AIBU To Be Genuinely Confused About UK "Shielding Letter"

[DamnYankee]

In US. Very curious about this shielding letter I keep hearing about.
People who get them but don't want them...People who want them but can't get them?
Are they sent from your GP's or specialists?
Since we're hearing obesity is a factor...
They can't be issuing those as well?

I had one from GP and one from hospital consultant. They said exactly the same thing. Of course I'd much rather not received any letter but I understand I am very high risk so I'm staying at home.

They're for people who are particularly at risk, say those who are immunosuppressed after an organ transplant.

They're not routinely issued to people who are obese or pregnant or have angina for example. They're quite selective.

The upside is meant to be that you get priority for home meal delivery services from supermarkets. You may also get someone from the local council ringing up asking if you want some unspecified support.

The downside is that you can not go back to work or send your kids to nursery even if you want to. You're expected to stay away from literally everyone.

In my experience, it's more of a hindrance than a benefit.

It's a letter sent by the health service advising you to stay inside for at least 12 weeks as you are considered to be very high risk of serious complications or death from the virus.

It's only a suggestion rather than a law, and people can ignore it. But the letter lays out the best way for you to stay safe.

Some people don't like the level of restriction the letter calls for, or don't believe their condition leaves them as at-risk as the letter says - but it's fairly strict criteria.

I was sent one, as was my OH. I'm fine with following it but OH is a little less happy but is doing it because he doesn't want to risk my health.

Being on "the list" entitles you to some extra help, such as a weekly free food parcel, and priority access to supermarket delivery slots. Slots are hard to come by as suddenly everyone is ordering online and there isn't enough capacity for everyone.

Some people want to be on the list as they feel their personal risk is too high for them, but are unable to get food delivered. Some don't want to be on it as they don't believe the risk to themselves isn't that high. Everyone on the list was diagnosed with a serious health condition or has been placed on there by their GP.

www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/at-risk-patient-letter-march-2020.pdf

We got one on Tuesday for DH. He is reasonably fit and well, no medication, doesn't get offered a flu jab etc.
I have heart disease, am obese, and am a key worker, and have been working almost triple my normal hours since lockdown began, with zero ppe. I didn't get one, and I still have to go to work as if I don't, we have no income. It's mad quite frankly.

Heart disease doesn’t qualify you for shielding though.

OP - some employers need to see these letters eg you can be placed on furlough if you are shielding. They can also help people access certain food supplies / food boxes.

I threw mine in the bin 🤷🏻‍♀️

I don’t think I’m being particularly reckless, I take a relatively low dose of immunosuppressants and have never taken any precautions re: illnesses before other than having the flu jab as recommended.

My husband is an essential worker and we have two young children and I most certainly will not be staying at least two metres away from them during this as it would be very upsetting for them. The advice in the letter is ridiculously impractical but it has made me feel more stressed than I would otherwise have been.

Oh and it’s still impossible to get supermarket deliveries.

I understand your confusion OP. I share it.

The UK government shielding list excludes some of those at the very highest risk. One of the highest death rates is in people with type 2 diabetes. Not on the list. Likewise hypertension and cardiovascular conditions.

By creating this list the government risks creating false reassurance in those not on it but who are in reality at very high risk. It's dangerous and irresponsible.

The irony is they've included people taking immunosuppressants. It's early days so clearly I urge continued caution in all those with autoimmune diseases. But there's growing evidence that immunosuppressants, whilst potentially increasing your risk of catching it, might play a protective role. Some of the drugs being trialled to treat Covid are immunosuppressants.

It was also known the highest mortality rates were amongst those with diabetes, hypertension, and cardiovascular issues (and severe lung and kidney conditions) before the government created the list.

So I've no idea why they came up with the list that they did. It's good they're protecting some like cancer patients and organ transplant recipients who are clearly vulnerable, but to exclude most of those at the very highest risk seems wrong.

There are two tiers of risk, shielding are people who are extremely vulnerable to complications from Covid 19 and the second list is people who are more vulnerable than average. A BMI of over 40 puts you into the vulnerable but not shielding group.

I got a shielding letter, it came from the Scottish government and I'm assuming they got the details from health records. I then got a phone call from my GP practice a few days later saying I had been put on it in error.

I'm diabetic and also really alarmed at the death rates and have no idea how truly vulnerable I am.

How are they managing vulnerable people in the USA?

Each state is giving its own advice and setting its own guidelines. In my state the advice is the same for everyone - stay home as much as you can. Supermarkets don’t deliver where we are. We are 23 miles from the nearest small supermarket and 75 miles from the nearest town with the usual chain shops and restaurants, etc. So nothing gets delivered here. My husband has cancer. I work from home. I go out once a week to make the almost 50-mile round trip journey to the nearest supermarket. The rest of the time we are at home or go for walks along the beach. Masks are recommended when out and about but we don’t wear them as we never see anyone. We were in isolation before isolation became a thing.

I got mine from the Rheumatology Department at my hospital, along with a covering letter from them about why I have received it.

