By February 2021 more than 4 million people across the UK had been identified as clinically extremely vulnerable to COVID-19 and advised to shield. 

Assessing the impact of COVID-19 on the clinically extremely vulnerable population

Already it is hard to remember what conditions were like in our communities as the Covid pandemic started to hit in March 2020.

By April 2020 the rate of deaths among the clinically vulnerable population was over two and half times that of the general population.  Those include people with respiratory conditions and those undergoing treatments for cancer.

In England alone, by the end of August 2020, the clinically extremely vulnerable population accounted for 19% of all deaths while only making up 4% of the total population

A new report from the Health Foundation’s Networked Data Lab (NDL) reveals the extent to which the pandemic  has had on the more than four million people who were identified as being ‘clinically extremely vulnerable’ and asked to shield. 

Analysing data from across the UK ,the Networked Data Lab  comprised of a team of experts including the University of Aberdeen and NHS Grampian’s, ‘Aberdeen Centre for Health Data Science’.  

You can read the report here: Assessing the impact of COVID-19 on the clinically extremely vulnerable population

Whilst people were arguing about wearing a mask to go into a shop and wanting to get ‘back to normal’ as soon as possible, those with underlying health conditions were having to shield at home. Across the UK, however, it was not always clear who needed to shield which left many without the support they needed.

Dr Jess Butler, who led the Aberdeen leg of the project explained:

“Identifying clinically extremely vulnerable people with records was challenging.  

“Clinicians in Grampian, across the acute sector and primary care, worked hard to identify those who were at risk and add them to the shielding list. This accounted for almost half of all people asked to shield and took a considerable amount of work.  

“While this approach helped rapidly identify some individuals, there are limitations to an algorithm-driven approach.

“Greater access to data from general practice and better data sharing would improve identification.

“Investment in data sharing and data quality monitoring will be essential to improving the process.

“This is needed to provide the NHS with an accurate picture of the clinically extremely vulnerable population so that services can be designed and delivered to meet their needs.

“Better data is also needed so that in the event of future emergencies we can more effectively identify those at the highest risk of poor outcomes.” 

And now that people are going out again, many still arguing about wearing a simple thing like a mask in order to limit the spread of the virus, those who were asked to shield have often been so isolated that it is not just their physical health but their mental health which has been seriously affected.

Commenting Kathryn Marszalek, Senior Analytical Manager at the Health Foundation, said:

“The negative impact goes beyond the harm to their physical health. 

“Over a period of 10 months, those advised to isolate at home have been unable to take part in usual activities, such as shopping for food, exercising, or seeing friends and family.  

“Our research reveals the toll this has taken on the mental wellbeing of many clinically extremely vulnerable people who were already more likely to suffer from mental health conditions than the general population.   

“Action is now needed by those planning the recovery at local and national levels to address the unmet need for NHS care and worsening mental health. 

“Further investment is urgently needed to ensure that in the event of a future health emergency, we can quickly, accurately and consistently identify individuals to enable rapid planning and delivery of relevant support.”