Coronavirus and clinically extremely vulnerable people in England: 17 May to 22 May 2021

• The total number of clinically extremely vulnerable (CEV) people in England is 3.7 million.

• The majority (85%) of CEV people reported being aware that the government advice to shield has paused; this was paused from 1 April 2021.

• Despite this, 43% of the CEV population reported continuing to shield when asked between 17 and 22 May 2021.

• Most CEV people, who were aware that previous government advice to shield had paused, reported completely or quite closely following the new precautionary guidance given to CEV people (92%).

• The majority (86%) of CEV people have had two doses of the vaccine, when asked between 17 and 22 May 2021.

Statistician's comment

Tim Gibbs, Head of the Public Services Analysis Team at the ONS, said:

“Our results today show almost half of those identified as clinically extremely vulnerable reported continuing to shield despite government advice to do so being paused.

“This isn’t surprising considering the higher risk COVID-19 poses for this group.

“Given this, I’m pleased to see the majority of those in this group have had two doses of the vaccine, offering them some protection from the virus.”

Follow the Public Services Analysis team on Twitter: @HughStick

In England, 3.7 million people have been identified as being clinically extremely vulnerable (CEV) to severe impact from coronavirus (COVID-19). Of these, 2.2 million CEV people were on the shielded patient list because they were identified by their clinical condition or a clinician's review. The remaining 1.5 million people were identified as CEV through the COVID-19 population risk assessment. More information on identifying CEV people, guidance for clinically extremely vulnerable people and collecting the data can be found in 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. Because of this, we expect the behaviours of CEV people to be different in wave five (17 to 22 May 2021) compared with waves one, two and three, which were collected when CEV people were being advised to shield (before 31 March 2021).

Despite all CEV people being advised they no longer need to shield from 1 April 2021, 43% of the CEV population have continued to shield. This is statistically significantly lower, compared with 50% who reported continuing to shield in wave four (collected between 26 April and 1 May 2021).

Although shielding guidance has paused, CEV people are still advised to take additional precautionary measures to keep themselves safe. Of those who reported being aware that shielding has paused, 92% reported that they followed the precautionary advice completely or quite closely.

A large majority of CEV people have had at least one dose of the vaccine (96%); 86% of CEV people have had both doses and 10% of CEV people have had a single dose.

Most CEV people reported leaving their home (89%), when asked between 17 and 22 May 2021. Of those who had left the home in the last seven days, approximately one in five CEV people left to socialise (22%, an estimated 725,000 people). Approximately 427,000 (11%) CEV people were estimated to have not left the house in the last seven days.

Clinically extremely vulnerable

People who are identified as clinically extremely vulnerable (CEV) are 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 are at higher risk of serious illness if they catch COVID-19.

From 16 February 2021, individuals can still be identified as CEV by these routes, but also by 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 risk assessment. More information can be found in Guidance on shielding and protecting people who are CEV from COVID-19.

Lockdown

From 23 March 2020, the UK was placed under lockdown measures, with schools shut, non-essential shops closed, and the population asked to work from home where possible and to only leave their houses for exercise and essentials. These measures began to be eased from mid-May 2020. CEV people were advised to shield from the start of this lockdown. Shielding was paused on 31 July 2020 for most of the country, with only a few local areas continuing to have shielding advice in place until 5 October 2020.

From 5 January 2021, the UK government announced a further national lockdown for England and on 6 January 2021 shielding guidance was reissued to all CEV people. Restrictions began to ease in England from 8 April 2021.

From 1 April 2021, CEV people were no longer advised to shield. The data used in this bulletin were collected during the time CEV people were not advised to shield.

Shielding

From 1 April 2021, the advice to shield paused. Shielding is 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) includes 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

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

Survey information

This is the fifth 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, Identifying clinically extremely vulnerable people. The data in wave one and wave two reflect only clinically extremely vulnerable (CEV) people identified through clinical condition or clinician's review.

Estimates for wave five

The fifth wave of data was collected between 17 and 22 May 2021. The sample size was 1,035 out of 3.7 million CEV people (as of 11 May 2021) and survey weighting was used to weight the sample estimates to provide estimates for the 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

The national advice given to CEV people to shield was paused from 1 April 2021. From 1 April 2021, CEV people were issued precautionary guidance and still had to follow the national restrictions in place. 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 or five should be made with this in mind.

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