As summer approaches and the COVID-19 vaccination programme has been a tremendous success with more than half the population in the UK now vaccinated, we can start to look forward to getting back to some kind of normal life. The number of infected people in the UK is decreasing and plans are underway to come out of the third lockdown. However, we still need to remain vigilant, and continue to follow Government advice to keep ourselves safe, especially those people who are vulnerable and who have cancer and their families.
Below is some information about coronavirus, and links to websites where you can find the latest information. There is also some advice about coronavirus for people with cancer from the One Cancer Voice group of charities.
Coronaviruses are a large group of viruses that are responsible for different illnesses, including the common cold. The latest outbreak started in an animal in China and was then transmitted to humans.
The current outbreak is a new strain of coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and has not been previously diagnosed in humans. SARS-CoV-2 infects humans to cause coronavirus disease 2019 or COVID-19.
- High temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
- New, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
- Loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal.
If you are worried about symptoms, please call NHS 111 or go to the NHS 111 coronavirus advice website. Do not go directly to your GP or other healthcare environment.
Staying at home if you have symptoms (self-isolation)
UPDATED: 2 February 2021
If your symptoms are mild, NHS 111 will usually advise you and anyone you live with not to leave your home. This is called self-isolation.
- If you have symptoms, however mild, OR you have had a positive coronavirus (COVID-19) test result you should immediately self-isolate at home for 7 days from when your symptoms started. Do not go to a GP surgery, pharmacy or hospital. You should arrange to have a test to see if you have COVID-19. See also the Government’s COVID-19 getting tested page. If you have a positive test result, you will receive a request by text, email or phone to log into the NHS Test and Trace service website and provide information about recent close contacts
- Consider alerting people who you do not live with and have had close contact within the last 48 hours to let them know you have symptoms of coronavirus COVID-19
- Anyone who lives in your household but does not have symptoms should self-isolate for 14 days from when the first person in your home started having symptoms. If anyone else in your household starts displaying symptoms, they must stay at home for at least 7 days from when their symptoms appeared, regardless of what day they are on in their original 14-day isolation period
- If you still have a high temperature after 7 days or longer you must continue to self-isolate until you feel better.
- You do not need to self-isolate after 7 days if you only have a cough or loss of sense of smell or taste, as these symptoms can last for several weeks after the infection has gone
- If you have symptoms, you should stay as far away from other members of your household as possible. It is especially important to stay away from anyone who is clinically vulnerable or clinically extremely vulnerable with whom you share a household
- Reduce the spread of infection in your home by washing your hands regularly for 20 seconds using soap and water, or use hand sanitiser, and cover coughs and sneezes
- If you feel you cannot cope with your symptoms at home, or your condition gets worse, or your symptoms do not get better after 7 days, then use the NHS 111 online service
- If you develop new COVID-19 symptoms at any point after ending your first period of isolation then you must follow the same guidance on self-isolation again.
It is critical that everybody observes the following key behaviours:
- HANDS – Wash your hands regularly and for 20 seconds.The NHS has made a video to explain how to wash your hands.
- FACE – Wear a face covering in indoor settings where social distancing may be difficult, and where you will come into contact with people you do not normally meet
- SPACE – Stay 2 metres apart from people you do not live with where possible, or 1 metre with extra precautions in place (such as wearing face coverings or increasing ventilation indoors).
The Government have issued guidance about how to stop the spread of coronavirus (COVID-19).
This guidance provides information about:
How to protect yourself and others
It is possible to have COVID-19 with no symptoms. You can pass COVID-19 on to others if you only have mild symptoms or even no symptoms at all. The main way of spreading COVID-19 is through close contact with an infected person. When someone with COVID-19 breathes, speaks, coughs or sneezes, they release particles (droplets and aerosols) containing the virus that causes COVID-19. These particles can be breathed in by another person.
Surfaces and belongings, such as furniture, benches or door handles, can also be contaminated with COVID-19, when people who are infected cough or sneeze near them or if they touch them.
- Keep a safe distance (social distancing) If you must leave your home stay at least 2 metres away from people from people you do not live with or who are not in your support bubble, avoid crowded areas and face to face contact with people you do not live with.
- Remember the basics of good hygiene, such as regular hand washing, cleaning your surroundings, and covering your nose and mouth when you cough or sneeze.
