“DHSC Clinically Extremely Vulnerable” – Sajid Javid’s latest advice about “you know what”

Yesterday, I received a letter (which I reproduce below, in FULL, except for the personal bits at the beginning) from The Rt Hon Sajid Javid MP Secretary of State for Health and Social Care.

I thought folk will be interested in my thoughts following reading the letter (refer to my Covid-19 – an historical review from this blogger’s perspective e-book for thoughts on Corona related matters). I may send this to Mr Javid by way of reply, although I doubt it will make a blind bit of difference – maybe posting this on my blog and social media will help to wake up some and encourage others who are already awake as to what is going on …

1. What a load of sanctimonious, patronising fear mongering BS sir
2. Stop being grumpy JB – should we not be grateful that Mr Javid cares about us vulnerable old dears?
3. “Clinically extremely vulnerable” – milk it man for what it’s worth, but then how much is it worth?
4. Now I understand better why project fear has had such a big affect on so many old dears
5. Much of the letter was about the jab (the way back to normality?) – but then imho the jab is bad!
6. I wasn’t aware there was a shielding program to end
7. Just to let you know sir, I am doing the opposite to your “keep safe” advice – read my ebook
8. All this NHS help – and all I wanted was to talk face to face with my doctor and go from there
9. Old people die because they are old, succumb to all sorts of illnesses, not because of Covid
10. You still don’t know anything (significant) about the “threat”.

Have a nice day

JB

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I am writing to you because you were previously identified as clinically extremely vulnerable to COVID-19. This means you were thought to be at high risk of becoming very ill if you caught the virus and may have been advised to shield in the past.

The Government wrote to you in March to tell you that shielding advice was being paused from 1st April 2021. Since 19th July 2021, you have been advised to follow the same guidance as everyone else, whilst potentially thinking about extra precautions you could take to reduce your chance of catching COVID-19.

Now that vaccination has been offered to all of the adult population, including those previously identified as clinically extremely vulnerable, and other treatments and care pathways are available, I believe it is the right time to end the shielding programme. This means that given the current situation you will not be advised to shield in the future and we will not be providing specific national guidance for you to follow.

You should continue to follow the same general guidance as everyone else, which can be found at https://www.gov.uk/coronavirus, in addition to any condition specific advice you may have been given by your specialist in recent weeks. As someone with a health condition you might also want to think about extra things you can do to keep yourself and others safe. This could include:

considering whether you and those you are meeting have been vaccinated – you might want to wait until 14 days after everyone’s second dose of a COVID-19 vaccine before being in close contact with othersconsidering continuing to practise social distancing if that feels right for you and your friendsasking friends and family to take a rapid lateral flow antigen test before visiting youasking home visitors to wear face coveringsavoiding crowded spaces

At the start of the pandemic we knew very little about the threat posed by COVID-19 and made the difficult decision to advise people we considered to be clinically extremely vulnerable to shield to protect themselves from the virus. That was the right decision at the time and helped keep the most vulnerable safe whilst we learnt more about COVID-19.

I know shielding advice is restrictive and that it may affect both mental and physical wellbeing. It is therefore important that we get the balance right between protecting vulnerable people and helping everyone get back to a normal life.

Although cases have gone up, there has not been the same increase in people becoming seriously ill and needing to go to hospital or dying. This is mostly because the vaccination programme has been so successful. Being vaccinated is the best way to protect yourself and other people. Vaccines are very effective at stopping people from getting seriously ill from COVID-19 so I would strongly encourage you to get all recommended doses of the vaccine.

All Government decisions on shielding advice have been led by the latest scientific evidence and advice has been kept up to date. Now that the risk of becoming very ill is lower, I believe the time is right to end the shielding programme and recommend people with underlying health conditions return to their usual personal care patterns.

COVID-19 vaccines

Although most people will be well protected by the vaccine, no vaccine is 100% effective. In particular, people who are immunosuppressed may not respond as well to COVID-19 vaccines as others. That is why the Joint Committee on Vaccination and Immunisation (JCVI) advised on 1st September that people over the age of 12 who were severely immunosuppressed at or around the time of their first or second dose, should be offered a third dose of the vaccine to increase their chances of being protected against COVID-19 as part of their primary immunisation course. This advice might apply to you if you have a condition or take medication that affects your immune system but not everyone receiving this letter will be eligible for a third dose. More detail on who it applies to can be found here: https://www.gov.uk/government/publications/third-primary-covid-19-vaccine-dose-for-people-who-are-immunosuppressed-jcvi-advice.

All COVID-19 vaccines should offer some protection so even if you have a condition or take medication that affects your immune system, you should still have the vaccine. The vaccine programme remains open and available for all those who are eligible. If you can’t have the vaccine for whatever reason, or if you are immunosuppressed, you should strongly consider taking the precautions listed at the start of this letter to help keep yourself and others safe.

