Coronavirus > Coronavirus information and support > Shielding: advice for very high-risk groups

Shielding

**Phase 3 updates to Scottish Government shielding advice**

‘Shielding’ advice is for people who are at very high risk of severe illness from coronavirus and have been advised to self-isolate.

While the number of people catching and spreading coronavirus is lower than it had been, it is not yet known the full impact of coming out of lockdown for the general population. For the highest risk groups however, shielding is working to protect them and the evidence shows that it is still important for these people to continue to follow shielding advice.

The Scottish Government is advising people to continue to shield until at least 31st July. However, there have been some important changes to the current guidance. Please note that these changes do not apply to those living in care homes.

Other changes to shielding guidance are expected before 31st July. For more information on these proposed changes and when you can expect them – as long as infection rates stay low – see the Scottish Government Shielding Route Map.

Previous changes to the guidance for those shielding included being able to:

  • go outside as much as you like for as long as you like, following strict physical distancing and washing your hands for at least 20 seconds when you get back home.
  • take part in non-contact outdoor activities such as golfing, fishing and hiking

As well as the changes above, from the 10th of July people who are shielding:

  • no longer have to physically distance from others in their household
  • can use the toilet in other people’s houses when visiting them outdoors
  • can meet up outside with 2 other households in one day, up to a total of 8 people
  • can travel as far as they want from home
  • can book self-catering accommodation or travel to a second home, but must only stay with people from their household
  • can form an ‘extended household’ if they live alone or with children under 18, with one other household.

Other guidance remains the same, for example, avoiding shops and public transport.

For more information on shielding, what you can and can’t do and how to keep safe, visit the Scottish Government website

Going outside again and meeting others

For some people being able to go outside and meet with others will be good news. For others, it may feel frightening or strange after being inside for so long. Some people may decide they do not want to go out yet. Everyone will be different. It is important to remember however that the risk of catching the virus outdoors when staying apart from others is very low.

Getting outside, doing some exercise and seeing others also has lots of benefits for your physical and mental health. These include better sleep, building your muscles and fitness levels and reducing stress and feelings of loneliness.

Further changes to shielding advice may be announced before the 31st July.

Does shielding apply to me?

The advice applies to people who have particular high-risk health conditions and who need to take extra steps to protect themselves. It also applies to their family, friends and carers.

You can find the full list of these health conditions on the NHS Inform website. Further detail on some of these conditions can also be found on the Scottish Government website. Very high-risk chest and heart conditions are also listed below.

Please note that experts are working very hard to provide the most accurate information on who is most at risk of coronavirus. Other chest and heart conditions may be considered very high-risk and will be added to the list when this information becomes available.

Very high-risk chest conditions

You are considered to be at very high-risk if you fall into any of the following categories:

  • You have any type of cystic fibrosis
  • You have asthma that has required hospital admission or steroid medication
  • You have COPD and any of the following apply:
    • You have severe or very severe airflow obstruction, as measured using a spirometry test. This is sometimes referred to as GOLD grade 3 (severe) or GOLD grade 4 (very severe).
    • Your breathlessness limits what you are able to do and you cannot walk as fast as other people your age. The is sometimes referred to as an MRC breathlessness score of 3, 4 or 5.
    • You have had 2 or more flare-ups or exacerbations in the past year needing emergency treatment
    • You have been admitted to hospital in the past because of an acute attack due to your COPD
    • You take prednisolone (steroid tablets) to treat you condition
    • You use non-invasive ventilation at home (a mask connected to a ventilator to help you breath at night)
    • You are on home oxygen therapy
  • If you are having chemotherapy or radiotherapy for lung cancer or mesothelioma or meet any of the criteria listed under COPD, above
  • If you have bronchiectasis and use nebulised treatments or meet any of the criteria listed under COPD, above
  • If you have interstitial lung disease of any type, including pulmonary fibrosis and sarcoidosis.

You are also considered very high-risk if you have more than one long-term health condition. This includes people with a long-term chest condition for which you receive treatment AND have diabetes or heart disease.

Very high-risk heart conditions

You are considered to be at very high-risk if you fall into either of the following categories:

  • You are pregnant and have significant heart disease of any kind
  • You have ever had a transplant of any sort, at any time

There are a number of other heart conditions that, while not considered very high-risk, still put you at higher risk of complications from coronavirus. If you have one of these, shielding measures do not apply to you but it is vitally important that you strictly follow the current social distancing guidance.

More information about what these heart conditions are is available on our coronavirus heart page.

How will I be contacted if I am considered very high-risk?

If you have one of the serious health conditions listed on the NHS Inform website, NHS Scotland will have contacted you directly. This could be via letter, text or phone. If you have been contacted, you will be strongly advised to stay at home (‘self-isolate’) from the date you are contacted. NHS Scotland will tell you what you need to do and who to contact if you need help.

How do I self-isolate safely at home?

If you are contacted, you should take steps to self-isolate.

What do people I live with need to do?

If you live with family or friends, they do not need to follow the same shielding advice as you. However, it is very important that they follow the Scottish Government on the rules as we come out of lockdown and on physical distancing.

They should also take further steps to help reduce your risk by strictly following the advice on the NHS Inform website.

How do I get food and medicines, and get to my medical appointments?

If you do not have someone who can help deliver food and medicines to you (keeping a safe distance from them at all times), NHS Scotland will tell you how you can arrange the support you need to stay at home safely. You can also find information on shielding support contacts on the Scottish Government website.

If you have any GP or hospital appointments planned, talk to your GP or hospital doctor about what you should do.

What do I do if I become unwell at home?

If you develop symptoms of coronavirus while you are staying at home, call 111 or your GP as soon as you get symptoms. Tell them that you are in the shielding group. Do not go to your GP, pharmacy or hospital. If you are seriously ill and it is a medical emergency, call 999.

I think shielding applies to me but I have not been contacted. What should I do?

NHS Scotland will directly contact people they believe should be shielding. If you think this advice applies to you but you haven’t been contacted, you should contact your GP or hospital doctor by phone or online. It is safest to stay at home and follow the shielding guidance until you are clear about whether shielding applies to you.

Support and advice about shielding

You can read more about the coronavirus shielding measures on the NHS Inform website.

If you have any questions about this new advice, call our Advice Line nurses on 0808 801 0899, email adviceline@chss.org.uk or text NURSE to 66777.

Source of information on very high-risk conditions: British Lung Foundation and British Heart Foundation, developed in consultation with medical experts and guidance from the Department of Health and Social Care.