- Wear a face covering, especially in places where you must wear a face covering by law. Wearing a face covering may not be possible in every situation and some people are exempt; please be mindful and respectful of such circumstances.
- Let fresh air in (ventilation) to reduce the spread of contaminated air to other parts of the household, especially after visitors such as cleaners or tradespersons.
- Get tested if you have symptoms, such as a new continuous cough, a high temperature, or a loss of, or change in, your normal sense of taste or smell. If you have any of these symptoms click get a free NHS test or call NHS 119 to book a free COVID-19 test. You should arrange a test even if you have been vaccinated against COVID-19 or if you have had COVID-19 before. It is important to know if you have COVID-19 so that you stay at home, self-isolate and do not infect other people. Contacting people you may have been in contact with to advise them to self-isolate.
- Self-isolate if you have COVID-19 symptoms or a positive COVID-19 test result. Your isolation period includes the day your symptoms started (or the day your test was taken if you do not have symptoms), and the next 10 full days. You must stay at home at all times and not have contact with other people, except for medical assistance or shopping. There is additional guidance for those who have symptoms or have tested positive for coronavirus and live with someone who is clinically extremely vulnerable or over 70.
- Self-isolate if you live with someone or are a contact of someone who has COVID-19
- Vaccination. The NHS is currently offering COVID-19 vaccines to all adults. The vaccines have been shown to reduce the likelihood of severe illness, but we do not know yet if they stop COVID-19 from spreading. Even if you have been vaccinated, you could still spread COVID-19 to others. To help protect your friends, family, and community you should continue to follow all of the advice above even if you have been vaccinated.
Clinically extremely vulnerable people
UPDATED: 1 April 2021
New national restrictions come into place on 7 January for everyone in England.
The new guidance for clinically extremely vulnerable people will help protect you from coronavirus (COVID-19). It covers things such as socialising, working, schools and universities, travel, shopping accessing medicines and support.
People who are defined as clinically extremely vulnerable are thought to be at very high risk of serious illness from coronavirus. There are 3 ways you may be identified as clinically extremely vulnerable:
- You have one or more of the conditions listed below
- Your hospital clinician or GP has added you to the Shielded Patient List because, based on their clinical judgement, they deem you to be at high risk of serious illness if you catch the virus
- You have been identified through the COVID-19 Population Risk Assessment as potentially being at high risk of serious illness if you catch the virus.
If you do not fall into any of these categories, and have not been contacted to inform you that you are on the Shielded Patient List, follow the national lockdown guidance for the rest of the population.
If you are considered to be clinically extremely vulnerable to coronavirus you need to stay at home as much as possible to keep interactions with other people to a minimum.
If you think there are good clinical reasons why you should be added to the Shielded Patient List, discuss your concerns with your GP or hospital clinician. People with the following conditions are automatically deemed clinically extremely vulnerable:
- Solid organ transplant recipients
- People with specific cancers:
- People with cancer who are undergoing active chemotherapy
- People with lung cancer who are undergoing radical radiotherapy
- People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
- People having immunotherapy or other continuing antibody treatments for cancer
- People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
- People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs
- People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
- People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
- People on immunosuppression therapies sufficient to significantly increase risk of infection
- Problems with your spleen, for example splenectomy (having your spleen removed)
- Adults with Down’s syndrome
- Adults on dialysis or with chronic kidney disease (stage 5)
- Women who are pregnant with significant heart disease, congenital or acquired
- Other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions
General shielding advice
The guidance for people who are considered to be clinically extremely vulnerable remains as follows:
- You should always follow general social distancing advice
- Try to stay at least 2 metres (3 steps) away from anyone you do not live with (or anyone not in your support bubble)
- Wash your hands with soap and water often – do this for at least 20 seconds
- Use hand sanitiser gel if soap and water are not available
- Wash your hands as soon as you get home
- Wear something that covers your nose and mouth in places where it’s hard to stay away from other people, such as on public transport, in shops and in hospitals
- Do not touch your eyes, nose or mouth if your hands are not clean
- Do not touch things that people you do not live with have touched, including food and drinks.
For practical tips on staying safe, see the guidance for people at high risk from coronavirus (shielding).
You will still be able to get:
- Local volunteer support by contacting your local authority
- Prescriptions, essential items and food you buy delivered by NHS Volunteer Responders
- Priority slots for supermarket deliveries (if you previously registered for free food parcels).
