The “extremely vulnerable” definition covers specific conditions:

People in this group include:

1.            Solid organ transplant recipients

2.            People with specific cancers:

• People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
• People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• People having immunotherapy or other continuing antibody treatments for cancer
• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer

3.            People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe Chronic Obstructive Pulmonary Disease (COPD)

4.            People with severe single organ disease (e.g. Liver, Cardio, Renal, Neurological).

5.            People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as Severe Combined Immunodeficiency (SCID), homozygous sickle cell).

6.            People on immunosuppression therapies sufficient to significantly increase risk of infection.

7.            People who are pregnant and children up to the age of 18 with significant heart disease, congenital or acquired.

Earlier in the UK Government's response to Coronavirus they discussed a longer set of criteria for people considered to be at increased risk. Broadly this included all categories eligible for seasonal flu vaccine (anyone over 70, people under 70 with a range of underlying health conditions such as diabetes liver disease etc.). People in these categories are advised to be particularly stringent in their adoption of social distancing but are not specifically recommended for shielding (and are therefore eligible for the additional support such as food boxes) unless they also fall into one or more of the categories above.

Residents who consider themselves to be in the shielding categories should now contact their GP practice if they have not received the shielding letter from Welsh Government (ideally by email providing patient details and information to confirm their eligibility against the “extremely vulnerable” criteria). This includes residents who have previously contacted their practice but received a response along the lines of “we are not involved, you need to call Welsh Government”. Data was received much later by GP practices than had originally been indicated by Welsh Government. The PTHB has asked GP practices wherever possible to re-contact people who had previously been in touch. 

Further updated guidance from Welsh Government has been issued in relation to shielding:

• CMO letter to extremely vulnerable people: support explained

• FAQs: https://gov.wales/cmo-letter-extremely-vulnerable-people-support-explained

• Detailed guidance: https://gov.wales/guidance-on-shielding-and-protecting-people-defined-on-medical-grounds-as-extremely-vulnerable-from-coronavirus-covid-19-html