Coronavirus and clinically extremely vulnerable people in England: 11 October to 16 October 2021

• Most people previously considered to be clinically extremely vulnerable (CEV) to coronavirus (COVID-19) were continuing to take precautions to protect themselves; 22% reported continuing to shield and 68% were no longer shielding but were taking extra precautions.

• The average life satisfaction scores of CEV people were statistically significantly lower for those continuing to shield (6.3 out of 10), compared with those not shielding but taking precautions (7.2) and those not shielding and not taking extra precautions (7.5).

• The majority (94%) of CEV people had left home in the last seven days, a statistically significantly higher proportion compared with previous waves (90%, 21 to 26 June 2021 and 89%, 17 to 22 May 2021, when the shielding guidance had paused but not yet ended).

• A statistically significantly higher proportion of CEV people reported feeling lonely often or always, compared with the general adult population of England (10% and 6% respectively).

Statistician's comment

Tim Gibbs, Head of the Public Service Analysis Team, said:

“Though shielding has ended in England, many clinically extremely vulnerable people have continued to take precautions against COVID-19, with almost one quarter still shielding. This has had an impact on their mental health and well-being, with one in ten reported feeling lonely often or always. I want to thank everyone who has taken part in this survey in helping us to monitor the attitudes and behaviours of the vulnerable."

In England, 3.7 million people had previously been identified as being clinically extremely vulnerable (CEV) to coronavirus (COVID-19). For more information on identifying CEV people, guidance for clinically extremely vulnerable people, and collecting the data, see the Glossary and Measuring the data sections.

The data reported in this bulletin were collected during a time in which CEV people were not advised to shield and the shielding programme had ended. Care should be taken when comparing wave seven estimates with other waves; data for waves one to three were collected when CEV people were advised to shield. Data for waves four to six were collected when shielding had paused and CEV people were advised to take extra precautions. CEV people are referred to throughout this bulletin; for wave seven this refers to adults previously considered to be CEV.

Of all CEV people, the majority (89%) were aware that the government shielding guidance for those that are CEV has now ended. Approximately 1 in 5 (22%) reported they were continuing to follow the previous shielding guidance. The majority (68%) of CEV people reported they were no longer shielding but were taking extra precautions. A small proportion of CEV people reported they were not shielding or taking any extra precautions (9%).

The majority of CEV people had left their home in the last seven days (94%). This was statistically significantly higher than previous waves (90%, 21 to 26 June 2021 and 89%, 17 to 22 May 2021). Of those who left home in the last seven days, common reasons included going to the shops or pharmacy (79%) and for exercise (58%).

The average life satisfaction scores of clinically extremely vulnerable (CEV) people were statistically significantly lower in those continuing to shield (6.3 out of 10), compared with those not shielding but taking precautions (7.2) and those not shielding and not taking extra precautions (7.5). Average life satisfaction for the general adult population of England was 7.0. For more information, please see Coronavirus and the social impacts on Great Britain: 22 October 2021. Well-being questions were not asked to those responding by proxy on behalf of someone else.

Similar to findings from the previous wave (21 to 26 June 2021), a statistically significant higher proportion of CEV people reported feeling lonely often or always, compared with the general adult population of England (10% and 6% respectively). For more information, please see Coronavirus and the social impacts on Great Britain: 22 October 2021.

Clinically extremely vulnerable

People who were identified as clinically extremely vulnerable (CEV) were considered to be at very high risk of severe illness from the coronavirus (COVID-19). Up to 16 February 2021, CEV people were identified either because of a pre-existing condition or based on the clinical judgement of their clinician or GP that they were at higher risk of serious illness if they caught COVID-19.

From 16 February 2021, individuals were still identified as CEV by these routes, but also by the COVID-19 population risk assessment. The NHS identified approximately 2.2 million people as being CEV by clinical condition or clinician's review. A further 1.5 million people were advised to shield through the COVID-19 population risk assessment.

From 15 September 2021, the shielding programme ended in England. People who were previously considered CEV were advised they should follow the national guidance on staying safe and preventing the spread of COVID-19 and may want to consider advice from a health professional on whether additional precautions are right.

More information can be found in Coronavirus Shielded Patient List Summary Totals and Guidance on shielding and protecting people who are CEV from COVID-19.

Shielding

From 1 April 2021, the advice to shield paused and from 15 September 2021 the shielding programme ended. Shielding was a voluntary action in which the individual stays in their home or garden as much as possible, except for leaving their household to attend essential medical appointments or for exercise. Guidance during the most recent period of shielding (January to March 2021) included that CEV people:

• can meet one person outdoors from another household for exercise
• should try to stay two metres away from others within their household, especially if they display symptoms of the coronavirus or have been advised to self-isolate
• can still meet with their support bubble
• should try to access services to minimise the need to leave their home, such as food and prescription delivery services

Precautionary guidance

From 1 April 2021 CEV people were advised to take precautions to minimise the risk of exposure to the virus whilst also adhering to the rules in place for everyone. The extra precautions for CEV people include:

• considering whether they and those they are meeting have been vaccinated; they might want to wait until 14 days after everyone's second dose of a COVID-19 vaccine before being in close contact with others

• considering continuing to practice social distancing if that feels right for them and their friends

• asking friends and family to take a rapid lateral flow antigen test before visiting them

• asking home visitors to wear face coverings

• avoiding crowded spaces

The current guidance can be viewed in Guidance on shielding and protecting people who are CEV from COVID-19.

Survey information

This is the seventh bulletin in this series, with the survey in its current format and using the current data collection methodology. However, it is not directly comparable with wave one and wave two (18 to 30 January 2021 and 22 to 27 February 2021) of this survey because of changes in the shielding population; for more information please see Coronavirus and clinically extremely vulnerable people in England methodology. The data in wave one and wave two reflect only clinically extremely vulnerable (CEV) people identified through a clinical condition or clinician's review.

Estimates for wave seven

The data for wave seven were collected between 11 and 16 October 2021. The sample size was 1,025 CEV people and survey weighting was used to weight the sample estimates to provide estimates for the total population of CEV people. For more information on how the estimates have been produced, please see Coronavirus and clinically extremely vulnerable people in England methodology.

Changes to the shielding guidance

From 1 April 2021, CEV people were issued precautionary guidance and still had to follow the national restrictions in place. From 15 September 2021, the shielding programme ended. Waves one to three were collected when shielding was advised, prior to 1 April 2021; any comparisons between wave three or earlier and wave four, five, six or seven should be made with this in mind. Wave seven was collected following the shielding programme in England ending.

Information on the strengths and limitations of this survey are available in Coronavirus and clinically extremely vulnerable people in England methodology.