Coronavirus and clinically extremely vulnerable people in England: 26 April to 1 May 2021

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

• The majority (84%) of CEV people reported being aware that the government advice to shield has paused; this was paused from 1 April 2021.

• Despite this, half (50%) of the CEV population reported continuing to shield when asked between 26 April and 1 May 2021.

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

• Two-thirds (67%) of CEV people have had two doses of the vaccine, when asked between 26 April to 1 May 2021.

Statistician's comment

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

“Since 1 April 2021, clinically extremely vulnerable people have been advised that they no longer need to shield to protect themselves from COVID-19.

“Our results today show that although government advice to shield has paused, half of those identified as CEV reported continuing to shield.

“We’ve recently seen lockdown restrictions ease significantly, this is great to see, however it’s critical that we continue to monitor the impact of these changes on groups such as the clinically extremely vulnerable.”

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 the 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 this wave (26 April to 1 May 2021) compared with previous waves, which were collected when CEV people were being advised to shield.

Despite all CEV people being advised they no longer need to shield from 1 April 2021, half (50%) of the CEV population have continued to shield. This is similar for those identified by clinical condition or clinician's review (50%) and those identified through the COVID-19 population risk assessment (51%).

Of CEV people who reported being aware that the advice to shield has paused, 93% of people reported that they followed the guidance completely or quite closely in those identified by clinical condition or clinician's review. This is similar to the proportion who reported doing so among those identified through the COVID-19 population risk assessment (92%).

Approximately 420,000 (11%) of CEV people were estimated to have not left the house in the last seven days. At the time of data collection, CEV people identified through the COVID-19 population risk assessment were statistically significantly more likely to have not left the house in the last seven days (15%), compared with CEV people identified through clinical condition or clinician's review (9%).

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 fourth 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 four

The fourth wave of data was collected between 26 April to 1 May 2021. The sample size was 1,390 out of 3.7 million CEV people (as of 20 April 2021) and survey weighting was used to weight the sample estimates to provide estimates for the population of CEV people.

Changes to the shielding guidance from 1 April 2021

The national advice given to CEV people to shield paused on 31 March 2021. From 1 April 2021, CEV people were issued precautionary guidance and still had to follow the national restrictions in place. Wave three was collected between 22 to 31 March 2021 when shielding was advised; any comparisons between wave three and wave four should be compared 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.