The Government has taken advice from clinicians, GPs, charities, the voluntary sector and patient groups.
Vitamin D supplements for people who have been shielding
During the autumn and winter months everyone is advised to take a supplement of vitamin D every day to support general health and in particular for bone and muscle health. Many of us have been indoors more than usual this year and so might not have been making enough vitamin D from sunlight. You can find general advice on vitamin D here.
This advice is particularly important for people who have been shielding this year due to COVID-19, or who are living in care homes, because they are most likely to have been indoors over the spring and summer and so may not have been able to obtain enough vitamin D from sunlight. The Government is offering a free 4-month supply of daily vitamin D supplements for all adults who are clinically extremely vulnerable. If you would like to opt-in to receive your free supply of vitamin D, you will need register your details between 30 November 2020 and 4 January 2021 at the following link: www.nhs.uk/get-vitamin-d
You should not opt in to receive the vitamin D supplement if:
- You are already taking, or are prescribed, a vitamin D supplement by your GP or healthcare professional
- You are already taking, or are prescribed, a medication that contains vitamin D by your GP or healthcare professional
- You are under the age of 18
- You have a medical condition or treatment that means you may not be able to safely take as much vitamin D as the general population. You should speak to your GP or healthcare professional at your next appointment if you under the care of a renal, endocrinology or cancer specialist.
The Government has issued guidance on vitamin D supplements and how to take them.
Coming out of lockdown if you have been shielding
If you’re at high risk from coronavirus, you should receive a letter from the NHS to explain that from 1 April 2021 you no longer need to shield. However, the Government still recommend that you take extra precautions to protect yourself while the virus is still spreading in our communities. The updated guidance provides practical steps that cover things like socialising, travel and going to work and school. These are not rules but advice, so you can choose whether you wish to follow them or not. You can find the full guidance at in the letter and on the Government’s website. In addition to this advice, you must continue to follow the regulations that are in place for everyone during the pandemic. This includes rules on mixing with people from other households.
Read the Government’s press release here: Shielding advice for the clinically extremely vulnerable to stop from April
One Cancer Voice 12-point Plan
One Cancer Voice, a group of charities led by Cancer Research UK, have issued a questions and answer leaflet for cancer patients. However, this document was last updated in June 2020, and some of the advice no longer applies.
One Cancer Voice have also issued a Covid and Cancer 12 point plan to describe how cancer services can be restored and recovered, both locally and at a national level. We would urgently like to see a national plan published, detailing how the Government and the NHS intends to manage cancer services over the next few months as we attempt to control COVID-19, and how we fully recover services and get back on track to deliver transformed cancer outcomes. Close monitoring and adequate action is needed to ensure inequalities are addressed. In addition, there are plans to significantly transform cancer services to deliver the improved outcomes that patients in this country expect and deserve.
Clinically vulnerable people
Guidance for clinically vulnerable people is similar to that for clinically extremely vulnerable people, including children. It advises on social distancing measures to reduce social interaction between people and reduce the transmission of coronavirus (COVID-19). It is intended for use in situations where people are living in their own homes, with or without additional support from friends, family and carers.
If you have any of the following health conditions, you may be clinically vulnerable, meaning you could be at higher risk of severe illness from coronavirus. Although you can meet people outdoors and indoors, you should be especially careful and be diligent about social distancing and hand hygiene:
People at moderate risk from coronavirus include people who:
- Are 70 or older
- Have a lung condition that’s not severe (such as asthma, COPD, emphysema or bronchitis)
- Have heart disease (such as heart failure)
- Have diabetes
- Have chronic kidney disease
- Have liver disease (such as hepatitis)
- Have a condition affecting the brain or nerves (such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy)
- Have a condition that means they have a high risk of getting infections
- Are taking medicine that can affect the immune system (such as low doses of steroids)
- Are very obese (a BMI of 40 or above)
- Are pregnant – see advice about pregnancy and coronavirus
If you’re at moderate risk from coronavirus, you can go out to work (if you cannot work from home) and for things like getting food or exercising. But you should try to stay at home as much as possible.
Unlike people at high risk, you will not get a letter from the NHS.
Other things that can affect your risk
There are other things that can make you more likely to get seriously ill from coronavirus, including if you are:
- Over 60 – your risk increases as you get older
- From a Black, Asian or minority ethnic background.
Where can I get help?
