Following the Prime Minister’s speech announcing changes to various Coronavirus measures and restrictions, the Government have published a detailed new document outlining a lot of detail of how these changes will look and how further changes might be rolled out in the weeks and months ahead. We’d recommend anyone who is able to should read this document as it guides not only Government strategy, but also how we should live our own lives. The latter is, as always, dependent to an extent on the behaviour and guidelines followed by others.
Below we have picked out the key points for vulnerable and shielded people. Very briefly, the practical outcomes of the document can be boiled down to the following:
1. The amount of contact between people is directly linked to the infection rate.
2. Adjustments will be made to contact and infections assessed, to allow changes to be adjusted as we go.
3. Those who are shielding for clinical reasons must continue to do so ‘for some time yet’; those who are over 70 or pregnant no longer need to shield, but need to be careful.
4. Step 1 takes effect this week:
4a. For the foreseeable future, workers who can work from home should continue to do so. Those who cannot work from home should travel to work only if their workplace is safe (placing onus on employers). Children to not go to school, all need to avoid public transport.
4b. Cloth face coverings now recommended where social distancing not possible (e.g. shops or public transport).
4c. You can now meet one person outside your household as long as you are 2m apart, and can exercise with 1 person outside your household, as many times a day as you want.
4d. You can drive to exercise with members of household, no limits on distance.
4e. Arrivals from outside the UK will be self-quarantined for 14 days.
5. Step two will start no sooner than 1st June and depends on infection rate, etc.
5a. Schools – Reception, Year 1 and Year 6 return to school, and Year 10 and Year 12 will get some face to face teaching to supplement their distance learning.
5b. Non-essential retail (not personal care or hospitality which will likely be in Step 3) will reopen in phases.
5c. Cultural and sporting events behind doors for broadcast.
5d. More local public transport.
5e. Social and family contact – potential for two households to share contact to allow childcare or for more social contact, for example.
6. Step three will see remaining businesses reopen.
We’ve picked a few key points out of the document, with the most vulnerable in society particularly in mind:
Protecting the most clinically vulnerable people
Some people have received a letter from the NHS, their clinician or their GP telling them that as a result of having certain medical conditions, they are considered to be clinically extremely vulnerable. Throughout the next period, the Government will need to continue an extensive programme of shielding for this group while the virus continues to circulate. The Government will also have to adjust its protections for other vulnerable locations like prisons and care homes, based on an understanding of the risk. Those in the clinically extremely vulnerable cohort will continue to be advised to shield themselves for some time yet, and the Government recognises the difficulties this brings for those affected. Over the coming weeks, the Government will continue to introduce more support and assistance for these individuals so that they have the help they need as they stay shielded. And the Government will bring in further measures to support those providing the shield – for example, continuing to prioritise care workers for testing and protective equipment.
Self-isolation still vital for those with symptoms
It is vital that those who are showing symptoms, however mild, must continue to self-isolate at home, as now, and that the household quarantine rules continue to apply. However, as the Government increases the availability and speed of swab testing it will be able to confirm more quickly whether suspected cases showing symptoms have COVID-19 or not. This will reduce the period of self-isolation for those who do not have COVID-19 and their household members.
It remains the case that some people are more clinically vulnerable to COVID-19 than others. These include those aged over 70, those with specific chronic pre-existing conditions and pregnant women.26 These clinically vulnerable people should continue to take particular care to minimise contact with others outside their households, but do not need to be shielded.
Those in the clinically extremely vulnerable group are strongly advised to stay at home at all times and avoid any face-to-face contact; this is called ‘shielding’. It means not leaving the house or attending gatherings at all, with very limited exceptions. Annex B sets out more detail on the guidance applicable to different vulnerable groups at this time.
The Government knows people are taking shielding advice seriously and is acutely aware of the huge commitment and resolve it requires to keep away from family and friends. Unfortunately, the current level of transmission of the virus is such that the Government needs to continue to ask that the guidance is followed. In recognition of the challenge faced by those shielding, the Government is:
- Providing essential food to those unable to leave their home. Over one million food boxes have now been delivered in England by wholesalers to those shielding who asked for help with food, with hundreds of thousands more to follow in the coming weeks.27 The Government has also arranged priority access to supermarket deliveries for those who have said they need it.
