The end date for shielding has been extended by more than a month with the medically at-risk told to stay at home until March 31, leaked emails suggest.
And the list of people who should stay at home to shield themselves from the coronavirus is being expanded by at least 1.7million in England after being identified by a new algorithm that looks at multiple Covid risk factors.
Almost a year after the epidemic started in Britain health chiefs are now considering urging more people to protect themselves and to do so for longer than anticipated, the Health Service Journal reports.
The date appears to pour cold water on hopes that lockdown rules could start to be eased next month, suggesting medics don’t think society will be safe.
This is despite the Covid vaccine rollout steaming ahead, with millions of people in the ‘clinically extremely vulnerable’ group immunised already – they were one of the top four priority groups targeted before February 15.
People who are shielding are advised not to leave their homes at any time, except for brief exercise or medical appointments, because they are at high risk of severe Covid-19 if they catch the coronavirus.
The Department of Health said it was expanding the shielding list after the Government’s scientific advisers identified additional adults at serious risk of Covid-19 using a new algorithm.
The DoH did not say who would be added, but the new list is said to go beyond looking only at people’s health conditions and to include other Covid risk factors including their age, weight, ethnicity and level of deprivation.
Of the 1.7million new shielders, 900,000 have already been vaccinated because their age or underlying health conditions has already made them eligible.
But health chiefs are now racing to vaccinate the 800,000 who were missed during the first wave of vaccinations. They will be targeted before the end of April.
People on the shielding list were among the first in line for Covid vaccines in the UK. (Pictured: Glasgow resident John Loch, 69, receives his jab at the NHS Louisa Jordan Hospital on February 10)
The additional 1.7 million will bring the number of people on the list to almost four million – all of whom are being advised to shield until March 31.
Dr Jenny Harries, deputy chief medical officer for England, said the new shielders will receive the additional support available to those deemed to be clinically extremely vulnerable, including medicine deliveries, priority slots for supermarkets and statutory sick pay.
Dr Harries told a briefing today: ‘We have a new, evidence-based, data-driven, predictive risk model which allows us to identify adults with multiple risk factors that make them more vulnerable to Covid-19.
‘We can now identify additional people and help protect them now and in the future.
‘All of these people who are identified for the first time are those who have not had an individual clinical condition that we’ve previously been able to identify through the clinically extremely vulnerable group, but they are people who have multiple personal risk factors and underlying health conditions which move them into a higher risk group.’
Originally 2.2 million people in England were on the list, many of whom were identified for a single reason.
These included obvious vulnerabilities, including having life-threatening conditions such cancer, taking immunosuppression drugs or suffering from genetic disorders.
But as the pandemic has progressed scientists have found that a slew of other factors that, when combined, can put people at risk of dying from Covid – including being overweight, living in deprived areas or taking certain medications.
Oxford University scientists used a new algorithm to analyse a combination of risk factors based on patients’ medical records.
They highlighted a further 1.7million more people who were at risk, which will bring the number on the shielding list to almost four million.
WHO WAS ON THE ORIGINAL SHIELDING LIST?
People who are considered ‘clinically extremely vulnerable’ should all have received an official letter warning them that they are on the shielding list and should stay at home unless necessary.
People on the shielding list include:
Organ transplant recipients;People having chemotherapy for cancer;Lung cancer patients receiving radical radiotherapy;People with blood or bone marrow cancer such as leukaemia;Cancer patients receiving immunotherapy or other therapies that affect the immune system;Bone marrow or stem cell transplant recipients who had the procedure during the last six months or are still taking immunosuppressant drugs;People with debilitating lung conditions including cystic fibrosis, bad asthma or severe COPD;Those with rare condition that increase the risk of infection, such as homozygous sickle cell disease;Patients having immunosuppressant therapies that raise infection risk;Pregnant women with significant heart disease;Others who have been individually judged extremely vulnerable by doctors;Adults with Down’s syndrome;People with stage 5 kidney disease.
The move is not thought to affect the devolved nations, which set their own shielding lists.
Dr Harries added: ‘As we learn more about Covid-19, we’re continuously reviewing the evidence… it was very clear that not all of those individuals who were at risk were identified by the binary approach.
‘The model that is used combines a number of underlying risk factors. And those factors include specific health conditions, and some treatments which, for example, put your immune system at risk.
‘Age, which is the highest risk factor, sex, ethnicity, body mass index and your postcode, which will also link to a deprivation score.
‘It provides a weighted cumulative risk of serious outcomes from Covid-19, and therefore allows us to prioritise these individuals for vaccination, and to give them appropriate advice.
‘And the easiest way for us to do that is to include them on the shielded patient list.’
Dr Harries said the approach was ‘risk averse’ to ‘protect as many people as possible’.
‘The letter will note that this is more likely to be an overestimate of risk in a way which hopefully handles any of their anxiety,’ she said.
‘And it makes it absolutely clear that it is a choice for them if they choose to follow shielding advice or not – that has always been the case.
‘What it does also do – which I hope will benefit them, which is why people will hopefully be grateful to receive this – is it will prioritise them for vaccination.
‘In addition to that it means they have advice and support and that is important not just now, but should there be any changes in the pandemic in forthcoming months – for example, perhaps in vaccinations perhaps in the autumn as we go forward, then clearly they will be identified within that group as well so there are current and longer term benefits.’
It comes as the Government’s leading vaccine experts met today to thrash out which groups will be prioritised when the top nine groups have been inoculated by April.
The Joint Committee on Vaccination and Immunisation (JCVI) is expected to urge ministers to vaccinate people by age and ethnicity rather than their job.
Members are said to be particularly concerned about mortality rates among South Asians, who studies have shown are twice as likely to succumb to the virus as their white peers.
Both Boris Johnson and Matt Hancock have previously said teachers, police officers, shop owners and other key workers could be bumped up the priority list once the top groups have been jabbed.
But JCVI sources said last night prioritising people based on their occupation would ‘create too much complication’ and ‘risk slowing the roll-out down’.
Officials have until now been focusing on vaccinating the top four vulnerable groups — everyone over the age of 70, NHS staff, care home residents and workers, and extremely ill adults.
Yesterday NHS England officially moved onto the second stage of the vaccine drive, inviting over-65s and ‘clinically vulnerable’ younger people. The programme will aim to give everyone over the age of 50 their first dose by the end of April.
NHS England boss Sir Simon Stevens yesterday vowed to double the number of jabs being given in order for the Government to hit that target. It could see up to 1million doses dished out each day.
The Labour party and workers’ unions have been campaigning for weeks for the Government to prioritise people based on their jobs once the top groups have been jabbed.
London mayor Sadiq Khan told the Radio 4 Today Programme this morning: ‘The next phase should include those occupations where…you’re more likely to catch the virus with adverse consequences’.
Ministers have not yet laid out how the jabs will be prioritised once the top nine groups have been jabbed, which includes roughly 32million people.
They are expected to receive recommendations from the JCVI by the end of this week.
A source on the committee told The Telegraph: ‘One of the main factors behind the success of the rollout so far has been the simplicity of the prioritisation rules because it has been based largely on age.
‘Once you make things more complicated, you run the risk of slowing things down. You create more telephone calls for surgeries to make, while people are bashing on the door demanding a vaccine because they think it’s their turn.’
On whether ethnic minorities should be considered, they added: ‘The mortality figures for people from South Asian backgrounds are particularly worrying. Once we get down to those in their 50s, we want to be reaching out especially to these ethnic minority groups.’