If you are vulnerable, shielding, or self-isolating and are in need of support, NHS volunteer responders may be able to help with shopping, collection of prescription medicines or a friendly chat. There is also guidance available for adult social care and you can register for support on the Government’s website here. Read the Government’s Local COVID alert levels: what you need to know here.
If you have any concerns about this advice, please contact us.
Wales, Scotland and Northern Ireland
The UK’s COVID-19 alert level is now at level three. This means that the virus is considered to be in general circulation. The Government has released the Government’s plan for recovery to return life to as near normal as possible in order to safeguard livelihoods, but in a way that is safe and continues to protect our NHS. Currently this plan only applies to people living in England.
Here is a pdf version of this help sheet: COVID-19 vaccination helpsheet 14 Apr 2021
See also the following guide to vaccinations for COVID-19 from the British Society for Immunology.
Recently there have been reports of a very rare condition involving blood clots and unusual bleeding after vaccination. The Government are carefully reviewing these cases, but the risk factors for this condition are not yet clear. Although this condition remains extremely rare there appears to be a higher risk in people shortly after the first dose of the Oxford AstraZeneca vaccine. Around 4 people develop this condition for every million doses of vaccine given. This is seen slightly more often in younger people and tends to occur between 4 days and 2 weeks following vaccination. This condition can also occur naturally, and clotting problems are a common complication of COVID-19 infection. An increased risk has not yet been seen after other COVID-19 vaccines but is being carefully monitored. The Government has released a leaflet to explain the risk of blood clotting.
Is the vaccine safe for kidney cancer patients?
“We are advising all our patients to be vaccinated as soon as they are invited unless there is a clear contraindication e.g. history of serious allergic reaction…….with the Pfizer/BioNTech vaccine.”
This advice covers kidney cancer patients taking targeted therapy (e.g., sunitinib, pazopanib, axitinib or cabozantinib) and immunotherapy (nivolumab, ipilimumab, pembrolizumab or avelumab), and those with reduced kidney function. If your individual situation is worrying you, then please make sure you discuss this with your doctor who is the only person who has access to all your medical notes. If you are aware that you have had a severe allergic reaction to any drugs, pills or potions or any type of foodstuff then please make sure your doctor is aware of this. Further information about the coronavirus vaccination can be found on the NHS website.
Even though kidney transplant recipients were not included in the early COVID-19 clinical trials, many doctors believe the COVID-19 vaccine will be safe for these patients because the virus used to make the vaccine is not living (similar to the flu vaccine).
So, while the vaccine may be safe, its effectiveness in people with one kidney is not yet known.
Most doctors agree that the benefits of the vaccine for people with chronic kidney disease at any stage, those on dialysis, and kidney transplant recipients are much greater than the risk of serious disease or complications from COVID-19. Talk to your doctor or other healthcare professional about getting a COVID-19 vaccine.
What to expect after your COVID-19 vaccination
Like all medicines, vaccines can cause side effects. Most of these are mild and don’t last a long time, and not everyone gets them. Even if you do have symptoms after the first dose, you still need to have the second dose. Although you may get some protection from the first dose, having the second dose will give you the best protection against the virus.
Very common side effects include:
- Having a painful, heavy feeling and tenderness in the arm where you had your injection. This tends to be worst around 1 to 2 days after the vaccine
- Feeling tired
- General aches, or mild flu-like symptoms.
Generally, these happen shortly after the vaccination and are not associated with more serious or lasting illness.
These types of reactions reflect the normal immune response triggered by the body to the vaccines. They are typically seen with most types of vaccine and tend to resolve within a day or two. The nature of reported suspected side effects is broadly similar across age groups, although, as was seen in clinical trials and as is usually seen with other vaccines, they may be reported more frequently in younger adults.
The most important symptoms of COVID-19 are recent onset of any of the following:
- A new continuous cough
- A high temperature
- Loss of, or change in, your normal sense of taste or smell (anosmia)
Although a mild fever can occur within a day or two of vaccination, if you have any other COVID-19 symptoms or your fever lasts longer, stay at home and arrange to have a COVID-19 test. Further information on symptoms is available on NHS.UK.
You should be able to resume normal activities as long as you feel well. If your arm is particularly sore, you may find lifting heavy objects difficult. If you feel unwell or very tired you should rest and avoid operating machinery or driving.