Separately, the JCVI has published advice on the vaccine booster programme which can be found here: (https://www.gov.uk/government/publications/jcvi-statement-september-2021-covid-19-booster-vaccine-programme-for-winter-2021-to-2022/jcvi-statement-regarding-a-covid-19-booster-vaccine-programme-for-winter-2021-to-2022). It recommends that “individuals who received vaccination in Phase 1 of the COVID-19 vaccination programme (priority groups 1 to 9) should be offered a third dose COVID-19 booster vaccine. This includes:

those living in residential care homes for older adultsall adults aged 50 years or overfrontline health and social care workersall those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe COVID-19 (as set out in the green book: (https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a), and adult carersadult household contacts (aged 16 or over) of immunosuppressed individuals”

You will be invited to book your vaccine by the NHS at least 6 months after your second dose if it is recommended for you.

I understand you may have concerns, and everyone will feel differently about their own risk, particularly those who may be less well protected by the vaccine.

If you are immunosuppressed and have any concerns about what this means for you, then please raise this with your specialist at your next routine appointment. They can provide you with support and guidance on any extra measures you can take to further reduce your risk of infection. Your GP is unlikely to be able to advise you on shielding issues as this requires specialist knowledge, so I would suggest not contacting them with queries about the shielding list. GPs are still open for general medical issues.

If you have not yet been vaccinated with your first or second dose then I would urge you to do so, and if you are eligible, to take the offer of a booster when it is your turn, to help keep you well.

Other treatments

Over the coming months we expect new treatments for COVID-19 to become available. When this happens, we will advise which patients could benefit.

It is really important that if you do a test because you have COVID-19 symptoms, you accurately enter your NHS Number and postcode into the Government website (found here https://test-for-coronavirus.service.gov.uk/register-home-test) so that your test result can be matched to your health records. Doing this will mean the NHS can contact you if you might benefit from a treatment.

Access to NHS Services

It is important that you continue to receive the care and support you need to help you stay safe and well. You should continue to get medical help from the NHS and other health providers for your existing health conditions and any new health concerns. You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health professional through an online consultation. To find out more visit https://www.nhs.uk/health-at-home, or download the NHS App. If you have an urgent medical need, you can access support and local services online at NHS 111 online (https://111.nhs.uk/), or call NHS 111 for free if you cannot use the internet. For a medical emergency, dial 999.

Mental Health Support

It is also really important to look after your mental health. You can access the Every Mind Matters website (https://www.nhs.uk/every-mind-matters) for advice and practical steps that you can take to support your wellbeing and manage your mental health. You can also access the Hub of Hope (https://www.hubofhope.co.uk) which tells you about support available in your area by entering your postcode.

If you or someone you care for is experiencing a mental health crisis, I urge you to make contact with a local health professional immediately. If you don’t have a health professional that you talk to regularly about your mental health, free NHS 24/7 crisis hotlines are available in every part of the country. You can find your local service at: https://www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline or by searching ‘NHS crisis lines’.

Your local council may also run support networks or hubs, and there might be charities in your area that can provide you with any extra help you need. Your local council’s website will have more information about this.

As restrictions ease, many people will still feel lonely and isolated so it will be more important than ever to take action if you or someone you know is feeling lonely. Please visit https://letstalkloneliness.co.uk/ to access advice and support.

NHS Volunteer Responders are also available to help with things like collecting shopping, medication, or other essential supplies, and with transport to medical appointments. They can also provide a regular, friendly phone call. More information is available at https://www.nhsvolunteerresponders.org.uk, or you can call 0808 196 3646 between 8am and 8pm.

Other Support

I know that the COVID-19 pandemic may have had a significant impact on many aspects of your life, particularly when you were advised to shield. If you are struggling financially, or with returning to work, there are a range of services that may be useful depending on eligibility.

Access to Work can offer practical support to people who have a health condition that affects the way they work. The scheme can offer support, including mental health support for people returning to work after a period of furlough or shielding, and travel-to-work support for those who may no longer be able to safely travel by public transport. For more information, please visit: https://www.gov.uk/access-to-work.

If you are struggling financially, you may also be eligible to apply for Universal Credit or Employment Support Allowance. For more information on benefits, please visit: https://www.gov.uk/financial-help-disabled.

Supermarkets stopped providing priority access to supermarket slots to clinically extremely vulnerable people on the advice of government on 21st June. Different supermarkets may have their own policies on priority access to supermarket slots, however.

Your local council may also be able to help if you are in need of support. You can find your local council here: https://www.gov.uk/find-local-council.

You can also find advice published by ACAS and developed in conjunction with the flexible working task-force on hybrid working here: https://www.acas.org.uk/hybrid-working.

Your Data

During periods of shielding, you may have registered your details with the National Shielding Service System to get support; this has now ended. The privacy notice for this service has now been updated in line with the decision to end the shielding programme. If you’d like to find out more about your personal data, please see the updated privacy notice here: https://www.gov.uk/coronavirus-shielding-support.

NHS Digital maintains clinical records of patients and their treatments in accordance with all appropriate data governance requirements. For more information about how NHS Digital uses your personal data, please see their Transparency Notice here: https://digital.nhs.uk/coronavirus/shielded-patient-list/shielded-patient-list-transparency-notice.

I know that the pandemic has been a difficult time for everyone and recognise that it has been particularly hard if you have been advised to take extra precautions. The decision to include you as part of what was the clinically extremely vulnerable group was made to help keep you safe, based on the information that we had at the time. I thank you for your efforts to keep yourself and others safe.