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Nearly 2 million more people in England will be asked to shield and 800,000 of those offered priority vaccination as a result of new modelling that has identified adults at higher risk from Covid-19 because of a combination of health factors and their circumstances, including ethnicity and low income.
Until now the NHS identified those most at risk on the basis usually of a single underlying health condition, such as specific cancers, together with age. But a more sophisticated modelling tool developed by the University of Oxford has shown that the shielding list should nearly double, adding 1.7 million people on the basis of multiple risk factors.
Among the issues the model takes into account are ethnicity and postcode, which will give a measure of economic deprivation. There have been higher rates of death among people from black, ethnic minority and Asian communities and also people from poorer neighbourhoods with cramped housing. Body mass index will also be factored in, because obesity is known to increase the risk of severe illness.
All those newly identified will get a letter from their GP suggesting they shield until at least 31 March, which is later than the current date of 21 February. The majority have already been vaccinated, because of their age or a particular health problem. But the rest will now be prioritised as part of the group with underlying health conditions who are being called up.
There are likely to be criticisms that this is long overdue. Shielding began in March last year and there have long been concerns that people particularly vulnerable because of their environment as well as their health were not getting enough protection and help.
About 2 million people are already on the list of those considered “clinically extremely vulnerable” and advised to shield. They include people with certain cancers, and those whose immune systems are suppressed such as people who have had organ transplants and people with severe asthma and cystic fibrosis. They are advised to stay at home full-time and offered services such as delivery of their medicines. Statutory sick pay is available and those who shop for them can get priority at the supermarkets
The new assessment method will not lead to whole groups of people getting higher priority. There has been a lot of concern about people with learning disabilities and those with Down’s syndrome are already on the shielding list. But while more of them may be prioritised, who should shield will depend on other factors also – for instance whether they are living in institutional care.
The new tool, called QCovid, has been in development for some months by a team led by Julia Hippisley-Cox, a professor of clinical epidemiology and clinical practice at Oxford. They published the method underpinning it in October.
Dr Jenny Harries, the deputy chief medical officer for England, said: “For the first time, we are able to go even further in protecting the most vulnerable in our communities.
“This new model is a tribute to our health and technology researchers. The model’s data-driven approach to medical risk assessment will help the NHS identify further individuals who may be at high risk from Covid-19 due to a combination of personal and health factors.
“This action ensures those most vulnerable to Covid-19 can benefit from both the protection that vaccines provide, and from enhanced advice, including shielding and support, if they choose it.”
A Royal College of Physicians spokesperson said: “The adoption of this risk-assessment model by the NHS will play an important role in supporting clinicians and patients with conversations about Covid-19 and enable decisions to be made with a greater understanding of personal risk.
“As with all research during the pandemic, we are constantly learning and so can continue to further enhance the model as data becomes available. We look forward to providing continued feedback and views from clinicians to support its ongoing development.”
Source: The Guardian
Keyword: Covid: almost 2m more people in England will be asked to shield | World news