Most children with asthma, diabetes and epilepsy do not need to shield, say doctors

The majority of children with conditions such as asthma, diabetes, epilepsy, and kidney disease do not need to continue to shield and could go back to school, according to new guidance.
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The Royal College of Paediatrics and Child Health (RCPCH) has published a new list for doctors - which the Government will take account of - on who should continue to shield and who no longer needs to.

It says many children with conditions such as cerebral palsy and scoliosis should no longer be shielded, adding that the benefits of school "in terms of access to therapies and developmental support" outweigh the risk of infection.

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It said: "Children and young people who are cared for just in primary care are very unlikely to need to continue to shield."

Parents drop off pupils as Reception, Year 1 and Year 6 begin to return to school as part of a wider easing of lockdown measures in EnglandParents drop off pupils as Reception, Year 1 and Year 6 begin to return to school as part of a wider easing of lockdown measures in England
Parents drop off pupils as Reception, Year 1 and Year 6 begin to return to school as part of a wider easing of lockdown measures in England

The RCPCH has created two lists, with those on List A being advised to continue to shield.

These include children with immunodeficiency and immunosuppression, such as those who have had transplants, children having cancer treatment for acute leukaemia and Non-Hodgkin's Lymphoma, and children with significant impairment in their ability to cough and to clear their airways.

Patients on List B, however, can discuss with their doctors whether it is safe for them to stop shielding, and, for example, return to school when these reopen.

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This includes children with some cardiac conditions, those with sickle cell disease and children who were born premature with oxygen requirements, and those with kidney disease, cystic fibrosis or more serious asthma.

The guidance says: "Many children with asthma, including those treated with biological agents and daily (drug) prednisolone, will not need continued shielding."

It adds: "There is no evidence that children with diabetes are more likely to be infected with Covid-19 compared to children without diabetes."

Dr Liz Whittaker, co-author of the guidance for the RCPCH, said: "There is a group of children who are very clinically vulnerable, and they should continue to shield.

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"There is a second group who are currently shielding but may not need to do so.

"It's important for parents and carers to have a conversation with their specialist to determine the best course of action.

"These conversations will be informed by knowledge of the severity of the disease, intensity of the treatment, and, for some, their home situation.

"We need to get the balance right between clinical risks and the social impact of shielding.

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"We know this has been a tough period for lots of children, young people, and their loved ones. This guidance is to help doctors have evidence-based discussions with parents and carers."

Figures out last month show that one in 25 people in England is currently on the Covid-19 "extremely vulnerable" shielding list.

Data from NHS Digital shows that 4% of the population in England, or 2,213,950 people, have been verified by GPs and hospitals as suffering from conditions that mean they should be closely protected from exposure to coronavirus.

Of the people on the current list, some 92,633 are under the age of 18, while 1,169,220 are aged from 18 to 69.

A further 952,027 people are aged 70 and over.

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