As advised in previous statements, the Chief Medical Officer for Wales reviews his advice for those who are shielding on the same 21-day cycle as the review of the lockdown regulations. Since the last review he has modified his advice to allow those who are shielding to be part of an extended household. This decision was taken because of the impacts that loneliness and isolation can have on an individual’s mental health and also to encourage those who have been staying at home for an extended period to come out into an environment where they have been able to discuss and agree in advance how they can be and feel safe.
In his review for the most recent period, the Chief Medical Officer has indicated that, should prevalence of coronavirus continue to fall within our communities, he will be able to pause his advice to those who are shielding. Those who are shielding will no longer need to do so after the 16th August. After this date, those who have been shielding should follow the advice given for the ‘at risk’ group.
The Chief Medical Officer for Wales has made this decision in line with CMOs across the other UK nations; recognising that shielding was put in place to protect those at the most significant risk of harm at a time when prevalence of the coronavirus in our communities was rising. As prevalence in our communities is now falling, that situation has changed. The significant harms associated with continuing to shield are of concern and we are focussed on helping people to make steps toward returning to the lives they lived before the advice to shield was put in place.
There are a number of weeks before the shielding period comes to an end, but it is important that we let people know as soon as we can what the expected advice will be so they can make plans. It may be that they need to prepare for a return to work or school. For those who are receiving food boxes these will remain in place until 16th August. Other support for those shielding such as the volunteer medicine delivery scheme will be available until the end of September and priority shopping slots will continue to be available for the time being.
It is important to note that just as we are planning relaxations, the experiences of other nations and indeed our own management of outbreaks has shown that we do need to be prepared to potentially step advice up again if required. The shielded patients list will remain in place and available should we need to ask anyone to shield again in future. As we move toward the autumn we will seek to refine the way we assess personal risk with the use of a tool currently in development on a four nations basis.
Children and Young people
As we learn more about the effects of COVID 19 and its impacts on those with existing health conditions, Chief Medical Officers across the UK have been keeping under review who they are asking to shield on the basis of clinical vulnerability. The Royal College of Paediatrics and Child Health (RCPCH) has recently published guidance on Shielding for Children and Young people and after consideration, this guidance has been adopted by the Chief Medical Officers of the 4 UK nations.
Taking into consideration new evidence and experience of the disease, the guidance from RCPCH indicates that not all those children and young people who are currently advised to shield need to continue to do so. It also takes account of the relative harms that can be associated with shielding unnecessarily, one of which being the impact of not returning to school.
We are considering how we can adopt this guidance in Wales over the summer.
Not feeling safe is one of the main areas of concern raised with us when we speak with organisations who support those who are shielding. Individuals are often very scared or worried about taking those first steps outdoors. They have not seen changes in supermarkets happen, or witnessed how we are adapting to maintaining a physical distance when out and about. They have not gone to work or school and have been very careful to follow a large set of rules to keep them safe. It is not as simple as just going outside because the Chief Medical Officer has told you it is safe to do so. As a community, we must appreciate that those around us are transitioning back to a normal life and we should support them to do so.
For those of us who have not had to remain at home at all times, the supermarket systems and physical distancing are familiar. We may have started to become complacent as we feel less vulnerable going about our daily lives. But we must remember it is not just ourselves we need to think about. Throughout this pandemic the people of Wales have been brilliant at keeping Wales safe – We have all behaved in a way that directly benefits others, and we have done it willingly. We must ask the welsh public to please stick to the rules and maintain a physical distance to support those around them who may just be getting used to the outdoors.