Information for patients who are or were shielding

The latest advice for those shielding or recently told they no longer need to shield.

Information on return to school for children previously, but no longer, shielding

FAQS

I have received a letter from NHS England to tell me that my child should be shielding but now I have been told by my consultant and team that this advice no longer applies to my child. Why has this changed?

  • At the beginning of the COVID-19 pandemic, there was very little knowledge about the groups most at risk of developing severe COVID-19 disease as it is a new virus. Several thousand children and young people were advised to shield because their pre-existing conditions were thought to put them at higher risk of severe illness from COVID-19. The experts based this on knowledge of other respiratory viruses such as the ‘flu viruses.
  • The good news is that we now have a lot more evidence, knowledge and experience of the impact of COVID-19 infection on children and young people, with and without pre-existing conditions, and the number of children that need to continue shielding is much smaller than we originally thought. 
  • The majority of children with conditions including asthma, diabetes, epilepsy, and kidney disease and some rare diseases such as tuberous sclerosis are NOT at greater risk of severe complications from COVID-19.

Is it safe for my child to return to school if they were previously shielding but my consultant/team have advised that they no longer have to?

It is SAFE to send your child back to SCHOOL in September 2020.

This is because of the new knowledge that we now have on Covid-19:

  • Far fewer confirmed cases of COVID-19 disease in children than adults:
    • Children make up 1 - 5% of total case numbers in the world of all COVID-19 cases (i.e. for every 100 people infected with COVID-19, there are 95 – 99 adults and only 1 – 5 children)
  • UK and International research tell us that COVID-19 is generally milder in children than in adults
    •  Infected children have mild or no symptoms at all
    • Very few (1% i.e. 1 in 100 of children infected with COVID-19) develop severe or life-threatening disease
    • Unlike adults, deaths in children due to COVID-19 have been extremely rare: mortality has been consistent at around 0.01% (i.e. 1 in 10 000) children of those infected with COVID-19
  • According to Professor Russell Viner, president of the Royal College of Paediatrics and Child Health, data from a research study in the UK shows “there is very little evidence” of coronavirus transmission where pupils have returned to school. Prof Viner said that “The risks to children from Covid are very low and the risks of school closures we know are very serious”.
  • Advice from the RCPCH: https://www.rcpch.ac.uk/resources/covid-19-shielding-guidance-children-young-people
  • Advice from the UK Chief Medical Officers: https://www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-schools-and-childcare-reopening

Why is it important to send children back to school?

Sending children back to school is very important for many reasons:

  • Schools play a key role in promoting children’s health, as well as their social and mental wellbeing.
  • Schools also provide the setting from which children can access
  • We know that keeping children isolated and unnecessarily away from school and other activities:
    • causes harm not only to their mental health but also
    • has a significant negative impact on their long-term prospects which in turn can also
    • affect their long term physical health

What happens if there is a local lockdown?

  • If your child is no longer on the shielding list, there is no need to shield if there is a local lockdown.

Should my child receive the flu jab that the school is offering?

Most children** can be given the intranasal live flu vaccine which is planned as part of the 2020/2021 flu vaccination programme for the following groups:

  • children aged two or three years old (on 31 August 2020)
  • all primary school-aged children
  • all year 7 secondary school-aged children
  • children with a health condition that puts them at greater risk from flu (most children who were previously advised to shield during Covid-19 pandemic)
  • children who are and/or live with someone who is on the NHS Shielded List

** Children who are immunosuppressed due to their illness or medication should NOT have the live intranasal vaccine. Instead, your child may need the intramuscular inactive injection.

If in doubt, please contact your team who will be able to advise further on which vaccine your child should be given.

Sources of further information and help

We know this is a difficult time and you, your child and your family may be struggling to cope with your daily activities or accessing essentials. If this is the case, please get in touch with the local council who is working with the voluntary sector and others, to support you and your family.  Government advice on Employment and financial support is available at https://www.gov.uk/coronavirus.   

You might also find the following sources of information useful:

You can contact your clinical team if you wish to discuss the advice on shielding or returning to school or which flu vaccine your child should receive.

Information on return to school for children on shielding list

**Please remember that any specific advice that your child’s clinical team has given should be followed especially for the early period after transplant or chemotherapy. If in doubt, contact your clinical team to clarify**

FAQS

My child has been identified as clinically extremely vulnerable and does not fall into the recent transplant/chemotherapy group. Should we still be shielding?

