Leukaemia Care’s response to the pausing of shielding on the 31stof March

Today, it was confirmed that shielding in England will once again be paused on the 31stof March. Here is our response to the news

In March 2020, Public Health England had advised that “people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment” may fall within the group considered clinically extremely vulnerable. Therefore, many of those we support have been shielding.

Today, it was confirmed that shielding in England will once again be paused on the 31stof March. This is based on the rationale that there has been a reduction in cases and indicate that some forms of support will remain, such as priority shopping delivery slots.

However, we have become increasingly concerned about the logic of shielding ending on this date. There are two reasons for our concern:

  • On the 31stof March, the country will still be under significant restrictions, with indoor gatherings still banned, and there will not yet have been a chance to assess the impact of the easing of restrictions on COVID-19 cases. Therefore, it remains feasible that cases may increase and so the most vulnerable should be protected until we can assess the impact.
  • Additionally, vaccines are likely to be less effective in the blood cancer population. This is a group where it is known that other vaccinations are less effective and so concerns have been raised, by us and by others (such as the British Society of Haematology), that extra measures may be needed to protect this population. Additionally, many of the clinically extremely vulnerable have not had the full course of vaccination, with the peak second doses due in April and May. As a result, blood cancer patients may be relying on immunity in the general population being high to protect them. Only 1.6 million people have been fully vaccinated so far, and half the population has not been vaccinated at all yet.

Therefore, we urge the Department of Health and Social Care, and its devolved counterparts, to extend the shielding advice and support further still, until the risk of COVID-19 is much lower to blood cancer patients.

Many will be pleased at the news that shielding is paused and are keen to return to their usual activities. Shielding is, and always has been, guidance and therefore this group are free to stop shielding when they feel able.

However, it is also vitally and equally important that those who are shielding are able to protect themselves as restrictions ease. Many who are able to continue shielding without detriment will continue to do so after the official guidance ends, as they are aware that they may remain at risk. However, this is not the case for everyone. For example, there are those who will be asked to return the workplace if they are not actively advised to stay at home. Some have already been asked to do so following their first dose of the vaccine, despite shielding being in place currently. Whilst furlough has been extended and can be used by employers for patients who are unable to return to work, not all employers will continue to support those that are vulnerable when the advice is lifted.

Our CEO, Zack Pemberton-Whiteley, said “We recognise that the extremely vulnerable cannot shield indefinitely and nor do we support that. However, support for those who want to continue to shield is vital, until the risk is further reduced”.

Food safety advice where neutrophil counts < 2.0 x 109/litre

The following advice is taken from British Dietetic Association 2016

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