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Further Advice for Clinically Extremely Vulnerable while in Tier 2

This guidance is for everyone who has been identified as clinically extremely vulnerable. If you are in this group, you will previously have received a letter from the NHS or from your GP telling you this. You may have been advised to shield in the past.

This guidance is effective from 2 December 2020.

Socialising inside and outside the home

At Tier 2: High, you must not meet with people indoors in any setting unless they are part of your household or support bubble. This includes private homes, and indoors in hospitality venues, such as pubs and restaurants.

You may continue to see friends and family you do not live with outside, including in a garden or other outdoor space. If you do so, you must not meet in a group of more than 6. In England, this limit of 6 includes children and young people of any age.

At this alert level, our additional advice for clinically extremely vulnerable people is that you keep the number of different people you meet with consistently low. The fewer people you meet, the less likely you are to catch COVID-19.

You are encouraged to continue to go outside because of the benefits of exercise. If you do choose to meet other households outside of your support bubble, this must be outside, must be in groups of less than 6 people and we advise you to keep the numbers low.

The more you socially distance from others, including your own household, the less likely you are to catch COVID-19. You should always stay at least 2 metres away from other people visiting your home.

Work and education

The advice is the same as for Tier 1: Medium.

You should continue to work from home where possible. If you cannot work from home, you can still attend your workplace as your workplace should be COVID-secure. The general advice on work has further details about what to do if you have concerns.

If you cannot make alternative arrangements, your employer may be able to furlough you under the Coronavirus Job Retention Scheme, which has been extended until the end of March 2021. You should have a conversation with your employer about whether this is possible.

All pupils and students should continue to attend education settings at local tiers unless they are one of the very small number of pupils or students under paediatric or other NHS care and have been advised by their GP or clinician not to attend an education setting. Children and young people whose parents or carers are clinically extremely vulnerable should also continue to go to school.


At Tier 2: High, all people are advised to minimise travel and to avoid busy times and busy routes where possible.

In addition, we advise clinically extremely vulnerable people to avoid travel where possible except for going to work, school, or for essential shopping.

If you need to travel, walk or cycle if you can. If this is not possible, travelling in a private car is generally lower risk than public transport because you are likely to come into contact with fewer people. You should avoid sharing a car, especially with people outside of your immediate household or support bubble.

Going to shops and pharmacies

You are advised to reduce the number of shopping trips you make. If you do go to the shops including pharmacies, consider doing so at quieter times of the day.

Consider using online delivery slots for food shopping or ask friends and family to help deliver shopping or collect medicines for you.

If you need further assistance with food shopping or medicine collection, NHS Volunteer Responders may be able to help.

If you require additional care and support

You should continue to receive care at home, either from professional social care and medical professionals, or from friends and family within your support bubble.

You should continue to access the NHS services that you need, and you should contact the NHS if you have an urgent or emergency care need.

For further information 

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