Coronavirus: Vulnerable patients told they can still go to work or school

More than two million people in England who are at extreme risk from coronavirus can still go to work or school despite the rising tide of infections, the government has said in a move labelled as “ludicrous” by one charity.

In new advice published for the 2.2 million patients who were told to shield themselves indoors during the first wave of the pandemic, the government has said those at risk can still go to work or school if they cannot work from home – even in areas where the local Covid alert level has been set at “very high”.

It comes as the latest data shows there were 17,234 lab-confirmed cases of coronavirus in the UK in the last 24 hours with 143 more people having died with the virus.

In total 3,905 patients are in hospital in England, up from 2,783 a week ago, with 441 patients in intensive care, up from 349 a week ago.

Ministers have shied away from reactivating formal shielding just yet amid concerns people may have to remain in isolation for months during winter.

In some of the areas hardest hit by coronavirus, patients on the original shielding list may be asked to take stricter measures and to protect themselves indoors but for a shorter period and only at the request of chief medical officer Chris Whitty and the agreement of health ministers.

The advice has angered some charities who accused the government of making vulnerable people choose between their health and their finances.

Gemma Peters, chief executive of Blood Cancer UK, said: “It is completely unacceptable that even in areas where the alert level is very high, the government expects people with blood cancer who cannot work from home to carry on travelling into work.

“It is a ludicrous situation where the government guidance is telling people with blood cancer to stay away from shops because they’re too dangerous, and in the same breath that it is fine for them to spend many hours in shops if they happen to work in them. In the same areas people with blood cancer are being told to avoid all but essential travel, the government is saying it is fine for them to continue working in busy places like cafes, restaurants and schools.”

She added the offer of statutory sick pay would not be enough to support a family, meaning some people may have to choose between their health and their finances. She called on the government to urgently reconsider its guidance.

Phillip Anderson from the MS Society added: "The prime minister told us yesterday that Covid-19 is once again ‘spreading among the elderly and vulnerable’. Yet today, the new shielding guidance doesn’t amount to a plan to protect the millions of people particularly vulnerable to Covid-19. Instead, it simply confirms there isn’t one.

“Where cases are so high that people who can’t do their job at home would be advised to avoid work, the government’s only response to the massive financial concerns this would raise is that they ‘may’ be eligible for some benefits. Vulnerable people deserve to know they will be supported through this crisis.”

Shielding was paused for most patients in August after being brought in at the start of the pandemic to protect those people thought to be most at risk from Covid-19 because of their underlying health conditions.

It includes people who have suppressed immune systems as a result of transplants, cancer and other diseases as well as those with lung conditions such as cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease.

Health officials believe measures such as the wearing of masks in shops and public transport and the rule of six mean those at greater risk are more protected than they were in March and April.

There are also concerns that asking people to formally shield with no end in sight during winter could significantly exacerbate mental health problems and loneliness among the shielding patients.

Deputy chief medical officer Dr Jenny Harries said: “Over the last few weeks, we’ve seen a sharp increase in the prevalence of the virus across the country and we know those who are clinically extremely vulnerable are looking for practical advice on how they can carry on their lives while the virus remains in our communities.

“The new system will provide clarity on how best those in this group can keep themselves as safe as possible depending on the rates of transmission in their local area. Whilst advisory, I would urge all those affected to follow the guidance wherever they can and to continue to access health services for their medical conditions.

“We will continue to monitor the evidence closely and fine-tune this approach to make sure everyone in this group is clear about the safest way to go about their daily lives, particularly over the coming winter months.”

The advice, which is on top of the rule of six and other general restrictions includes:

The Department of Health and Social Care said where people living in exceptionally high risk areas are asked to adopt formal shielding measures, support packages will again be available and they may also be eligible for statutory sick pay or employment and support allowance.

The DHSC said shielding advice will not automatically be triggered by an area going into “very high” alert level and will only happen with the agreement of ministers.  

People in those areas will receive specific written advice.

Dr Yvonne Doyle, director of health protection at Public Health England added: “People who are defined as clinically extremely vulnerable are at very high risk of severe illness from Covid-19. If you are in this group, we recommend that you follow the advice to help protect yourself at each alert level as set out in the guidance.

“In addition to the rules you must follow at each alert level, you can take additional precautions. Continue to maintain strict social distancing, wash your hands regularly and try to keep the number of social interactions that you have low. The fewer social interactions you have, the lower your risk of catching Covid-19.”