Guidance on shielding for people who have lymphoma

Some people are considered to be at high risk of severe illness from coronavirus (COVID-19). The government uses the term 'extremely vulnerable' to describe people in this group. It includes people affected by lymphoma. People who are considered extremely vulnerable are advised to follow the latest shielding guidance in their area to protect themselves from infection. In many parts of the UK, shielding is now paused, but you should still take care to follow strict social distancing guidelines.

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?

Shielding advice for areas in local lockdown

How might shielding advice change 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 support is available to me?

What if I have a medical appointment during this time?


What are the latest changes to shielding advice?

Changes to shielding guidance may not apply to you if you live in an area that has local restrictions or is in local lockdown due to a rise in the number of coronavirus infections. You should be contacted by letter or text if this affects you but make sure you check the guidance for your area.

In EnglandNorthern Ireland and Scotland and Wales

Shielding has now been paused in England, Northern Ireland, Scotland and Wales. The government advice is that you no longer need to shield unless you live in some areas that have local restrictions or are in local lockdown due to a rise in the number of coronavirus infections. People who are considered to be 'extremely vulnerable' remain on the shielded patient list so they can be contacted if the advice changes.

Shielding has been paused because virus levels are lower than they were when shielding was first introduced so your risk of developing COVID-19 is also lower. You are still considered 'extremely vulnerable' if you do develop COVID-19.

You will no longer receive food or medicine boxes from the government. If you have already registered, you can continue to access priority supermarket delivery slots. You can also access the NHS Volunteers Scheme on 0808 196 3646, and other local volunteer schemes.

If you would like to, and if you feel comfortable to:

  • You can see more people. The exact guidance on how many people are permitted to meet indoors and outdoors varies between EnglandNorthern IrelandScotland and Wales.
  • You can go out to more places – for example, to shops, pubs and restaurants, places of worship and leisure venues. The exact guidance on what you can do varies between EnglandNorthern IrelandScotland and Wales.
  • If you cannot work from home, you can go to work as long as your place of work is COVID-safe.
  • Children who have been shielding can go back to school.

If you choose to go out, it is important to follow strict social distancing and hygiene measures:

  • 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. You might find our 'distance aware' badge a helpful reminder to everyone to social distance when possible. The government also produces some downloadable 'please give me space' badges and cards.
  • Wash your hands often using soap and water, or use hand sanitiser if hand-washing facilities aren’t available. Try not to touch your face.
  • 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).

You should continue to follow any specific advice your medical team gives you.

We have more information about general measures you can take to reduce the spread of COVID-19. We also have more detail about the changes to shielding advice, provided by the Department of Health and Social Care.

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. Even though shielding is paused, you will stay on the list of shielded patients so you can be contacted if the advice changes.

Whether or not you choose to see more people or go out to more places is a personal decision. The government has produced some information that might help you decide what you are comfortable doing.

Public Health England has produced a visual guide to working and living safely during the COVID-19 pandemic. This applies to everybody, whether or not they have been shielding.

The government in Northern Ireland has produced guidance on taking care of your mental health and wellbeing.

The Scottish government has produced some useful resources to help people who have been shielding make informed choices based on their own individual circumstances. These include:

The Welsh government has produced a document with information, advice and frequently asked questions for people who have been shielding that you might find helpful.

    These resources might also be helpful for people in other nations, but please be aware that some of the guidance is specific to the individual nation (for example, the number of people you are allowed to meet).

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    Shielding advice for areas in local lockdown

    If you live in an area that has local restrictions or is in local lockdown due to a rise in coronavirus levels, you might be advised to shield again. If this is the case, you should be contacted with further information, most likely by letter or text message. If you do not receive a letter and you think you should, you can request one.

    If you work in an area that is in local lockdown where shielding is recommended but you live elsewhere, you should work from home or from a location outside the lockdown area if you can. If this is not possible, you might be eligible for the furlough scheme, statutory sick pay or other benefits. You can request a letter if you need it for work or to claim sick pay.

    Shielding might not be advised for all areas that have local restrictions. Whether or not you are advised to shield depends on the particular restrictions where you live. Check the latest local restrictions in your area:

    If you live in Scotland and you are on the shielding list, you can sign up to receive SMS text updates to tell you about your risk of coming into contact with the virus in your local area. Text your 10 digit Community Health Index (CHI) number to 0786 006 4525 to register for this service. You will be contacted to confirm that you are on the shielding list.

    Local authorities might also put restrictions in place. You can find out more about this on your local authority’s website or by calling the national COVID-19 helpline free of charge on 0800 111 4000 (9am to 5pm).

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    How might shielding advice change in the future?

    The government constantly monitors levels of coronavirus throughout the UK. If levels of coronavirus rise too much, you might be advised to shield again. Guidance on whether to shield in the future is likely to be based on the level or coronavirus in your local area, rather than across the UK as a whole. If shielding is recommended in your area, you should be contacted by letter or text message with further advice.

    The government is also working on ways to provide shielding advice based on a person's individual risk in the future.

    View the government's latest shielding advice for people living in England, Northern Ireland, Scotland and Wales.

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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?

    Shielding has now been paused in England, Northern Ireland, Scotland and Wales.

    • 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 has local restrictions or 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?

    Shielding has now been paused in England, Northern Ireland, Scotland and Wales. The government advice is that you no longer need to shield unless you live in some areas that have local restrictions or are in local lockdown due to a rise in the number of coronavirus infections. People who are considered to be 'extremely vulnerable' remain on the shielded patient list so they can be contacted if the advice changes.

    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. These people are on the shielded patient list.

    If you are in the extremely vulnerable group, you should have been contacted by the NHS or your GP advising you what to do. It is important that you read the government guidance in full for the nation where you live: England, Northern Ireland, Scotland or Wales.

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

    If you have been contacted by the government or your GP advising you to shield, you should follow the latest shielding guidance in your area.

    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.

    Shielding has now been paused in England, Northern Ireland, Scotland and Wales. The government advice is that you no longer need to shield unless you live in some areas that have local restrictions or are in local lockdown due to a rise in the number of coronavirus infections. The guidance below is for people who live in areas where shielding is still recommended.

    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?

    Shielding has been paused in all nations of the UK. The government advice is that you no longer need to shield unless you live in some areas that have local restrictions or are in local lockdown due to a rise in the number of coronavirus infections.

    All four nations are regularly reviewing their shielding guidance and this advice might change.

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    What support is available for me?

    In areas where shielding is paused, you will no longer receive food or medicine boxes from the government. If you have already registered, you can continue to access priority supermarket delivery slots.

    If you need help accessing food, medicines or social contact, check what support is available where you live:

    • In England, you can access the NHS Volunteers Scheme by phone on 0808 196 3646. 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. The government also provides a service you can use to find out what help you can get if you’re affected by coronavirus.
    • In Northern Ireland, you can contact the COVID-19 community helpline online or by phone on 0808 802 0020.
    • In Scotland, you can contact your local authority by telephone on 0800 111 4000 or textphone on 0800 111 4114 for help accessing food and medicines.
    • In Wales, the Welsh government website has more information on accessing support.

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    What if I have a medical appointment?

    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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