What is shielding?

In the UK we are all being asked to follow the government’s social distancing guidelines. This means avoiding contact with people as much as possible.   

People are also being asked to self-isolate (stay at home) if they or someone they live with has symptoms of coronavirus. 

Some people are more at risk of becoming seriously unwell if they get coronavirus (COVID-19). These people are being asked to follow ‘shielding’ measures.

Doctors sometimes call this being ‘at highest clinical risk’ or being ‘extremely vulnerable’. The government has asked these people to stay at home at all times and avoid all face to face contact as much as possible, for at least 12 weeks. 

Who is considered extremely vulnerable?

For people with cancer, this includes:

  • people having chemotherapy
  • people having immunotherapy or other continuing antibody treatments for cancer
  • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
  • people having intensive (radical) radiotherapy for lung cancer
  • people who have had a bone marrow or stem cell transplant in the last six months, or who are still taking immunosuppression drugs
  • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment.

Non-cancer conditions that are considered vulnerable include people with severe respiratory illnesses like asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD).

For detail on other conditions that are considered vulnerable visit the GOV.UK website

How will I know if I am extremely vulnerable?

If you are in the group of people who are at risk of being seriously ill if you get coronavirus (COVID-19), the NHS will contact you directly. This will be by letter or by text message.

The letter or text will tell you what you should do to keep yourself and others safe. There is also information about the support available for people who are shielding.

If you have been contacted and you have any questions or concerns about your situation or what shielding might mean for you, you can contact your GP or hospital team.

I think I am at highest clinical risk, but I have not received a letter

Most people that are in the highest clinical risk group have already received a letter by post. But hospital doctors and GPs are still identifying some people that should be in this group.

If you are worried you should have received a letter and you have not been contacted, you should speak to your healthcare team.

I have received a letter to say I am at highest clinical risk, but I think this is incorrect

If you have any questions about the letter you have received, you should speak to your GP or healthcare team. In the meantime, we suggest you follow the guidance on shielding unless you are told otherwise by a healthcare professional. 

I have been told that I am not at highest clinical risk, but I still want to be in the shielding group. What should I do?

If you still wish to follow shielding guidance, this is a personal decision.

However, shielding can be challenging to cope with for a long period of time, so it is only being recommended for people who are extremely vulnerable. And the NHS can only provide a food and medicine delivery service to people in the extremely vulnerable group.

The NHS suggests that people who are not in the shielding group but who are in the ‘broader vulnerable group’ follow strict social distancing measures instead. This group of people includes people who are:

  • over 70
  • under 70 with an underlying health condition (for adults this usually means anyone advised to get a flu jab each year on medical grounds)
  • seriously overweight (a BMI of 40 or above)
  • pregnant.

I am not registered with a GP or a hospital specialist. Who will contact me if I am in the highest clinical risk group?

The NHS is trying to identify everyone who should be on the highest clinical risk list. But it is difficult to get in touch with people who are not registered with a GP or a hospital service. The NHS is working with the voluntary sector (charities) and local community groups to get support to people who might need it. 

Are people who are having targeted therapies for lung cancer classed in the same way (highest clinical risk) as people having immunotherapy?

Both these groups of people are considered to be at highest clinical risk from coronavirus (COVID 19). Anyone in these groups should stay at home and avoid face to face contact for 12 weeks and follow the advice on shielding.

Are people with secondary lung cancer who are not currently having treatment at highest clinical risk?

People with secondary cancer in the lungs may be more vulnerable to the effects of coronavirus (COVID-19). Whether this affects you will depend on the type of cancer you have and the treatment you have had. If you have not received a letter identifying you as being at higher clinical risk, contact your healthcare team. They know your situation and will be able to give you the best advice.

In the meantime, you should follow the guidance on shielding.

I have received a letter to say that I am at highest risk and have to shield. What happens if I become very unwell with COVID-19?

