Guidance on shielding for people who have lymphoma

The government has issued specific guidance for people who are considered to be at high risk of severe illness from coronavirus (COVID-19). This includes people affected by lymphoma. The government advises that these people should practise ‘shielding’ to protect themselves from infection.

View the full government guidelines on shielding for England, Northern Ireland, Scotland and Wales.

On this page, we summarise the main advice for people affected by lymphoma.

What are the latest changes to shielding advice?

How is shielding advice changing in the future?

Changes to shielding advice for children and young people (up to 18)

Who does shielding advice apply to?

What is shielding?

For how long do I need to shield?

What if I receive essential care?

What support is available to me?

What if I have a medical appointment during this time?


What are the latest changes to shielding advice?

The government regularly updates its shielding advice for people living in England, Northern Ireland, Scotland and Wales. This is because virus levels are lower than they were when shielding was first introduced.

If you’re shielding, you are advised to stay at home as much as possible. Do not meet up with anybody who has symptoms of COVID-19 (high temperature and/or a new, continuous cough and/or a loss of or change in sense of taste or smell).

However, if you would like to:

  • In England and Northern Ireland:
    • You can go outside with other members of your household.
    • You can meet people from different households outdoors in groups of no more than six. You should stay at least 2 metres away from people who are not members of your own household.
    • You no longer need to observe social distancing with other members of your own household.
    • If you are the only adult in your household, you can form a 'support bubble' with one other household. People in a support bubble will be allowed to meet in each other's houses and do not have to stay 2 metres apart.
  • In Scotland:
    • You can go outside with other members of your household.
    • You can meet people from two other households outdoors in groups of no more than eight. You can also take part in non-contact outdoor activities (for example, golf, hiking, canoeing, outdoor swimming or fishing). You should stay at least 2 metres away from people who are not members of your own household.
    • You no longer need to observe social distancing with other members of your own household.
    • If you are the only adult in your household, you can form an 'extended household' with one other household. Members of an extended household can meet indoors and stay overnight at each other's houses and do not have to stay 2 metres apart.
    • You can go indoors to use a toilet in someone else's house if you are visiting them outdoors.
    • You can stay in self-catering accommodation or a second home with other people from your household or extended household.
  • In Wales:
    • You can go outside with other members of your household.
    • You can meet people from another household outdoors. You should stay at least 2 metres away from people who are not members of your own household.
    • You can form an 'extended household' with one other household. Members of an extended household can meet indoors and stay overnight at each other's houses. If you are shielding, you are still advised to stay at least 2 metres apart from other people, including members of your own household or extended household.

These changes to shielding guidance do not apply to you if you live in an area that is in local lockdown due to a rise in coronavirus cases. 

This does not mean that shielding has ended. You should not go outside for other reasons, including work or shopping or to attend gatherings. You are still entitled to support accessing food and medicines, if you need it. If you don't feel comfortable going outside, you might prefer to carry on shielding as you were before.

If you live in one nation of the UK but you usually work in another, you should follow the shielding guidance based on where you live.

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How is shielding advice changing in the future?

The government has set out a 'roadmap' of how they intend to relax the restrictions for people who are shielding over the coming months. They are making these changes because the level of coronavirus in the community is much lower than it was when shielding was introduced, so your risk of catching it is lower. If you are on the shielded patient list, you should have received a letter informing you of the planned changes to the shielding guidance. The letter is also available in other formats and languages. The guidance will be reviewed regularly based on the latest clinical evidence and it could change.

Changes to shielding guidance do not apply to you if you live in an area that is in local lockdown due to a rise in coronavirus cases. 

    In England and Northern Ireland:

    From 1 August:

    • You will no longer be advised to shield. If you would like to, you can go out to more places and see more people. However, you should still follow strict social distancing measures:
      • Stay at home where possible.
      • Minimise contact with people who are not in your household, support bubble or extended household.
      • Stay at least 2 metres away from other people whenever you are out.
    • If you cannot work from home, you will be able to go to work as long as your place of work is COVID-safe.
    • You will be able to go outside to buy food, to places of worship and for exercise.
    • Children who have been shielding will be able to go back to school if they are eligible to.
    • Food and medicine boxes provided by the government will stop. You will still be able to access priority supermarket delivery slots. The NHS Volunteers Scheme and other local volunteer schemes will continue.
    • You will stay on the list of shielded patients so you can be contacted if the advice changes.

