Overview
Shielding is for people, including children, who are at very high risk of severe illness from coronavirus (COVID-19).
Shielding measures should be used when an extremely vulnerable person is living in their own home, with or without additional support. This includes extremely vulnerable people living in long-term care facilities.
On 24 March the Scottish Government announced they would provide you with support to self-isolate if you’re at very high risk of severe illness from COVID-19. This includes including helping you to access medicine and food supplies.
To help you further we would like to contact you by text message. If you don’t have a mobile phone, you‘ll still be able to access support by phoning your local authority’s shielding support line.
If you’re in this group you will receive a letter with more information, including details on how to register with the SMS service.
Extremely high risk of severe illness
Some groups of people are considered to be at extremely high risk of severe illness with COVID-19 and should strictly follow shielding measures. Their household and other contacts should strictly follow social distancing measures in order to protect them.
This group includes people who:
- have had solid organ transplants
- have cancer and are receiving active chemotherapy
- have lung cancer and are either receiving or previously received radical radiotherapy
- have cancers of the blood or bone marrow, such as leukaemia, lymphoma or myeloma who are at any stage of treatment
- are receiving immunotherapy or other continuing antibody treatments for cancer
- are receiving other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
- have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
- have severe chest conditions such as cystic fibrosis or severe asthma and severe COPD
- have rare diseases, including all forms of interstitial lung disease/sarcoidosis, and inborn errors of metabolism (such as SCID and homozygous sickle cell) that significantly increase the risk of infections
- are receiving immunosuppression therapies that significantly increase risk of infection
- are pregnant with significant heart disease (congenital or acquired)
Shielding is for your personal protection, it’s your choice to decide whether to follow these measures.
If you received a letter from NHS Scotland saying you have a condition that makes you at very high risk of severe illness from COVID-19, you’re strongly advised to shield yourself to reduce your chance of getting the virus.
People who have been given a prognosis of less than six months to live, and some others in special circumstances, could decide not to undertake shielding. This will be a deeply personal decision you may want to discuss with family or others that are close to you. You should phone your GP or specialist to discuss this as well.
NHS Scotland will be directly contacting people with these conditions to provide further advice.
This may be anxious time for people considered extremely vulnerable and you will have questions and concerns. Plans are being made to make sure you can rely on a wide range of help and support.
What is shielding?
Shielding is a measure to protect extremely vulnerable people from coming into contact with coronavirus, by minimising all interaction between them and others.
Those who are extremely vulnerable should:
- not leave their homes
- minimise all non-essential contact with other members of their household
This is to protect those who are at very high risk of severe illness from coronavirus (COVID-19) from coming into contact with the virus.
If you have one of the conditions listed and have not yet received a letter regarding shielding, then please contact your GP to confirm that you should be shielding and to arrange for registration with the support service. If you have received a letter from NHS Scotland, you’re strongly advised to shield yourself to reduce your chance of getting coronavirus (COVID-19).
You should also follow these face-to-face distancing measures:
- Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19) – these symptoms include high temperature and/or new and continuous cough
- Don’t leave your house
- Don’t attend any gatherings – this includes gatherings of friends and families in private spaces for example family homes, weddings and religious services
- Don’t go out for shopping, leisure or travel and, when arranging food or medication deliveries, these should be left at the door to minimise contact
- Keep in touch using remote technology such as phone, internet, and social media
- Use telephone or online services to contact your GP or other essential services – if you require an ambulance, call 999 and tell the call handler you’re following shielding measures because of an underlying health condition
We know that stopping these activities will be difficult. You should try to identify ways of staying in touch with others and participating in your normal activities from your home. However, you must not participate in alternative activities if they involve any contact with other people.
This advice will be in place for at least the next 12 weeks.
Can’t get an isolation note
You need to contact your employer if you require to shield from COVID-19 due to underlying conditions but are currently well. Please don’t phone 111 or your GP.
If you received a letter from NHS Scotland saying you have a condition that makes you at very high risk of severe illness from COVID-19 and should be shielding, this letter is evidence for your employer to show that you cannot work outside the home.
What should I do if I have someone else living with me?
The rest of your household aren’t required to adopt shielding measures for themselves. However, they should support you in shielding by following the guidance on social distancing.