The shielding is completely unworkable if you live in a normal house. It's a case of shut yourself away from the world, it's madness.

If anyone who hasn't received one wants one, you are welcome to mine.

My 4 year old received one; he’s well and healthy; but did have an admission for a night for a viral wheeze in January, and a couple of admissions when he was 2 also. The doctors at the time didn’t think it was too serious, didn’t think it necessarily meant he had asthma, and didn’t think in balancing risk he needed to be on preventative inhaler (I’ve now liaised with another doctor and he’s on one; mainly due to the coronavirus threat).

The letter wasn’t tailored to a child (ie advised he should stay in a different room of the house than us?!). We’re still going on bike rides with the children as it makes a massive difference to be able to burn off their energy, his strength and confidence, and I see it as a low risk activity as never go close to people.

I’m nervous whether he may not be ‘allowed’ to go to school if it opens in September. We have to balance risks; I don’t want him getting coronavirus, but there is also the risk of his mental development (he is shy and prone to tears) of him missing reception class.

@Ninjava you have to register on gov.uk to be added to the priority supermarket lists www.gov.uk/coronavirus-extremely-vulnerable And answer ‘no’ you do not have a way of getting essential supplies delivered.

We had one for ds and although we are being careful about social distancing we are not shielding him. It's a personal decision and any benefits of it for him are outweighed by the disadvantages. He is more at risk for hospital admission forthe mental distress of never going out than he is of covid. Ds's letter came in the later batch of GP letters and is for a condition that makes him more vulnerable but is not a shielding condition.

To add we are not using any of the advantages that go with it.

BovvyDazz my son is currently in school.

I don't get why some people resent the letters going out. It was an early attempt to warn those most likely to be at risk. It helped people have access to online deliveries and included a food parcel.

And some other things I think though I didn't have one (Because while I am vulnerable it's not immediately obvious from the records)

Of course it didn't include everyone at risk. They didn't conduct personal interviews and weigh people. They are now trying to add others to the list, but there isn't a master list of all people vulnerable to work from.

Ninjava you know you can call the supermarkets and get put on their list for access? I don't know if you need any kind of code from the letter.

there isn't a master list of all people vulnerable to work from.

Exactly. There are all sorts of branches of the NHS including GP's practices, trying to create lists of people who are particularly at risk if they got Corona-virus, warn them and offer them help to safely self isolate if they need it, as right now it's actually the only answer we have.
Inevitably there are some people who got added who actually don't need to be, and others who do need to shield who aren't yet on it.

As you can see on the Gov. form that's linked to above the list of main conditions you can self register under seem quite random to most.

There are also other non self registering systems that allow for other conditions.
The aim is to try and give the 'known to be truly vulnerable' as good a chance as possible if they want it, and if they need it, then help to safely shield themselves.

There really is a very big difference for some, between getting this virus and other illnesses.

It's obvious I think why people with severe asthma are on it.
Perhaps less obvious why certain types of lung condition but not others etc.

If you've had a letter or get a call and you think it's an overreaction, please ask your Dr to review why. They may tell you it's fine.

It seems really random. My friend has one for mild asthma

I have a friend with asthma who received a shielding letter, and yet a relative with both asthma and Type 2 diabetes is not. I believe it’s to do with the medication you take.

I have one. I have Addison’s disease, moderate asthma, anaemia, a microprolactinoma (tiny harmless pituitary tumour, had it my whole life) and I suffer with recurrent urine infections for which I take daily long term antibiotics. It’s the steroids I take for my Addisons and asthma and the antibiotics that have put me into the shielding category I think.

The letter is advisory. It isn’t legally binding.
It’s helpful if you usually work as you can give it to your employer as it says you shouldn’t work outside the home. But everything else is “shouldn’t” or “should”. It’s up to you if you follow it or not.

I live very rurally so still go out on daily walks. I don’t see anyone and even if I did there is so much space I could easily avoid someone. I have a child with special needs who needs to get out. I can’t stay inside non stop, it’s not good for my child, my physical health or mental health.

If I lived somewhere busier I might feel differently.

Sadly I now know four people who've died and one who's been severely ill but survived, as well as a few who think they've had it without it being a particularly big deal.

Two of those who died, had no known health issues, two had health conditions but lived normal working lives. Severely ill survivor - fit elderly.

One of those who died had no virus symptoms prior to needing help.

They became confused one night and a slightly higher temperature.
An ambulance was called because a normally fine person had become suddenly disorientated and extremely confused.
They developed breathing problems on way to hospital and where admitted.
Successfully treated and normality resuming within a week. One week on discharge was organised for the morning. They died overnight.

Death was caused by their underlying condition reacting to the damage done by the virus. I'm in no way a Dr, but I think that's why some specific conditions are listed.

I should add I am very confident I have already had Covid 19 - didn’t have a test as didn’t go to hospital but Gp and 111 but so confident they have flagged me as having had it. I was very unwell for 2.5 weeks at the start of March with it and only now really starting to feel “normal” again.

Letters are still arriving for some people btw.