Lockdown guidance for care home visits and shielding groups not yet decided by government

'We learnt a lot from last time with the shielding programme - some of the things worked but some of the things did not', Chris Whitty says

Vincent Wood,Peter Stubley
Sunday 01 November 2020 16:42 GMT
Coronavirus in numbers

Care home residents and people with serious health conditions were left in limbo over the second lockdown in England after the government failed to issue updated guidance.

During the UK’s first coronavirus lockdown, millions of people classed as clinically extremely vulnerable were told to stay at home and received extra government support such as food deliveries. Visits to care homes were banned as Covid-19 deaths surged in March and only gradually restarted in recent months. 

Announcing a new four-week shutdown on Saturday, Boris Johnson stopped short of implementing formal shielding and said vulnerable people - including the elderly and those with certain medical conditions -  should take "extra precautions". Further guidance on those classed as "extremely clinically vulnerable" will be issued on Monday while advice on care home visits is still being prepared.

While some people classed as vulnerable have welcomed the second lockdown, charities warned that millions who were previously asked to shield need urgent clarity and support and urged the government not to abandon those in care homes.

The Alzheimer's Society warned that increasing numbers of people with dementia faced "giving up on life, not understanding what is going on or why they're not seeing the people they love and experiencing the things they live for."

Fiona Carragher, the charity’s director of research, said: "While it is important to protect the vulnerable with necessary precautions, designated family carers are an integral part of fundamental care and must be allowed to visit care homes.”

Will care home visits be allowed during the second lockdown?

The government says that new guidance on care home visits “will be published ahead of Thursday” but gives no further details on its website.

Instead people are asked to follow existing guidance, which states that decisions should be taken at a local level based on testing of the local community, weekly testing of staff and monthly testing of residents, the location of the home and its preparedness for an outbreak, and the benefits and risks of visits on a particular resident.

Any visits should be restricted to a maximum of two visitors at a time per resident.

For local areas with a high local Covid alert level (Tier 2 high risk or Tier 3 very high risk), visiting should be limited to exceptional circumstances only such as end of life.

If visits are not possible, the care home should “support visiting in a virtual manner”.

Will people be told to shield during the second lockdown?

No, although they are being told to take extra precautions such such as minimising contact with others and working from home.

Prime minister Boris Johnson told the Downing Street press conference on Saturday: "I know how tough shielding was and we will not ask people to shield again in the same way. 

"But we are asking those who are clinically extremely vulnerable to minimise their contact with others and not to go to work if they are unable to work from home."

Why is the shielding programme not being resumed?

Professor Chris Whitty, England’s chief medical officer, said vulnerable people who were shielding during the previous lockdown should continue to take extra care compared to the public at large.

But he added: “We learnt a lot from last time with the shielding programme - some of the things worked but some of the things did not.

“There were both some practical problems, and there was also the issue of people having significant problems with loneliness and feeling completely cut off.

"What we’re trying to do is avoid those downsides to shielding, whilst reinforcing the message that for people who are particularly vulnerable they do need to take even greater precautions than the general public.”

Data suggests that people became less inclined to take heed of the guidance on shielding as time went on following its implementation in March.

According to the Office for National Statistics, of the 2.2 million people asked to shield in the first lockdown, around 58 per cent completely obeyed the guidance between 24 and 30 June - down from 63 per cent at the start of the month.

Who is classed as vulnerable?

Millions more people are now classed as "clinically vulnerable" after the government lowered the age range to 60 and over, down from 70 and over during the first lockdown. The group also includes those under 60 with an underlying health condition including chronic diseases, respiratory diseases like asthma, pregnant and overweight people.

A further group of people are defined as "clinically extremely vulnerable" to coronavirus because of their specific health conditions. They have been advised to work from home. If they cannot work from home they are advised not to go out to work and may be eligible for Statutory Sick Pay (SSP) or Employment Support Allowance (ESA). They should stay at home as much as possible but are encouraged to go outside for exercise.

The government said full guidance for both groups will be published on Monday.

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