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Staying safe and government guidance

We're here for you if you want to talk

0808 2080 888

support@bloodcancer.org.uk

Coronavirus guidance for children at high risk

This page is about the guidance for children, including children who are clinically extremely vulnerable, and explains what you can do to protect them.

Page updated 1 April 2021

Children with blood cancer and the Shielded Patient List

In the summer of 2020, the guidelines about which children are clinically extremely vulnerable changed. Clinically extremely vulnerable children and adults are those who are considered to be at higher risk of getting seriously ill from coronavirus and have therefore been advised to shield at home.

Anyone who is clinically extremely vulnerable should be on the Shielded Patient List, but this doesn’t include all children with blood cancer. Many children who were initially advised to shield were removed from the list, based on data that suggests they are not as vulnerable to coronavirus as previously thought.

We have more information about which children are currently considered clinically extremely vulnerable.

After shielding is paused cross the UK, the Shielded Patient List will be maintained and children can still be added to it. This is in case shielding is brought back in the future, although the Government has no plans to do this.

  • If your child has blood cancer and is not considered clinically extremely vulnerable (is not on the Shielded Patient List), they do not need to shield and can go to school or nursery even if shielding is in place. They should still follow general social distancing and hygiene advice as far as possible – you’ll find some practical steps you can take to reduce their risk below. We also have information about coronavirus, children and schools which you may find helpful.
  • If your child has blood cancer and is considered clinically extremely vulnerable (is on the Shielded Patient List), they should shield until shielding is paused in your home country. Once shielding is paused, take advice from their treatment team about whether it is safe for them attend school or nursery. Children in this group may have a generally increased risk of infection which would have kept them at home even before the coronavirus pandemic. So it’s best to discuss your child’s individual situation with their team and ask them what precautions you should be taking.

If you're not sure whether your child should attend school or take part in other activities outside the home, speak to their treatment team.

If you’re worried about your child’s risk from coronavirus

As infection rates are getting lower across the UK, the risk to your child is also getting lower. But it’s understandable if you’re worried about your child’s safety, and you can still choose to take extra precautions to reduce their risk even if their treatment team doesn't advise shielding. You'll find some practical tips below.

You may also want to:

  • Read our information on why some children were removed from the Shielding Patient List and the evidence behind this.
  • Speak to your child's healthcare team about your worries and ask questions.
  • Read our page on what we know about coronavirus in schools and children.
  • Speak to your child's school about your concerns. They can explain what measures are in place to reduce risk. They may even be able to continue supporting home learning if you feel that your child's health is at risk.
  • Remember, it's difficult to be completely risk-free. There will be some risks you can remove, some you can't remove, and some you choose not to remove if the benefit of doing something outweighs the risk. This will be a personal decision for you and your family, based on your own feelings, the healthcare team's advice, and your understanding of the level of risk.
  • If you need help thinking things through, you can talk to us or talk to other parents on our online community forum.

What if we're advised to take extra care by the treatment team?

Even when shielding is paused, your child’s treatment team may still advise you to take extra precautions to protect your child. This could happen because their immune system is particularly weak because of the blood cancer or recent treatment. This advice may have been given even before the coronavirus pandemic, just because of your child’s general risk of infection.

This is a really difficult situation to be in, especially if other household members are going out to work or to school. But even if you can't all stay at home together, there will be lots you can control.

  • Remember the main ways to avoid catching coronavirus – avoiding close contact with other people, keeping hands clean, not touching your face with your hands. These are still the main ways to avoid catching coronavirus and any other infection. If your child and everyone else in the household does this as much as possible, it will reduce the risk. There are more practical tips for how to reduce risk inside and outside the home below.
  • Speak to your child's healthcare team – they can answer your questions and talk to you about sensible precautions you can take.
  • If you or your family are still going out to work – speak to your employer about adjusting your role to reduce contact with other people to protect your child. Make sure your workplace is COVID-safe, and if you're not sure, ask for a risk assessment. See our Money and work page for more options to reduce risk and protect your income.
  • If their siblings are at school – speak to the school about your situation. They can explain what measures are in place to reduce risk. They may even be able to continue supporting home learning for other children – it's worth asking. You could also read our page on what we know about coronavirus in schools.
  • Supporting your child's mental health – some children are themselves struggling with worry about their own risk, or about putting their sibling at risk. Sometimes, your treatment team might have access to psychological support for your family. Other helpful resources are Young Minds, Fruit Fly Collective, The Mix and the NHS website.
  • Remember, it's difficult to be completely risk-free – There will be some risks you can remove, some you can't remove, and some you choose not to remove if the benefit of doing something outweighs the risk. This will be a personal decision for you and your family, based on your own situation and the treatment team's advice.
  • If you need help thinking things through - you can talk to us or talk to other parents on our online community forum.

Practical things you can do to protect your child

Here are some things you can do to reduce your risk of your child catching coronavirus, in addition to government guidelines for the general public listed below.

If your child goes outside, try to go to places where there is more space and you won't be near other people.

Try to help them follow social distancing measures and maintain good hygiene. This means you and your child should:

  • keep 2 metres away from other people (unless they are in your household, support bubble or extended household)
  • avoid touching your mouth, nose or eyes (though this may be difficult for younger children)
  • wash your hands thoroughly (for around 20 seconds) as soon as you get back.

You may also want to consider:

  • avoiding places that will be busy
  • avoiding public transport, where possible
  • washing clothes worn outside more regularly (there is some evidence to suggest that coronavirus can stay on fabrics for a few days)
  • wearing a face mask or covering. In some situations, wearing a face mask is mandatory, unless you're exempt. See "Wearing a face mask or covering" below.

See also our information about going to school.

Even if your child is advised to shield, they aren't expected to observe social distancing with other members of your household, support bubble or extended household.

