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CLDF News

Three tier system and guidance for the clinically extremely vulnerable

As you will all be aware, official shielding requirements ended a few months ago. With many national measures now in place that apply to everyone, the clinically extremely vulnerable group is already helped by measures not previously in place when shielding was originally introduced.

With England now moving into a three-tier system, the government have published additional guidance for those in extremely vulnerable groups (or Group A of BSPGHAN guidance) in each tier so that you can take appropriate actions, while retaining as much normality as possible.

Please note: There has been no national re-introduction of shielding at this stage. Furthermore, the guidance below are not compulsory restrictions for those clinically extremely vulnerable but recommendations.

Local COVID alert level: MEDIUM (Tier 1)

This tier applies to the whole of England regarding a 10pm curfew on bars, pubs, restaurants and gatherings of more than six people banned (except weddings and funerals).

Those extremely vulnerable are also advised to:

  • strictly observe social distancing.
  • meet others outside where possible.
  • limit unnecessary journeys on public transport and work from home where possible.

You can still go to work and children should still attend school.

Local COVID alert level – HIGH (Tier 2)

In addition to the other general restrictions in these areas, those extremely vulnerable are advised to:

  • reduce the number of different people met outside.
  • avoid travel except for essential journeys – work from home where possible and reduce the number of shopping trips made or go at quieter times of the day.

You can still go to work if you cannot work from home because all workplaces should be COVID secure. Children should still attend school unless they are one of the very small number of pupils under paediatric care who have been advised by their GP/clinician not to attend an education setting.

Local COVID alert level – VERY HIGH (Tier 3)

In addition to the other general restrictions in these areas, those extremely vulnerable are advised to:

  • work from home
  •  in general stay at home as much as possible and avoid all but essential travel.
  • significantly reduce shopping trips and if possible, use online delivery or ask people in your household, support bubble or volunteers to collect food and medicines.

People in these areas are encouraged to still go outside for exercise and can still go to work if they cannot work from home. Children should still attend school unless they are one of the very small number of pupils under paediatric care who have been advised by their GP/clinician not to attend an education setting.

You can read the full published guidance here.

Formal shielding

Formal shielding will not be automatically triggered by going into the very high alert level. However, those in exceptionally high-risk areas may be advised to adopt this in the future by local public health experts and the Chief Medical Officer.

If this is reintroduced in your area, support packages similar to those in place in March will be available to you.

School/education

All pupils should continue to attend education settings at all local COVID alert levels unless they are one of the very small number of pupils under paediatric care who have been advised by their GP or clinician not to attend an education setting.

Not attending school is only advised if your local area reintroduces formal shielding practices and your child is on the current shielding list.

Scotland, Wales and Northern Ireland

  • Scotland – First Minister, Nicole Sturgeon, says Scotland will look to align closely with measures in England with those measures. More information will be available by the end of October.
  • Wales – Update 19.10.2020: A short two week lockdown will be taking place from 6pm  Friday 23 October until the start of Monday 9 November 2020. Shielding has not yet been reintroduced as part of this. https://gov.wales/coronavirus-circuit-break-frequently-asked-questions
  • Northern Ireland – Update 14.10.2020: Executive tightens restrictions to curb Covid-19 through what is referred to as a circuit breaker. Shielding has not yet been reintroduced as part of this.

Updates from these nations about further guidance for those in the extremely vulnerable category and shielding will be provided as we hear more.

Support

It is more important than ever that you keep a close eye on what is happening in your local area as more and more guidance becomes localised to towns and cities. Details will be available on your local authority’s website.

If you require additional support to follow the guidance, it is advised that you contact your local authority for assistance. You should also contact your/your child’s medical team if you have concerns about an extremely high alert level and can also contact us to discuss your needs at families@childliverdisease.org, youngpeople@childliverdisease.org or by calling 0121 212 3839.

We will update the coronavirus section of our website if there are any further updates provided to us by professionals.


Further links

View the BSPGHAN shielding groups (July 2020) article here: Updated BSPGHAN shielding guidance (Published 07 July 2020)

Any changes to the Local COVID Alert Level of your area will be clearly communicated to you, and further information of the guidance can be found here.

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