    The government will continue to monitor levels of coronavirus over the coming months. If it spreads too much, you might be advised to shield again.

    We have more detail about the changes to shielding advice, provided by the Department of Health and Social Care.

    In Scotland:

    • Shielding guidance in Scotland is expected to be updated on 17 July, when you will be able to visit more places outdoors.
    • It is expected to be updated again on 24 July, when you will be able to meet more people indoors, use public transport, and go to more public places, including some indoors if you wear a face covering. We will update this information when the detailed guidance is confirmed.
    • The Scottish government hopes to be able to pause shielding from 1 August if the risk of developing COVID-19 remains very low.

    In Wales:

    • The Welsh government has not yet announced a timetable for any changes in shielding guidance.
    • If you are living in Wales and you are shielding, you should continue to do so until 16 August unless you are advised otherwise by a medical professional.

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    Changes to shielding advice for children and young people (up to 18)

    Recent research has found that the risk of becoming seriously ill due to COVID-19 is very low for most children and young people, including many of those who were previously identified as being ‘clinically extremely vulnerable’. In view of this, the majority of children and young people are expected to be removed from the shielding list. Only a small group of children and young people who receive specialist care in hospitals will remain on the shielding list, including children who are receiving cancer care or children who are at risk of severe infection due to a lowered immune system. Your GP or specialist doctor should discuss with you (or your parent or carer) whether or not you need to remain on the list.

    What does this mean?

    Children and young people who have been advised to shield should continue to do so until 31 July in England, Northern Ireland and Scotland, and 16 August in Wales.

    After this, shielding for everybody is expected to be paused.

    • If you remain on the shielding list, you might need to shield again in the future if, for example, the coronavirus infection rate increases or if you live in an area that is in local lockdown.
    • If you are removed from the shielding list, you will not need to shield again in the future even if shielding measures are reintroduced for other people.

    The Royal College of Paediatrics and Child Health has detailed guidance on shielding for children and young people, including information on who is considered to be 'clinically extremely vulnerable'. The government has produced specific guidance on shielding for young people in England. The Children's Cancer and Leukaemia Group has more information on coronavirus guidance for children and young people with cancer.

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    Who does shielding advice apply to?

    People who have cancer of the blood or bone marrow, such as lymphoma, leukaemia or myeloma, who are at any stage of treatment, are considered to be at high risk of severe illness from COVID-19. The government uses the term 'extremely vulnerable' to describe people in this group, and advises them to shield.

    If you are in the extremely vulnerable group, it is important that you read the government guidance in full for the nation where you live: England, Northern Ireland, Scotland or Wales.

    The NHS is directly contacting people who are at high risk of severe illness from COVID-19 in order to provide further advice.

    • If you think you fall into this category and you have not received a letter or been contacted by your GP, you should discuss it with your GP or medical team.
    • If you have received a letter or text advising you that you are at high risk but you think it is an error, check the government advice on what to do.

    If you have received advice from the government or your GP to shield then you should follow this advice.

    The government guidance refers to ‘Patients at any stage of treatment’ for blood cancers, including lymphoma. This includes people before, during and after treatment.

    Before treatment

    People who are on active monitoring (watch and wait) for low-grade lymphoma (including chronic lymphocytic leukaemia).

    During treatment

    People who are currently having treatment for any type of lymphoma.

    (Patients on treatment should follow the standard neutropenic sepsis pathways and telephone for clinical advice as stated by their chemotherapy unit prior to commencing treatment.)

    After treatment

    COVID-19 is a new illness and at present, there is limited scientific evidence to guide decisions on exactly who is at high risk of severe disease. Public Health England recommends that anybody who has had treatment for lymphoma should shield but does not give a time frame for how long ago the treatment was and when you need to shield.

    A consensus of UK lymphoma specialists agree that it is sensible for people who have low-grade non-Hodgkin lymphoma to shield even if they have not required treatment for many years.

    If you were successfully treated for Hodgkin lymphoma or high-grade non-Hodgkin lymphoma many years ago and your lymphoma has not come back, the situation is more complicated. Your GP or specialist will consider lots of factors to help determine if you might be at high risk of severe illness due to COVID-19. This includes:

    • the specific type of lymphoma you had
    • how long ago you were treated
    • the exact treatment you had
    • any late effects of treatment you might be at risk of
    • any other medical conditions you have
    • your individual circumstances (for example, your living situation or your occupation).