 If you become ill with coronavirus or any other illness, please contact your GP or hospital team. If you are admitted to hospital, your doctors will discuss a  plan of care with you. This plan is based on how unwell you are, the type of cancer you have, the treatment you have had in the past and the aim of treatment now. Your doctors will consider what is important to you and how treatment may affect you. Being in the shielding group will not stop you from having any treatment that your doctors feel is necessary. 

What does shielding involve?

If you are in this group of people you should strictly follow the shielding guidance outlined in the letter:

  • Strictly avoid contact with someone who is showing symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or a new and continuous cough.
  • Do not leave your house. If you have a medical appointment in this time, contact your hospital team before your appointment to see if you need to attend the hospital or if there are other arrangements.
  • Do not attend any gatherings. This includes meeting with friends and families in private spaces for example family homes, weddings and religious services.
  • Do not go out for shopping, leisure or travel. When arranging food or medication deliveries, these should be left at the door to minimise contact.
  • Keep in touch using the phone, internet and social media.
  • Use the telephone or internet to contact your GP or other essential services.

You can read more about the government’s advice about shielding.

If you have received a letter advising you to follow shielding guidelines, you should register with the government’s website.

This will help you get support with things like getting food or medicines delivered. Even if you do not need any support with daily tasks, please register with this website as it shows that you have received your letter. If you have not received a letter but think that you should have, you can register yourself. 

If you are shielding and have signs of an infection

If you have cancer or are having a treatment that affects your immune system and you experience any signs of infection including COVID-19 symptoms, you should get urgent medical advice.

You should contact:

  • the chemotherapy care line
  • the Acute Oncology Service at your treating hospital
  • or whatever number you were given by your team in the event of an urgent query.

If I am shielding can I go outside into my garden?

The government guidance suggests that you spend time with windows open to let in fresh air. It suggests arranging your living space so you can get some natural sunlight and see a nice view if possible. If you are sitting in a private space, like a garden or on your doorstep, you should keep at least 2 metres between you and your neighbours and other household members.

I live with other people. Do I need to stay away from them?

If you live with other people, you still need to try and stay away from them as much as possible. Try to:

  • Reduce the time spent in shared spaces like the kitchen, bathroom and sitting areas
  • Keep shared spaces well aired
  • Aim to keep 2 metres (3 steps) away from others and encourage them to sleep in a different bed if possible
  • Use a separate bathroom from the rest of the household. If this is not possible, clean the bathroom after every use
  • Avoid using the kitchen when other people are there, take meals to your room if possible and make sure all kitchenware is thoroughly cleaned.

What support is available to people who are shielding?

Many people who are shielding (staying at home and avoiding all face to face contact) will have family and friends who can help. For example, people who can do shopping and collect medicines and deliver these to the front door of the person who is shielding.

But some people will not have anyone to support them. Local councils are working with the voluntary sector and other organisations to support people during this time. Your local council’s website will have information and advice about support in your area.

If you are shielding you should register with the government’s website. This will help you get support such as food packages, medicine deliveries and other care you might need.

Even if you feel you don’t need this kind of support it is important to register as it shows that you have received your letter.

In England you can also call 0808 196 3646 if you are shielding and you need help collecting shopping, medication or other essential supplies. This is a direct line to the NHS volunteer responders scheme. Lines are open 8am-8pm.

Looking after your mental well-being

Shielding can have an impact on your mental health. You might be feeling anxious, isolated and lonely and find that your mood goes up and down. This is perfectly understandable. It is really important to take care of your mental well-being as well as your physical well-being.

Create a routine

Creating a daily routine can help you feel more in control. Try sticking to your regular daily routine. Waking up at your regular time, getting ready for the day, and going to bed at the same time as you usually would can help bring some normality to your day.

Keep in touch

Keeping in touch with people can help you feel less isolated even if you can’t be in the same room. Use the phone and social media to help you keep in touch. There are video conferencing sites that you can use so you can see people.