It may take a week or two for your body to build up some protection from the first dose of vaccine. Like all medicines, no vaccine is completely effective, so you should continue to take the recommended precautions to avoid infection. Some people may still get COVID-19 despite having a vaccination, but this should be less severe.
The vaccine cannot give you COVID-19 infection, and a full course will reduce your chance of becoming seriously ill. We do not yet know whether it will stop you from catching and passing on the virus, but we do expect it to reduce this risk. So, it is still important to follow the guidance in your local area to protect those around you.
UPDATED: 13 January 2021
Two vaccines have been approved for use in the UK: the Pfizer/BioNTech COVID-19 vaccine and the Oxford/AstraZeneca COVID-19 vaccine. Both vaccines will be rolled out to the priority groups over the next few months. Both vaccines protect people against the new SARS-CoV-2 variant. There is no preference for one vaccine over the other for any specific population. As the vaccines are rolled-out further data are being collected about their safety and effectiveness. Because of the high rate of COVID-19 infection in the UK, the Government need rapid and high levels of vaccine uptake. Therefore, delivery of the first dose of vaccine will take priority, and the second dose may be given up to 12 weeks after the first for both vaccines. The second dose is important and may affect the duration of protection.
An independent group of experts has recommended that the NHS offers these vaccines to those at highest risk of catching the disease and of suffering serious complications or dying from COVID-19 first. This includes older adults in care homes and frontline health and social care workers. The Government has released guidance on the priority groups for the new vaccines that are now becoming available, as well as guidance for the vaccination of older adults and why you are being asked to wait for your vaccination. When more vaccine becomes available, the vaccines will be offered to other people at risk as soon as possible.
You will be contacted by your GP surgery, the vaccination centre or the NHS to attend your vaccination appointment. Please do not ring your GP surgery to ask for an appointment but wait for them to contact you. You might hear via a letter in the post, an email, a text message or a phone call. If you are contacted electronically, please be careful about the validity of the message: There are a number of bogus messages going around. Only people in the top 4 categories below will be asked to attend their vaccination appointment during January and the first 2 weeks of February.
Vaccination will take place in two phases:
The first priorities for the COVID-19 vaccination programme should be the prevention of death and the maintenance of the health and social care systems. As the risk of death from COVID-19 increases with age, prioritisation is primarily based on age.
This priority list is as follows:
- Residents in a care home for older adults and their carers
- All those 80 years of age and over and frontline health and social care workers
- All those 75 years of age and over
- All those 70 years of age and over and clinically extremely vulnerable individuals
- All those 65 years of age and over
- All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality. This also includes those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill
- All those 60 years of age and over
- All those 55 years of age and over
- All those 50 years of age and over
It is estimated that taken together, these groups represent around 99% of preventable deaths from COVID-19.
The COVID-19 vaccine programme should aim to achieve high vaccine uptake. An age-based programme will likely result in faster delivery and better uptake in those at the highest risk. Implementation should also involve flexibility in vaccine deployment at a local level with due attention to:
- Mitigating health inequalities, such as might occur in relation to access to healthcare and ethnicity
- Vaccine product storage, transport and administration constraints
- Exceptional individualised circumstances
- Availability of suitable approved vaccines, for example for specific age cohorts
The next phase – further reduction in hospitalisation and targeted vaccination of those at high risk of exposure and/or those delivering key public services
As the first phase of the programme is rolled out in the UK, additional data will become available on the safety and effectiveness of COVID-19 vaccines. These data will provide the basis for consideration of vaccination in groups that are at lower risk of mortality from COVID-19.
Vaccination of those at increased risk of exposure to SARS-CoV-2 due to their occupation could also be a priority in the next phase. This could include:
- First responders
- The military
- Those involved in the justice system
- Transport workers
- Public servants essential to the pandemic response.
Wider use of COVID-19 vaccines will provide a better understanding of whether they can prevent infection and onward transmission in the population. Data on vaccine impact on transmission, along with data on vaccine safety and effectiveness, will potentially allow for consideration of vaccination across the rest of the population.
The Government has released guidance on What to expect after your COVID-19 vaccination, which includes side effects to the vaccine, whether you can catch COVID-19 from the vaccine, whether you can go back to normal activities after the vaccine, and what to do next. The Government have also issued guidance explaining Why you have to wait for your COVID-19 vaccination. There is also a COVID-19 vaccination guide for adults.