    Your GP or specialist will offer advice that is specific to you. Ultimately, it is your decision as an individual to decide about shielding.

    We appreciate that shielding can feel like an extreme measure, but it is recommended for your personal protection. However, this will be a deeply personal decision. We advise discussing your decision with your GP or specialist. They can give you advice based on your individual circumstances.

    If you have had a splenectomy, you are advised to shield.

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    What is shielding?

    Shielding is a way of protecting people who are at risk of severe illness from COVID-19 by minimising their interaction with other people. This reduces their chance of coming into contact with the virus.

    If you are considered to be at high risk, you should stay at home. Within your home, you should minimise all non-essential contact with other members of your household.

    If you think you have a condition that puts you at very high risk, or you have received a letter from the NHS advising you to shield yourself, you are strongly advised to follow the face-to-face distancing measures below:

    • Strictly avoid contact with anyone who has symptoms of coronavirus (COVID-19). These symptoms include a high temperature and/or a new, continuous cough and/or a loss of or change in your sense of taste or smell.
    • Stay at home. You can go into your garden if you have one but you should stay at least 2 metres away from other people.
    • Do not attend any gatherings. This includes gatherings of friends and families in private spaces.
    • Do not go out for shopping, leisure or travel. If you are having food or medication delivered, make sure they are left at the door to minimise contact.
    • Keep in touch remotely with other people using technology such as your phone, internet, and social media.
    • Use telephone or online services to contact your GP or other essential services.
    • Wash your hands regularly, avoid touching your face, and clean frequently-touched surfaces regularly.

    If you share a living space with other people, you should also minimise your contact with them.

    • Aim to keep at least 2 metres (3 steps) away from people you live with.
    • Keep the time you spend in shared spaces such as kitchens, bathrooms and sitting areas to a minimum, and keep these spaces well ventilated.
    • If you usually share a bed with someone else, encourage them to sleep in a different bed if this is possible.
    • If you can, use a separate bathroom from the rest of the household. If you do share a toilet or bathroom with other people, make sure they are cleaned after use every time. Use separate towels from the other people in your house.
    • If you share a kitchen with other people, avoid using it while they are present. If you can, take your meals back to your room to eat. Make sure all used crockery and cutlery are thoroughly washed and dried, in a dishwasher if you have one. If you are using separate crockery, cutlery and utensils from the rest of the household, remember to use a separate tea towel for drying these.
    • Encourage everyone in your household to wash their hands regularly, avoid touching their face, and clean frequently-touched surfaces.

    Some of these shielding measures have been relaxed in recent weeks, because virus levels are lower than they were when shielding was first introduced. Please see our section on What are the latest changes to shielding advice? to see what the latest guidance is where you live.

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    For how long do I need to shield?

    If you are in the extremely vulnerable group, the latest government guidance recommends that, unless you are advised otherwise by a medical professional, you should continue to shield:

    All four nations are regularly reviewing their shielding advice and these dates might change.

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    What if I receive essential care?

    If you receive regular health or social care from an organisation, either through your local authority or privately, tell your care providers that you are shielding and agree a plan for continuing your care.

    If you receive essential care from friends or family members, speak to your carers about extra precautions they can take to keep you safe.

    Speak to your carers about a back-up plan for your care in case your main carer is unwell and needs to self-isolate.

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    What support is available for me?

    You might be able to register for government support for help getting deliveries of essential supplies. If you have had a letter advising you to shield, the government recommends that you register for support even if you don't need it at the moment. You might need your NHS number, which should be on your letter. Check what support is available where you live:

    If you need help but you’re not sure who to contact, get in touch with your local council. They can work with you to identify your social care needs and help you get the support you need. The government is also developing a service you can use to find out what help you can get if you’re affected by coronavirus.

    You can also register for support from the NHS volunteer responders scheme on their website or by calling 0808 196 3646. This is open to vulnerable or high-risk people who are self-isolating and who need support. You do not need to have received a shielding letter to access this support. Carers can also request support, either on behalf of the person they care for, or for themselves if the support would help them continue in their caring role.

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    What if I have a medical appointment during this time?

    The government advises everyone to access medical assistance remotely (for example, by phone or online), wherever possible. If you have a scheduled hospital or other medical appointment while you are shielding, contact your GP or medical team to make sure you continue to receive the care you need and to check if your appointments are absolutely essential.

    It is possible that your hospital might need to cancel or postpone some clinics and appointments. You should contact your hospital or clinic to confirm appointments.

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