- Facilitating volunteer support. Up to 200,000 calls a day have been made to the shielded in England to confirm their support needs,28 and councils are helping to support them in other ways – including, in some cases, organising regular calls from volunteers to those isolated. Those who are shielding can also directly request the support of NHS Volunteer Responders.
The Government is also aware that when – in time – other members of society return to aspects of their normal daily lives, the challenge for those being asked to shield may deepen. The Government will continue to review the support needs of those shielding and the Government will continue to provide support to individuals for as long as they need its direct help. Along with the support the Government is providing to those shielding, it will provide vital support for other vulnerable people, such as those at risk of loneliness. The Government is continuing to work to further support these groups, including by providing vital financial support to frontline charities working in these areas. The GOV.UK website provides information about the huge range of support that is available including from local authorities and the voluntary and community sector. The Government will continue to update GOV.UK as new services and support become available.
As the UK recovers, the Government will ensure people with disabilities can have independent lives and are not marginalised. This will include making sure that they can access public services and will consider their needs as the Government creates safe work environments and reopen the transport system. The Government will ensure their overall health outcomes do not suffer disproportionately.
Other Key Points
For the foreseeable future, workers should continue to work from home rather than their normal physical workplace, wherever possible. This will help minimise the number of social contacts across the country and therefore keep transmissions as low as possible. All those who work are contributing taxes that help pay for the healthcare provision on which the UK relies. People who are able to work at home make it possible for people who have to attend workplaces in person to do so while minimising the risk of overcrowding on transport and in public places. All workers who cannot work from home should travel to work if their workplace is open. Sectors of the economy that are allowed to be open should be open, for example this includes food production, construction, manufacturing, logistics, distribution and scientific research in laboratories. The only exceptions to this are those workplaces such as hospitality and nonessential retail which during this first step the Government is requiring to remain closed.
The rate of infection remains too high to allow the reopening of schools for all pupils yet. However, it is important that vulnerable children (including children in need, those with an Education, Health and Care plan and those assessed as otherwise vulnerable by educational providers or local authorities)23 and the children of critical workers are able to attend school, as is currently permitted.
While most journeys to work involve people travelling either by bike, by car or on foot, public transport takes a significant number of people to work across the country, but particularly in urban centres and at peak times. Social distancing guidance on public transport must be followed rigorously. As with workplaces, transport operators should follow appropriate guidance to make their services COVID19 Secure; this will be published this week.
As more people return to work, there will be more movement outside people’s immediate household. This increased mobility means the Government is now advising that people should aim to wear a face-covering in enclosed spaces where social distancing is not always possible and they come into contact with others that they do not normally meet, for example on public transport or in some shops. Homemade cloth face-coverings can help reduce the risk of transmission in some circumstances. Face-coverings are not intended to help the wearer, but to protect against inadvertent transmission of the disease to others if you have it asymptomatically. A face covering is not the same as a facemask such as the surgical masks or respirators used as part of personal protective equipment by healthcare and other workers. These supplies must continue to be reserved for those who need it. Face-coverings should not be used by children under the age of two, or those who may find it difficult to manage them correctly, for example primary age children unassisted, or those with respiratory conditions. It is important to use face coverings properly and wash your hands before putting them on and taking them off.
SAGE advise that the risk of infection outside is significantly lower than inside, so the Government is updating the rules so that, as well as exercise, people can now also spend time outdoors subject to: not meeting up with any more than one person from outside your household; continued compliance with social distancing guidelines to remain two metres (6ft) away from people outside your household. People may exercise outside as many times each day as they wish. For example, this would include angling and tennis. You will still not be able to use areas like playgrounds, outdoor gyms or ticketed outdoor leisure venues, where there is a higher risk of close contact and touching surfaces. You can only exercise with up to one person from outside your household – this means you should not play team sports, except with members of your own household. People may drive to outdoor open spaces irrespective of distance, so long as they respect social distancing guidance while they are there, because this does not involve contact with people outside your household.