Stay active and eat healthily

Eating regularly and healthily ad staying active really helps our mood and energy levels. We know it’s not easy when you’re at home and getting certain food is more difficult.

We have detailed information about eating healthy and staying active while you’re isolating at home.

Take up a new hobby

It’s really important to keep yourself occupied. As well as your favourite hobbies, you might want to take up something new. Cooking, reading, online learning, puzzles, knitting, drawing, there are lots of things you could do from home.

Get help

Ask for support if you need it. Speak to your friends and family over the phone or on social media. You can also call the Macmillan Support Line or reach out to people on our Online Community.

There are also some great sources of support and information online that can help:

The Government also has guidance on looking after your mental health.

I am considered extremely vulnerable, but I don’t want to shield. Do I have to?

The shielding guidance will make a big difference to how you will live your life for this period of time. Some people may feel that they do not want to follow the guidance. For example, if you have been advised that you only have a limited time to live, you may not want to follow the strict shielding guidance.  

It is your choice whether you follow it or not. The NHS is asking that you discuss your situation with your healthcare team before you make a decision about what to do.

If, after discussing it with your healthcare team, you still decide not to follow the shielding guidance, it is important that you still follow the Government’s guidance for social distancing.

Am I entitled to statutory sick pay while I am shielding?

The government has set up measures to support people who are not able to work during the current situation.

We have information about financial help and coronavirus.

I have had a telephone call from the National shielding helpline. How do I know this is not a scam?

While you are at home shielding, a government support service may contact you. This could be by letter, email or telephone. The team is calling to understand your support needs:

  • They will always identify themselves with their name and say that they are representing the National shielding helpline.
  • The number they are calling from will show on your phone as 0333 30 50 466
  • The person calling will ask you to confirm details like your name and NHS number. This is to make sure they are speaking to the right person.
  • You will never be asked for bank details or your National Insurance number.

As well as the National shielding helpline, your local council may also be in touch with you.

I have received a letter for a family member or loved one who has died. Why have I received this letter?

Unfortunately, a small number of letters have been sent to people who have sadly died. This is understandably very upsetting. For more information about this you can visit the NHS website.

Macmillan Telephone Buddies

Going through cancer can be an isolating experience at any time, and especially when social distancing. Our free Telephone Buddy service is here for you. We'll match you with someone who understands what you're going through, and they'll give you a weekly call.

More information and registration

How we are supporting people with cancer

How we are helping

Coronavirus is having a huge impact on people living with cancer. From introducing new support services, delivered over the phone or online, to our nurses being redeployed to the areas of greatest need within the NHS, we are doing all we can to meet the growing demand on our services.

  • To keep everyone safe, we have stopped all our face-to-face volunteering. But if you need someone to talk to, you can sign up for our new Telephone Buddies service.
  • We can't run our Mobile Information and Support buses at the moment, so we've created a virtual version. You can now email our Mobile Information and Support staff. They can provide information about local services and support.
  • You can now make a virtual appointment with our No7 Boots Macmillan Beauty Advisors. They can give make-up and skincare advice to help you manage visible side effects of cancer treatment.
  • To help you stay fit and healthy during the coronavirus crisis, we've launched SafeFit. This is a free remote service that connects you with a cancer exercise specialist.

How you can help

Cancer nurses need urgent support

We need to be there for people living with cancer. But we can't do it alone. Your support has never mattered more. Find out more about how we're supporting people during the coronavirus outbreak, and how you can help us be there.

Read more about how we are supporting people with cancer

How we can help

Macmillan Cancer Support Line
The Macmillan Support Line offers confidential support to people living with cancer and their loved ones. If you need to talk, we'll listen.
0808 808 00 00
7 days a week, 8am - 8pm
Email us
Get in touch via this form
Chat online
7 days a week, 8am - 8pm
Online Community
An anonymous network of people affected by cancer which is free to join. Share experiences, ask questions and talk to people who understand.
Help in your area
What's going on near you? Find out about support groups, where to get information and how to get involved with Macmillan where you live.