As we learn more about coronavirus, guidance about who should take extra steps to protect themselves will change. You might receive a text or letter from the Government to let you know that your child needs to start or stop ‘shielding’. We know that this can cause a great deal of anxiety, so we’ve put together some advice from GOSH to clarify what this means for your child and your family.
Although COVID-19 does affect children, very few children develop severe symptoms, even if they have an underlying health condition, including a weakened immune system. This does not mean we should not protect our children, but we can adapt the shielding advice for adult patients, so it is child-friendly and appropriate.
We’ve also since learned more about the impact of long-term shielding on children and young people’s physical and mental health. It is very important that we balance protecting them from COVID-19 with their general safety and well-being.
As national experts in children’s health, the Royal College of Paediatrics and Child Health (RCPCH) has reviewed the Government’s latest shielding advice and provided special guidance for medical teams that care for children. This includes an updated list of patients who need to shield, which is significantly shorter than before. At GOSH, we’re consulting this guidance and the Government's carefully, reviewing lists of patients who are being advised to shield, and providing advice for specific patient groups.
If you’re unsure whether your child should be shielding, it may help to look at the shielding lists outline by the RCPCH. If you’re still unsure, please contact your clinical team. If you’ve been asked to self-isolate before coming into GOSH, please remember this is different to shielding and speak to your clinical team for advice.
How do I shield my child?
Children are aware of anxiety and pick up the concerns of adults. This is a stressful time for everyone, and your child might be particularly in need of comfort, care and attention because of this. Children need to be cared for by their families, and this means there are additional things to consider when they are isolated from others.
We advise you to institute measures that are possible and safe for your child and family. We have put together some advice below to help you ensure you follow the government guidelines to keep your child safe, while also keeping them well looked after, happy and able to be comforted if they are upset. You should read this alongside the latest Government guidance on shielding.
Until 6th July 2020
If your child has been advised to ‘shield’, here are some recommendations for how you can achieve this:
- We advise that your child and everyone else in your household stay home as much as possible, and that the only visitors into the house are essential carers. Depending on where you live and advice from your clinical team, your child may be able to spend some time outdoors if they wish, though this should be kept to a minimum. If your child does go outside, it’s very important that they only spend time with people from their household and they try to keep a 2m distance from everyone else.
- Others in the household should only attend school or work if strict social distancing can be followed. Your shielded child should not go back to school – we recommend that they are taught remotely.
- If other people in your household must make regular trips outside, such as travelling to work, you and your child should try to keep 2m away from them and minimise the time you spend in shared spaces. We recognise this may not always be possible.
- Try to limit sharing of toys and other items between your shielding child and other children. If that is not possible, ensure that everyone who plays with the toys washes their hands thoroughly before they pick them up, and where possible, use antibacterial wipes to wipe down toys in between use.
- We also recommend separate bath times for children, with your vulnerable child being bathed first, and no sharing of towels and flannels.
- It is vital that that those shielding also continue to follow widely published precautions to avoid infection, including social distancing, keeping good hand hygiene and avoiding touching their eyes, nose and mouth.
Until 31st July 2020
The Government has said restrictions for those shielding will be reduced from 6th July 2020. However, there will still be special shielding advice you need to follow during this period. Check the latest advice on gov.uk and the RCPCH website.
GOSH may also provide special advice for your shielded child during this period, to keep them as safe as possible. Make sure to check the latest advice from clinical teams at gosh.nhs.uk/news/coronavirus-covid-19-information-hub/covid-19-specialty-information-sheets. If you’re unsure, please contact your clinical team.
Even though some restrictions are lifting for now, it’s still really important that everyone in your household follows precautions to avoid infection. This includes keeping a safe distance from others unless you have formed a ‘bubble’ with another household, keeping good hand hygiene, and avoiding touching your eyes, nose and mouth.
1st August 2020 onwards
The Government expects to stop recommending strict shielding measures for vulnerable groups after 1st August 2020. This would mean that, from this date, you and your child could choose to follow the same national guidance as everyone else. However, you should still be very careful to follow precautions to avoid infection, including strict social distancing.
We know this may be worrying and you may feel that you should keep protecting your shielding child. We need to protect those who may be extremely clinically vulnerable to the virus, but we also know that children have a much milder symptoms of COVID-19 and that unnecessary shielding can have a negative impact on their health and wellbeing. If you’re advised that you can stop strict shielding measures, you should feel comfortable doing so.
If you’ve received conflicting advice or are unsure about following guidance, we recommend you speak to your clinical team.
If someone in the household develops symptoms
It is advisable that the carer who is well and does not have symptoms stays with the child and keeps separate from other members of the family if possible. If this is not possible, then taking whatever precautions can be taken is likely to be sufficient.
I’ve been advised to stop shielding my child. Is it safe?
Very few children develop severe symptoms of COVID-19, even if they have an underlying health condition. The latest guidance from the Government suggests that most children and young people no longer need to shield, as long as they follow national guidelines for social distancing and handwashing.
We need to protect those who may be extremely clinically vulnerable to the virus, but we also know that we need to protect children and young people from the negative impact of unnecessary shielding. If you’ve received a letter or text stating that your child no longer needs to shield, you should feel comfortable taking this advice.
However, if you’ve received conflicting guidance or are unsure, we recommend you speak to your clinical team.
We know many families are anxious about their child returning to school. Decisions about how your child accesses education during COVID-19 should be made jointly between you and your child’s school. If you have questions or concerns about your child’s schooling, we’d encourage you to contact their school directly.
Advice from your specialty team
It is important to remember any existing advice given to you by your specialty team for your child’s wellbeing, which is not related to COVID-19. This advice should continue to be observed at all times. You can access our specialty guidance here.
It is important not to stop any medication without first discussing this with your specialty team. If your child becomes unwell, and you would normally attend your local hospital, please call them as normal. If they are unable to offer the usual review please contact your GOSH team.
If you’re very worried about your child or your feel their life is at risk, please call 999 or take them to A&E or an urgent care centre as you normally would. They are open for all children who need care and are safe to attend.
If you are due to attend GOSH, and you have difficulties getting to your appointment, or your child has symptoms of COVID-19, please call the relevant specialty for further assistance before attending GOSH.
If any of this advice changes, we will update this information. We also recommend you keep an eye our FAQs at gosh.nhs.uk/covid-19-FAQ, which are regularly updated.
We’re here to help
We recognise that some families may find it difficult to shield. GOSH has a number of support services available to families to help you cope and follow the guidance. As well as speaking to your child’s clinical team, please contact the PALS team on 020 7829 7862 or firstname.lastname@example.org for confidential support and advice.
Further information and support
- Coronavirus (COVID-19) - www.gosh.nhs.uk/news/coronavirus-covid-19-information-hub - translations of this information in languages other than English as well as Easy Read versions are online too.
- Information from the NHS at www.nhs.uk/conditions/coronavirus-covid-19/
- Information for children is available on the BBC Newsround website at www.bbc.co.uk/newsround