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The UK’s shielding list is almost doubled, as the risk of getting seriously ill if you get Covid-19 increases, adding 1.7 million to the 2.2 million people advised to stay home at all costs.

This is not the recommendation I would like to see for anyone. Everyone has enough of their own 4 walls. However, it will be a relief for some. This means you can get support through legal sick leave, drug delivery, and shopping assistance. And it means that about 800,000 people under the age of 70 are now moving to the vaccination priority group.

These are individuals with a variety of health problems that can include obesity, diabetes, dementia, epilepsy, severe mental illness, and hip fractures. The list is long. Many of them, as well as their family and friends, will worry that if they are infected, the outcome can be poor. Some will be staying at home as much as possible before being officially included on the shielding list.

The reason these people are now being identified is thanks to the lengthy and laborious work of an Oxford University-based team to determine how each risk factor is weighted and how different risk factors affect the prognosis of people with Covid. It was commissioned by Chief Medical Officer Professor Chris Whitty and was funded by the National Institute of Health Research. But it’s not easy. Julia Hippisley-Cox, professor of clinical epidemiology and clinical practice who led the team, previously developed a similar risk assessment tool for cardiovascular disease. It took 10 years to build, so QCovid was produced at so-called lightning-fast speeds.

UK case

This isn’t about the risk of getting infected or mildly ill, it’s about the risk of getting hospitalized with a serious Covid. We already know that age is the biggest risk factor for death. So this is why over 80 years old asked for vaccination first. Since then, the priority has been descending, but has added NHS and caregivers, as well as people with conditions that are at risk of dying that weaken the immune system, such as cancer chemotherapy and organ transplants.

The original masking list did not contain anything about black people, Asians, and people of minority backgrounds. The Joint Committee on Vaccines and Vaccinations, which advises the government, did not put them in the priority group. This is because they thought that those at most risk would be caught by other criteria, such as age or underlying disease.

This time race and zip code were included as factors to be weighted to provide information on deprivation. This acknowledges that many people in socioeconomically poor areas are more likely to have underlying health problems and high exposure to the virus due to their lifestyle and occupation.

Previously, there was no way to differentiate between people in the affluent and healthy BAME group from those who suffer from greater health inequalities and are therefore at risk for severe Covid. We hope this desperately needed algorithm will achieve it.

As the debate about ending the obstruction progresses, it is even more important to know who is most at risk from the virus and take strict measures to protect it, starting with the vaccine. With an expanded list of about 4 million most vulnerable, we have learned that if the epidemic turns in an unwelcome direction again, we need to be able to keep it safe, and we need a new vaccine against the new strain in the fall.

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