Government plan for 'smarter shielding' will relax advice for some at-risk patients

[Northerner]

Patients currently included on shielding lists could be advised that they can 'take more risk' under government plans to overhaul the system for identifying people most at risk from COVID-19.

Plans to adopt a 'more nuanced' risk assessment mechanism for patients at increased risk were set out in a 50-page COVID-19 recovery plan published on 11 May by the government.

The document reveals more detail on how lockdown measures could be eased over the coming days and weeks after prime minister Boris Johnson announced the change in approach on Sunday.

The decision to ease lockdown restrictions has been sharply criticised by the BMA as 'too fast, too confusing and too risky', with doctors' leaders warning it threatens to trigger a deadly second wave of coronavirus infection.

Vulnerable patients
GPs have faced significant workload in identifying and verifying patients who should be shielding during the pandemic. A senior NHS England official apologised last month and admitted that the process had been 'really frustrating' after problems including patients being missed out or incorrectly identified for shielding, and changes to guidance on who should be included.

The recovery plan document suggests that in the second phase of the NHS response to the pandemic, shielding will change again as the government takes a 'more differentiated approach to risk'.

The document says: 'As the UK moves into phase two, the government will continue to recognise that not everybody's or every group's risk is the same; the level of threat posed by the virus varies across the population, in ways the government currently only partly understands.

Government plan for 'smarter shielding' will relax advice for some at-risk patients

Patients currently included on shielding lists could be advised that they can 'take more risk' under government plans to overhaul the system for identifying people most at risk from COVID-19.

www.gponline.com

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[mikeyB]

I presume this more nuanced advice will mean that all men should be shielding, as they are twice as likely to die as women from this virus, and all BAME folk who seem to be particularly at risk, whatever underlying conditions they have. By my reckoning, that's around 35 million in the UK. That's the reality.

 

[Docb]

Dunno about that mikeyB. It has often occurred to me that it is well beyond time that politicians stopped talking about safe and unsafe and started talking about risk. Safety is not absolute, safety is relative. Something is not safe, it can only be safer than something else.

In all of words shoved out by anybody and everybody on the subject of how to handle the COVID epidemic nobody has tried to quantify the risk. For example, going for a drive to an open space for a walk with other people. Is the chance of coming to harm from catching coronavirus on the walk greater or less than the chance of coming to harm from having a motor accident en route? Or, is the risk of coming to harm by catching coronavirus after going to hospital because you have got chest pain greater or less than the risk of coming to harm through having a heart attack? Or for the lady who swerved aside to avoid me this morning - was the risk of harm from catching the virus from me greater or less than the risk of harm from the fag she was smoking.

Whitty has tried to bring some of these ideas into the debate but the politicians can't cope with the processes needed to think it through. Advertising messages are easier to construct if you tell everybody that if you get CV you will die and the only way forward is for everybody to adopt extreme behaviour. If you quietly ignore care homes in the process (high risk, horrendous consequences) then so be it and just express your deepest sympathy and concern, there's not a lot of votes in it.

 

[Bruce Stephens]

I presume this more nuanced advice will mean that all men should be shielding, as they are twice as likely to die as women from this virus, and all BAME folk who seem to be particularly at risk, whatever underlying conditions they have. By my reckoning, that's around 35 million in the UK. That's the reality.

Since these things all matter, presumably this smarter shielding will have men protected at lower ages than women and similarly for BAME people. You wouldn't want to shield all men: an 18 year old man is (other things equivalent) less vulnerable than a 50 year old woman. (I'm actually guessing at the last example, but if it's wrong change to a 60 year old woman and I imagine that would be true.)

 

[Northerner]

Since these things all matter, presumably this smarter shielding will have men protected at lower ages than women and similarly for BAME people. You wouldn't want to shield all men: an 18 year old man is (other things equivalent) less vulnerable than a 50 year old woman. (I'm actually guessing at the last example, but if it's wrong change to a 60 year old woman and I imagine that would be true.)

Given the fact the the most obvious group to 'shield' since long before the lockdown has been the elderly and vulnerable in care homes I think it's a meaningless concept, and a futile exercise to expect any nuanced action from the government in this respect