Minimise the time other family members spend in shared spaces (such as kitchens, bathrooms and sitting areas) as much as possible and keep shared spaces well ventilated.
You should:
- aim to keep 2 metres (3 steps) away from people you live with and encourage them to sleep in a different bed where possible
- use a separate bathroom from the rest of the household, if you can – if you do share a toilet and bathroom with others, it’s important that they are cleaned after use every time (for example, wiping surfaces you have come into contact with)
- consider drawing up a rota for bathing, with you using the facilities first
- make sure you use separate towels from the other people in your house, both for drying yourself after bathing and for hand hygiene purposes
- avoid using the kitchen while they are present
- take your meals back to your room to eat, if you can
- use a dishwasher (if you have one) to clean and dry the family’s used crockery and cutlery – if you don’t have a dishwasher, wash them using your usual washing up liquid and warm water
- use a separate tea towel for drying crockery and cutlery
It will be difficult for some people to separate themselves from others at home. You should do your best to follow this guidance and everyone in your household should:
- regularly wash their hands
- avoid touching their face
- clean frequently touched surfaces
Handwashing and respiratory hygiene
To help prevent the spread of respiratory viruses like COVID-19, you should:
- wash your hands more often with soap and water for at least 20 seconds, or use a hand sanitiser
- wash your hand when you get home or into work, when you blow your nose, sneeze or cough, eat or handle food
- avoid touching your eyes, nose and mouth with unwashed hands
- avoid close contact with people who have symptoms
- cover your cough or sneeze with a tissue, then throw the tissue in a bin and wash your hands
- clean and disinfect frequently touched objects and surfaces in your home
Everyone should:
- Wash their hands more often
- Stay at home for 7 days if they have a new continuous cough or high temperature
- Stay at home for 14 days if someone in their household has a new continuous cough or high temperature
Help with food and medicines
Discuss your daily needs with carers, family, friends, neighbours or local community groups, to see how they can support you. You can also use online services to arrange food deliveries.
You may receive a letter from NHS Scotland saying you have a condition that makes your risk of severe illness from COVID-19 very high. This letter provides details on how you can register to get help with delivery of groceries and medication.
The government will also be offering support to help you self-isolate, including making sure that you have the food and medication you need – if you don’t have other means of getting these.
You can access this support:
- through a text message service, which is specifically for supporting people who are at higher risk of severe illness from COVID-19
- by phoning your local authority’s shielding support line, which will be able to arrange for food and medicine deliveries, and signpost you to other support services
Text message service
You will have received information about this service in the letter sent to you by the Chief Medical Officer telling you that you’re considered to be in the shielding group.
This service will:
- send you text messages to ask if you need us to arrange a weekly delivery of basic groceries or if you’re running low on medication
- never ask you for financial or other personal information, and the text messages will always come from the same number, which is the one that you originally used to register with the service
- keep you up to date with the latest information for people who are shielding
If you have been told by your GP that you’re in the shielding group, but you haven’t yet received a letter from the Chief Medical Officer, you may find there is a delay of several days before you are able to register for the text message service while your records are being updated.
If you need help arranging groceries or other support while you are waiting to be able to register, you should contact your local authority.
Prescriptions
The Government is helping pharmacies to deliver prescriptions.
Prescriptions will continue to cover the same length of time as usual. If you don’t have your prescriptions collected or delivered, you can arrange this by:
- asking someone who can, to pick up your prescription from the local pharmacy – this is the best option, if possible
- using the text message service
- phoning your local authority’s shielding support line
You may also need to arrange for collection or delivery of hospital specialist medication that’s prescribed to you by your hospital care team.
Health and social care support
If you receive support from health and social care organisations, such as care support through your local authority, this will continue as normal.
Your health or social care provider will be asked to take additional precautions to make sure that you’re protected.
Common questions
What should I do if I develop symptoms of coronavirus (COVID-19)?
If you develop symptoms of COVID-19 (high temperature above 37.8 C and/or new and continuous cough), phone 111. Do this as soon as you get symptoms.
