Webchat with Dr Jenny Harries, Deputy Chief Medical Officer for England, on shielding children, Wednesday at 9.30am

[BojanaMumsnet]

Hello

We’re pleased to announce a short webchat with Dr Jenny Harries, Deputy Chief Medical Officer for England, at 9.30am tomorrow (Wednesday 8 July) and for half an hour only.

This webchat is aimed at parents of shielded children - apologies for the narrower remit of this webchat, but the aim is to answer questions around this specific policy announcement, and we only have 30 minutes of Dr Harries’ time because of her considerable commitments elsewhere.

On Monday, the government confirmed that the majority of children currently considered extremely clinical vulnerable to Covid-19 will be able to be removed from the shielded patient list.

Children will only be removed from the shielded patient list by their GP or specialist doctor following consultation with the child and their family. Specialists and GPs will be asked to contact children and their families to discuss this over the summer, so families do not need to take any immediate action.

The latest guidance for families is in line with the recommendations from the RCPCH and is as follows:

• A small group of children who receive specialist care in hospitals may need to carry on shielding following a consultation with their doctor. This includes those receiving cancer care or those at risk of severe infection due to an immunodeficiency.
• Most other children who were initially identified as being clinically extremely vulnerable will no longer be considered at highest risk. In particular, children and young people who are cared for just by their GP are very unlikely to need to continue to shield in the long-term. This includes children with conditions such as asthma, diabetes, epilepsy and kidney disease

Jenny Harries was appointed Deputy Chief Medical Officer for England in July 2019, taking on a broad portfolio including the health service and commissioning support. Jenny’s previous roles include: PHE Deputy Medical Director, PHE Executive Lead for specialised commissioning and Welsh National Health and Healthcare Director. Alongside these roles, Jenny has been a member of the Welsh Medicines Committee and the Clinical Priorities Advisory Group. Jenny has an extensive clinical and public health background (BSc (Hons) Pharmacology; MPH; FFPH) and her work has extended overseas as far afield as New Zealand, Pakistan and Kenya. She was awarded an OBE in the 2016 New Year’s Honours List for services to Public Health. She advises the government on its response to coronavirus.

As always, please remember our guidelines - one question per user, follow-ups only if there’s time and most questions have been answered, and please keep it civil. Also if one topic is dominating a thread (other than shielded children, in this case), mods might request that people don't continue to post what's effectively the same question or point. (We may suspend the accounts of anyone who continues after we've posted to ask people to stop, so please take note.) Rest assured we will ALWAYS let the guest know that it's an area of concern to multiple users and will encourage them to engage with those questions.

Many thanks,
MNHQ

@Flynnshine

Hi, I have a nine year old daughter currently on 3rd line chemotherapy for a very stubborn brain tumour. We have been shielding since mid March. Today we have received a letter to say we no longer need to shield as she is not classed as vulnerable. While I am glad I can't help but feel worried that she is still vulnerable due to her low immune system. I would desperately love for her to be able to see her grandparents but is this just too much of a risk right now? Although we don't need to shield should we still take extra precautions over the general population? Thank you in advance.

[from Dr Harries]

Hello @Flynnshine,

Sorry to hear your daughter has had a difficult start to her life.

I am guessing that the letter you have just received is the one which lets people know the shielding advice is being paused for everyone from the 1st August. This is because the programme was designed to support people to reduce their social connections when the virus was circulating strongly in local communities, but in most areas that no longer applies.

While most children are at a low risk of significant illness from Covid-19, some conditions still pose a higher risk and some people may need to continue shielding. Your doctor will be able to advise the best course of action going forward.

I don’t know the exact medical history of your daughter so my advice is that you should discuss this with the hospital specialist treating her when you see them next but most people with significant conditions will stay on the list. If cases should rise again in your local area the NHS will be back in touch with you with new advice.

My general advice for minimising the risk of infection is to keep washing your hands regularly and social distancing whenever you can.

My thanks to Dr Harries for interesting answers

@nether

Are children who are deshielded permanently deshielded? Or is it more a 'pause plus'?

Also, from the other way round, is it safe for a child to be at schools (mixing freely with 240 other DC, who in turn mix with siblings etc) and then return to a house where someone else is shielding, given that isolation within household containing DC doesn't work? (By shielding, I mean exceptionally medically vulnerable, whether actively shielded, or paused)

How can you reinforce the message to the general public that they need to stay 2m away from strangers? We can live with the idea that many shops and attractions need people closer together, and so we cannot go. But finding that parks, pavements and playing fields are becoming no-go areas (when we have only been outside for a few weeks) is grim

Will schools have a duty to provide online education, including full support to all GCSE and A level (and Highers, BTEC etc) options for shielded students if onsite attendance at school becomes too risky this autumn/winter? Who will be advocating for this cohort if they lose even more time in the run up to public exams?