To protect your child at home, help them to:

  • regularly wash their hands thoroughly (for 20 seconds) with soap and water, or use a hand sanitiser
  • avoid touching their face with their hands (though this may be difficult for younger children).

It's also a good idea to clean and disinfect frequently touched objects and surfaces in the home.

If members of your household are going out to work or school, they should be following the strict advice to prevent catching or spreading coronavirus in those settings. When they get home, they should wash their hands thoroughly.

If you're still worried, you may want to consider restricting your household's movements outside the home, or taking more precautions in the home, for example:

  • minimising time spent in shared spaces, and keeping shared spaces well ventilated
  • using separate bathrooms (or cleaning them after each use) and using separate towels
  • sleeping separately
  • using separate cutlery, dishcloths and tea towels
  • taking hygiene precautions when leaving and entering the home.

Your child's healthcare team are the best people to advise on the specific precautions your household could take.

The restrictions on meeting up with people outside your household, support bubble or extended household are different in different areas. Check the links to your government's guidelines below.

The risk of infection increases the closer you are to another person with coronavirus, and the longer you spend in close contact with them. So if you are allowed to meet people who aren't in your household, support bubble or extended household, these extra precautions may help:

  • keep 2 metres (3 steps) apart
  • if guidelines allow you to meet inside, keep the area well ventilated
  • don’t share food or utensils
  • avoid being face-to-face (the risk of infection is lower if your child interacts side-by-side)
  • avoid shouting or singing near each other (there is some evidence to suggest that these activities can increase the risk of coronavirus spreading between people).

See also our information about going to school.

Using a face mask may not be appropriate for young children, but if you think your child can manage one, consider giving them a face mask or covering to wear – particularly if they're going anywhere they can't stay two metres apart from other people.

The government has guidance on how to make and wear your own face covering.

There are different rules about when children of a certain age must wear face coverings across the UK. For the latest regulations, visit the relevant government page on face coverings in:

Current advice from the World Health Organisation and the British Veterinary Association is that there’s no evidence that pets can be a source of infection or become sick from coronavirus.

However, there is some evidence that coronavirus can survive on surfaces. This could include your pet’s fur, so it’s important that everyone in your household washes their hands regularly, including before and after contact with animals. Avoid letting your pet touch your child's face, and try to encourage your child to avoid touching their own face.

PDSA have more information about pets and coronavirus.

If your child is clinically extremely vulnerable and you also have vulnerable relatives living outside of your support bubble or extended household, there are other people and services that can help. You can also help by being in regular contact.

  • Call your relative regularly to check in with them.
  • If your relative has a garden or nearby outdoor space, you could arrange to meet them outside, staying 2 metres apart, as long as this is allowed in the local guidelines.
  • Ask your relative's neighbours if they could help by bringing them supplies.
  • Ask other family members or friends who are not vulnerable themselves to drop off supplies.
  • Book online deliveries for your relative.
  • If you are worried about your relative getting supplies and don't have anyone nearby that can help, read our page on practical support.
  • Contact their pharmacy if they need a volunteer to deliver their medication.
  • Contact their local council and tell them the situation.
  • Contact Age UK.
  • There are charities and groups in local communities working to support those who are vulnerable – look into anything happening in your relative's local area.

Government guidance

Below you'll find links to the latest guidance in each of the four countries of the UK for people who are clinically extremely vulnerable, and for the general public.

You may also find it helpful to read our information on:

England

Scotland

Wales

  • In Wales, shielding advice is paused from 1st April 2021.
  • Shielding guidance in Wales – specific advice for clinically extremely vulnerable people.
  • Money and work – our page about financial support, help talking to your employer, and understanding your rights as someone with cancer.
  • Alert level 4 – explains what you need to do at Alert level 4. Currently all of Wales is in Alert level 4.
  • Alert level 4: frequently asked questions – more detail on how to keep safe and the rules in place in Alert level 4.
  • COVID-19 Alert levels – explains the national guidance in different Alert levels. Currently all of Wales is in Alert level 4.
  • General coronavirus guidance – find all other guidance for Wales including protecting yourself and others, testing and tracing, work, financial support, businesses, volunteering, education and travel.

Northern Ireland

  • In Northern Ireland, shielding advice is expected to pause on 12th April 2021.
  • Shielding guidance in Northern Ireland – specific advice for clinically extremely vulnerable people.
  • Money and work – our page about financial support, help talking to your employer, and understanding your rights as someone with cancer.
  • Coronavirus regulations and restrictions – explains the national restrictions in place in Northern Ireland now.
  • General coronavirus guidance – find all other guidance for Northern Ireland including testing and tracing, financial support, face coverings, travel, work, businesses and schools.
A mother and son - Melody and Andrew - making faces into the camera.

Shielding as a family

Melody talks about shielding to protect her son Andrew, who's in remission from leukaemia.

Melody's story

Keep updated about coronavirus and blood cancer

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Support for you

Call our free and confidential support line on 0808 2080 888. We are currently receiving a very high volume of calls related to coronavirus, so if you're not able to get through straight away, please leave a message and we'll get back to you as soon as we can.

You can also email us if you prefer to get in contact that way. We'll usually get back to you within two working days, but due to the current rate of calls and emails we are currently receiving it may take us longer.

Talk to other people with blood cancer on our Online Community Forum – there is a group for coronavirus questions and support.

You can also find out what's helping other people affected by blood cancer through coronavirus and beyond in our pages on living well with or after blood cancer.

The following companies have provided funding for our coronavirus support, but have had no further input: AbbVie, AstraZeneca, Celgene, Gilead, Incyte, Kyowa Kirin, Novartis, Pfizer, Sanofi, Takeda.

We're here for you if you want to talk

0808 2080 888

support@bloodcancer.org.uk

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