If you’re seriously ill, or in an emergency, phone 999 for an ambulance. Tell the call handler if you or someone you live with has symptoms of COVID-19. Don’t visit the GP, pharmacy, out of hours centre or hospital.
If you need to go to hospital as a result of catching coronavirus, you should prepare a single hospital bag. This should include:
- your emergency contact
- a list of the medications you take, including dose and frequency)
- any information on your planned care appointments
- things you would need for an overnight stay such as snacks, pyjamas, toothbrush and medication
- your advanced care plan, if you have one
What should you do if you have hospital and GP appointments during this period?
You should access medical assistance remotely (not face-to-face), wherever possible.
If you have a scheduled hospital or medical appointment during this time, talk to your GP or clinician to ensure you continue to receive the care you need. Consider whether appointments can be postponed.
What’s the advice for visitors, including those who are providing care for me?
You should let your regular visitors know that you are reducing social contacts and they shouldn’t visit you during this time, unless they are providing essential care for you. Essential care includes things like help with washing, dressing, or preparing meals.
If you receive regular health or social care from an organisation, either through your local authority or paid for by yourself, inform your care providers that you are shielding and agree a plan for continuing your care.
If you receive essential care from friends or family members, speak to your carers about extra precautions they can take to keep you safe.
It’s also a good idea to speak to your carers about what happens if one of them becomes unwell. If you need help with care but you’re not sure who to contact, your local council should be able to help you.
What is the advice for informal carers who provide care for someone who is extremely vulnerable?
If you’re caring for someone who’s vulnerable, there are some simple steps that you can take to protect them. You should follow advice on good hygiene, such as:
- Wash your hands on arrival and often – use soap and water for at least 20 seconds or use hand sanitiser
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- Put used tissues in the bin immediately and wash your hands
- Don’t visit if you’re unwell and make alternative arrangements for their care
- Provide them information on who they should call if they feel unwell (their GP phone number and 111) and how to use NHS inform
- Access advice on creating a contingency plan from Carers UK
- Find out about different sources of support that could be used
- Look after your own well-being and physical health
How do I look after my well-being?
Social isolation, reduction in physical activity, unpredictability and changes in routine can all contribute to increasing stress. Many people including those without existing mental health needs may feel anxious.
If you’re receiving services for your mental health, learning disability or autism and you’re worried about the impact of isolation, contact your keyworker, care coordinator or provider to review your care plan.
If you have additional needs please contact your key worker or care coordinator to develop a safety or crisis plan.
Constantly watching the news can make you feel more worried. If you think it’s affecting you, try to limit the time you spend watching, reading, or listening to media coverage of the outbreak. It may help to only check the news at set times or limiting this to a couple of times a day. Try to focus on the things you can control, such as your behaviour, who you speak to and who you get information from.
You may find your mood and feelings are affected by shielding. You may feel bored, frustrated low or worried and have problems sleeping.
It can be easy to fall into unhealthy patterns of behaviour which in turn can make you feel worse.
There are simple things you can do that may help, to stay mentally and physically active during this time, such as:
- Exercise regularly – look for ideas of exercises you can do at home
- Spend time doing things you enjoy – this might include reading, cooking, other indoor hobbies or listening to/watching favourite radio or TV programmes
- Eat healthy, well-balanced meals
- Drink enough water
- Try to avoid smoking, alcohol and drugs
- Keep your windows open to let in fresh air
- Arrange a space to sit with a nice view, if possible
- Get some natural sunlight if you can or sit on your front step, staying more than 2 metres away from others
- Take vitamin D if you’re not getting enough natural sunlight
If you’re still struggling with your mental health and it’s affecting your daily life, you should phone 111.
What steps can I take to stay connected with family and friends during this time?
Try to stay in touch with those around you over the phone, by post, or online.
Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing. You may find it helpful to talk to them about how you’re feeling.
Remember, it’s okay to share your concerns with others you trust. You may end up providing support to them too.
What is the advice for people living in long-term care facilities, either for the elderly or persons with special needs?
Care providers should carefully discuss shielding with the families, carers and specialist doctors caring for such people to ensure shielding measures are strictly followed.
What is the advice for parents and schools with extremely vulnerable children?
Shielding advice also applies to extremely vulnerable children in mainstream and special schools.