[from Dr Harries]

Hello @nether

We are all really aware how important it is for children to be in school and complete their education.

It is impossible to absolutely guarantee safety for any illness, including Covid - 19. The same sorts of issues often arise for families when it is flu season.

However, we have relaxed the advice for shielding people because we know that the transmission of the virus in most communities is very low. If it rises in a local area in the future - such as Leicester - then we will immediately provide special advice for those in the affected area who are on the Shielded Patient List.

Your school and the Department for Education will be best placed to advise on your question about online lessons and future exams. However all schools have been prepared to be Covid safe including early testing if necessary and access to support and advice from specialists in infectious diseases at the Public Health England Local Health Protection Teams. This means schools should be able to operate safely and children can return knowing that any infectious disease risk is being continually monitored.

@Oaksideboard

My DC is shielding due to a life-limiting condition. Pre-Covid 19, my DC didn't go to school if there were infectious diseases present (other than coughs/colds) in the class or surrounding classes due to being hospitalised with even minor illnesses. Winter, September to May, is normally a very difficult time for my DC, and DC's attendance is very low due to illness.

Therefore, how can I send my DC and sibling to school in September with confidence that my shielded DC won't get ill?

[from Dr Harries]

Hello @Oaksideboard

We have relaxed the shielding advice because we know the transmission of the virus in most communities is very low and the risk to children of developing serious illness is also low. This is new evidence from UK and internationally based on studies on schools and children needing to attend hospitals

You should always speak to your GP or hospital specialist if you have any particular concerns but given how important it is for children to be in school and complete their education it is a really good idea to make sure you have had a look at the science. There is a good guide explaining this which parents can access here.

@CGB1

What happens when a Mother is considered extremely clinical vulnerable to Covid-19 & has been shielding since March & possibly has to send 3 kids back to School in September - I am waiting for a Double Lung Transplant!!! Nothing has been said about this! What do I do??

Hello @CGB1,

As I don’t know your exact medical history, you should always discuss any specific details with your GP or hospital specialist who are best placed to offer advice next time you see them. However, the shielding programme was designed to advise people to reduce their social interactions when the level of transmission of the disease in the community was high. The advice has changed because for most people this is no longer the case and on average, you – or your children – are unlikely to meet the virus. Should this change again in your local area and rates rise, the NHS will let you know and issue specific advice for your area.

Most children are at a low risk of significant illness from Covid-19 and general transmission in the community is very low and schools are also being very carefully monitored so if there are any issues at your children’s school they will be advised by the local Health Protection teams and any necessary action will be put in place.

But we must remain alert and regularly wash our hands and social distance where possible to minimise the risk of infection – if your kids do this at home as well as at school, they will be keeping you safe.

@nevergooogle

Hi Dr Harries, My 15 year old son is shielding due to an acute flare up of inflammatory bowel disease and high dose steroid treatment. Tomorrow we meet with the consultants to discuss moving on to biological infusion treatment (Infliximab) which is an immunosuppressant. This is a long term treatment option for him but I'm assuming he will be immunosuppressant and extremely vulnerable until a vaccine is created? How will this even work? We are unable to shield him within the house (one bathroom, tiny house) is he likely to be off school until a vaccine is found? (GCSE's next year) And what about his 2 siblings? Are they to also forgo their education to protect their brothers life? Can I continue to work in my healthcare job?

What is the plan long term for those who continue to be on the extremely vulnerable list. Particularly those transitioning to adult services over the next few months?

[from Dr Harries]

Hello @nevergooogle

Sorry to hear about your son’s condition.

Although you have noted he will be on long-term treatment, the shielding advice applies when the level of virus in the community is high and there is a strong possibility of infection. That is not the case at the moment so, on average, the risk of your son or his siblings getting ill are very low and so none of them should be missing their education. Not all patient on biological treatments will need to shield but as I don’t have his full medical history, you should speak to his hospital specialist who will be best placed to advise next time you see him/her.

While evidence shows young people are at a low risk of becoming seriously ill from Covid-19, certain conditions increase that risk and your doctor may advise your son to stay on the shielding patient list

The transmission of the virus in the community continues to fall and our advice is that people no longer need to shield from 1 August but the NHS will update you again if rates rise in your local area

Of course, we should all continue to take precautions to minimise the risk of the virus by washing our hands regularly and follow social distancing guidelines and that will best protect both you in your workplace and him from infection with Covid-19 but also any other illnesses such as flu. He will probably be eligible for flu vaccination too so that is something you should make sure he has.

Thanks @iVampire

We're going to close this thread again now - thanks to all for your questions, and we hope it was useful.