It was a good idea to set up the shielding list so that people who needed to stay at home completely to reduce their risk from coronavirus would get a letter from the NHS advising them to do that.
But it was a stupid idea for the government to give the public the impression that it would be a simple thing to do. In reality it’s been really complicated identifying who should and shouldn’t be on, and taken a long time to get it right.
There are several reasons why it’s taken a while to get from the 1.5 million people on the original list to the 2.5 million on it now. One involves the way the NHS codes certain diseases. For example, if someone has asthma – as many millions of people do – it’s simply recorded on their medical records as “asthma”. It doesn’t specify whether someone has mild asthma, which means they don’t need to be on the shielding list, or severe asthma, which means they do.
Human error has been another problem. That is, when GPs and other health professionals have updated someone’s medical records, they haven’t differentiated between someone who is a carrier – who has a genetic predisposition to a disease but doesn’t suffer from it – and someone with active disease. That has led to people being on the list unnecessarily, and people not being on it when they should.
Identifying people for the list requires clinical judgment, not just a sweep of patient records. So GPs have had to look at the medical history of all their patients and make these judgments. Some people have come off the list as a result of that process too.
People who weren’t originally selected have approached their GP and asked to be put on the list, often because they were fearful of putting themselves in danger if they went into work. Some others have been added because in trying to book home deliveries with supermarkets, they realised they were medically vulnerable and that being classed as that meant they could get guaranteed weekly slots.
The number of people on the list will continue to change as more people are diagnosed with certain illnesses and also as our understanding of the risk factors for Covid become clearer.
