 2 weeks before your transplant.

Strictly follow the advice of your specialist clinician or your transplant unit if you have been asked to shield because you are waiting for a solid organ transplant from a deceased donor.

If you’re in this group and you have coronavirus symptoms

If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are on the shielding list, and the condition you have or medicine you take. Please also inform your clinical specialist.

For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.

Information and support

For more coronavirus information and support for solid organ transplant recipients and those on the transplant waiting list, visit these websites:

People with specific cancers

 

Who is in this group

You are in this group if you:

  • have cancer and are undergoing active chemotherapy, or have had radical radiotherapy for lung cancer
  • have cancer of the blood or bone marrow and are at any stage of treatment. This includes cancers such as leukaemia, lymphoma or myeloma
  • have cancer and are having immunotherapy or other continuing antibody treatments
  • have cancer and are having specialised treatments that can affect the immune system. This includes protein kinase inhibitors or PARP inhibitors
  • have had a bone marrow or stem cell transplant in the last 6 months, or if you are still taking immunosuppression drugs

If you’re in this group and you have coronavirus symptoms

If you are worried about coronavirus symptoms, it’s important to call your existing cancer treatment helpline immediately. Or call the national Cancer Treatment Helpline on 0800 917 7711.

For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.

Information and support

For information and support related to coronavirus and cancer, you can:

People with severe respiratory conditions

 

Who is in this group

You are in this group if you have:

  • cystic fibrosis
  • lung conditions which require home oxygen
  • severe asthma requiring regular inhaler use and long-term steroid tablets to control your asthma – for example, Prednisolone or regular injections
  • severe non-cystic fibrosis bronchiectasis
  • pulmonary hypertension
  • 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 require oxygen to help with your breathing

If you’re in this group and you have coronavirus symptoms

If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are on the shielding list, and the condition you have or medicine you take. Please also inform your clinical specialist.

For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.

Information and support

For more information about coronavirus and severe respiratory conditions, you can:

  • visit the British Lung Foundation website or call their helpline on 03000 030 555
  • visit the Asthma UK Scotland website or call the helpline on 0300 222 5800
  • visit the Chest Heart & Stroke Scotland website to submit a request for help or get condition-specific guidance, or call the advice line for free on 0808 801 0899 to speak to a nurse
  • contact Chest Heart & Stroke Scotland’s nationwide network of Kindness Volunteers for support, including help with shopping during the pandemic or just keeping in touch to check on your wellbeing

People with rare diseases including all forms of interstitial lung disease / sarcoidosis

 

Who is in this group

This group includes people with inborn errors of metabolism that significantly increase the risk of infections. For example, SCID and homozygous sickle cell disease, and adults with Down's syndrome. 

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.

If you’re in this group and you have coronavirus symptoms

If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are on the shielding list, and the condition you have or medicine you take. Please also inform your clinical specialist.

For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.

Support and advice

You can get more information about coronavirus and rare diseases at:

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

 

About immunosuppressive therapy

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 tell you if your medications put you in this group.

Who is in this group

You are in this group if you:

  • are on high dose corticosteroids (equal to Prednisolone 20mg or more per day) for more than 4 weeks
  • are on specific single therapies, for example Cyclophosphamide (these medications are usually prescribed by specialists in hospitals)
  • are on a lower dose of corticosteroids for more than 4 weeks in combination with other disease modifying medication
  • are on disease modifying medications who also have other chronic medical conditions

If you’re not sure if you’re in this group

People who take some medication and are otherwise healthy may not need to be added to the shielding list. 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’re not sure.

If you’re in this group and you have coronavirus symptoms

If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are on the shielding list, and the condition you have or medicine you take. Please also inform your clinical specialist.

For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.

Information and support

You can find more information about coronavirus and immunosuppressive therapies at:

People who are pregnant with significant heart disease, congenital or acquired

 

Who is in this group

You are in this group if you are being supported by a specialist heart clinic during your pregnancy.

If you’re in this group and you have coronavirus symptoms

If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are on the shielding list, and the condition you have or medicine you take. Please also inform your clinical specialist.

For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.

Information and support

For more information and support about coronavirus and heart disease during pregnancy, you can:

People who are receiving renal dialysis treatment, and people who have chronic kidney disease stage 5 or liver cirrhosis (Child-Pugh class B and C)

 

Who is in this group

You are in this group if you are receiving or starting renal dialysis, or if you have chronic kidney disease stage 5, or liver cirrhosis (Child-Pugh class B and C).​​​​​​

If you’re waiting for an organ transplant

If you’re planning to receive a liver or kidney transplant from a living donor, both you and your donor will be asked to shield yourselves for 2 weeks before your transplant.

Strictly follow the advice of your specialist clinician or your transplant unit if you have been asked to shield because you are waiting for a solid organ transplant from a deceased donor.

If you’re in this group and you have coronavirus symptoms

If you have coronavirus symptoms, do not go to the hospital or GP. Instead call 111 immediately. Tell the call handler that you are on the shielding list, and the condition you have or medicine you take. Please also inform your clinical specialist.

For other non-emergency health concerns, your first point of contact should still be your GP or 111. They are likely to assess you over the telephone or via video link rather than in person to reduce the risk of infection from coronavirus.

Information and support

Find out more about coronavirus and renal dialysis and kidney disease at Kidney Care UK.

How we identify people who should be on the shielding list

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

Not everyone who has an annual flu vaccine for medical reasons will be added to the shielding list.

Advice for people with medical conditions that are not included in the shielding list

We have also published advice about coronavirus for people who have certain medical conditions not included on the shielding list.  

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.

Find more information about how the NHS handles your personal health information on the NHS inform website.


First published: 23 Feb 2021 Last updated: 22 Apr 2021 -