Shielding is currently “PAUSED” – this means that those on Shielded Patient List (SPL)

(unless advised by your clinical team)

  • do not need to follow previous shielding advice
  • can go to work as long as the workplace is COVID-secure, but should carry on working from home wherever possible
  • should attend education settings in line with the wider guidance on reopening of schools and guidance for full opening: special schools and other specialist settings
  • can go outside as much as you like but you should still try to keep your overall social interactions low
  • can visit businesses, such as supermarkets, pubs and shops, while keeping 2 metres away from others wherever possible or 1 metre, plus other precautions
  • should continue to wash your hands carefully and more frequently than usual and that you maintain thorough cleaning of frequently touched areas in your home and/or workspace
  • will no longer receive free food parcels, medicine deliveries and basic care from the National Shielding Service

When should my child shield again?

  • If advised by your clinical team (in cases of recent transplants or chemotherapy)
  • If there is a local lockdown in the area where you currently live
  • To find out if an area is in lockdown visit the government website

Should my child return to school if they are still on the shielding list? Why is it safe now?

  • At the beginning of the COVID-19 pandemic, there was very little knowledge about the groups most at risk of developing severe COVID-19 disease as it is a new virus. Several thousand children and young people were advised to shield because their pre-existing conditions were thought to put them at higher risk of severe illness from COVID-19. The experts based this on knowledge of other respiratory viruses such as the ‘flu viruses.
  • The good news is that we now have a lot more evidence, knowledge and experience of the impact of COVID-19 infection on children and young people, with and without pre-existing conditions, and the number of children that need to continue shielding is much smaller than we originally thought. 

It is SAFE to send your child back to SCHOOL in September 2020.

This is because of the new knowledge that we have now on Covid-19:

  • Far fewer confirmed cases of COVID-19 disease in children than adults:
    • Children make up 1 - 5% of total case numbers in the world of all COVID-19 cases (i.e. for every 100 people infected with COVID-19, there are 95 – 99 adults and only 1 – 5 children)
  • UK and International research tell us that COVID-19 is generally milder in children than in adults
    •  Infected children have mild or no symptoms at all
    • Very few (1% i.e. 1 in 100 of children infected with COVID-19) develop severe or life-threatening disease
    • Unlike adults, deaths in children due to COVID-19 have been extremely rare: mortality has been consistent at around 0.01% (i.e. 1 in 10 000) children of those infected with COVID-19
  • According to Professor Russell Viner, president of the Royal College of Paediatrics and Child Health, data from a research study in the UK shows “there is very little evidence” of coronavirus transmission where pupils have returned to school. Prof Viner said that “The risks to children from COVID are very low and the risks of school closures we know are very serious”.

Why is it important to send children back to school?

Sending children back to is very important for many reasons:

  • Schools play a key role in promoting children’s health, social and mental wellbeing.
  • Schools provide the setting from which children
    • can access health surveillance
    • support and advice and
    • individual and group therapeutic programmes.
  • We know that keeping children isolated and unnecessarily away from school and other activities causes harm not only to their mental health but also has a significant negative impact on their long-term prospects which in turn can also affect their physical health in adult life with more illnesses.

Does my child need a flu jab and which one should my child receive?

For children on the shielding list, influenza can be even more risky than Covid-19 and should receive the flu vaccine unless otherwise advised by their clinical team (e.g. if your child has just received heavy immunosuppression, this may not be appropriate)

  • Most children who remain on the shielding list should have the inactive Flu vaccine (i.e. the one given by intramuscular injection) and NOT the live intranasal flu vaccine which is being offered at school.
  • Everyone in the household i.e. all those that live in the same house or have close contact with your child should also receive the flu vaccine by injection.

If in doubt, please contact our team who will be able to advise further on which vaccine your child should be given.

Sources of further information and advice:

We know this is a difficult time and you, your child and your family may be struggling to cope with your daily activities or accessing essentials. If this is the case, please get in touch with your local council who is working with the voluntary sector and others, to support you and your family. 

You might also find the following sources of information useful:

You can contact your clinical team at BCH if you wish to discuss the advice on shielding or returning to school or which flu vaccine your child should receive.