Risk of Covid-19 in shielded and care home patients

Early in the Covid-19 pandemic, the elderly and people who were clinically extremely vulnerable were asked to shield to reduce their risks of Covid-19 infection and its complications. We evaluated the effectiveness of shielding in a study published recently in the journal BJGP Open.

We found that Covid-19 rates were much higher in the shielded group compared with non-shielded group (6.5% vs 1.8%). The increase in risk of infection in the shielded group persisted after adjustment for a wide range of factors in a Cox proportional hazards regression model.

We also found that Covid-19 rates were seven times higher in people living in care homes; and were also higher among people from ethnic minorities, those living in poorer areas, and in people with long-term medical conditions such as respiratory disease.

Our results suggest that shielding alone is not enough to protect clinically vulnerable people and that vaccination, along with suppressing community infection rates, remains the best way to protect these patients from the risk of serious illness and death from Covid-19.

Our results also refute suggestions that the UK could have avoided lockdowns by shielding vulnerable groups, whilst allowing society to otherwise function normally. This policy would probably have led to even higher infection, hospitalisation, and death rates in vulnerable people.

DOI: https://doi.org/10.3399/BJGPO.2021.0081