ESMO statements for vaccination against COVID-19 in patients with cancer
The European Society for Medical Oncology has issued statements for vaccination against COVID-19 in cancer patients.
On 4 January 2021 the UK entered into another national lockdown. This lockdown is gradually being eased. However, you must follow Government guidance to protect the NHS and save lives. From 8 March, people in England will see restrictions start to lift and the government’s four-step roadmap offer a route back to a more normal life. This is underpinned by law.
The Government has ordered millions of vaccine doses to be made available across the UK, and a nationwide vaccination programme has been deployed across the whole country. By the summer, these advances should reduce the need for economic and social restrictions. There is a route out of this epidemic, provided the vaccines are successfully deployed.
However, we must be patient, and realistic. There are still months ahead, and in the meantime we must keep the virus under control and follow the Government guidance.
Step 1: From 8 March
All children and students return safely to face-to-face education in schools and colleges from 8 March. Childcare and children’s supervised activities can also resume where necessary to enable parents to work or engage in similar activities. Twice-weekly rapid testing for secondary and college pupils – in addition to regular testing for all teachers – to reduce the chance of the virus spreading in schools.
Higher Education students at English universities on practical courses can also return from 8 March.
People will be allowed to leave home for recreation and exercise outdoors with their household or support bubble, or with one person from outside their household. Care home residents will also be allowed one regular visitor.
Up to 30 people will be able to attend funeral and up to 6 people will be able to attend weddings, receptions and wakes. This limit of 6 will also apply to other types of significant life events including bar mitzvahs and christenings.
Step 1: From 29 March
The evidence shows that it is safer for people to meet outdoors rather than indoors. And this is why from 29 March, when most schools break up for the Easter holidays, outdoor gatherings (including in private gardens) of either 6 people from any number of households (the Rule of 6) or in a group of any size from up to 2 households will also be allowed, making it easier for friends and families to meet outside. A household can include an existing support bubble, if eligible.
Outdoor sports facilities such as tennis and basketball courts, and open-air swimming pools, will also be allowed to reopen, and people will be able to take part in formally organised outdoor sports with any number of people.
Childcare and supervised activities are allowed outdoors for all children. Formally organised parent and child groups can take place outdoors for up to 15 attendees. Children under 5 will not be counted in this number.
The ‘stay at home’ rule will end on 29 March but many restrictions will remain in place. People should continue to work from home where they can and minimise the number of journeys they make where possible, avoiding travel at the busiest times and routes. Travel abroad will continue to be prohibited, other than for a small number of permitted reasons. Holidays abroad will not be allowed, given it will remain important to manage the risk of imported variants and protect the vaccination programme.
If you are clinically extremely vulnerable, you are no longer advised to shield. However, you should continue to follow the guidance for people who are clinically extremely vulnerable and are advised to take additional precautions to protect yourself. It is important that you continue to keep the number of social interactions that you have low and try to limit the amount of time you spend in settings where you are unable to maintain social distancing.
You may leave the home to:
- Shop for basic necessities for you, your household (or support bubble) or a vulnerable person
- Go to work, or provide voluntary or charitable services, if you cannot reasonably do so from home
- You can take part in formally organised outdoor sports with any number of people (outdoor sports venues and facilities will be able to reopen)
- Seek medical assistance or avoid injury, illness or risk of harm (including domestic abuse)
- Attend childcare and supervised activities outdoors for all children
- Attend formally organised parent and child groups outdoors for up to 15 attendees. Children under 5 will not be counted in this number
- Go to school (primary and secondary), college, early years settings or university (for practical courses only)
- You must stay local, unless you have a valid reason for travel, e.g. for work purposes
You can help to protect your friends and family by downloading the NHS COVID-19 App.
There is separate guidance for households with a possible or confirmed coronavirus infection.
This guidance applies in England only and can also be found on the NHS website here. The guidance also refers to the NHS test and trace programme for testing people with coronavirus symptoms and tracing close contacts for self-isolation. There is also guidance for getting tested for COVID-19.
Step 2: From 12 April
The rules on social contact will still applying. Indoor settings must only be visited alone or with household groups. Outdoor settings are limited to either six people or two households. You must not socialise indoors with anyone you do not live with or have formed a support bubble with. You should continue to work from home if you can and minimise the number of journeys you make where possible.
You should get a test and follow the stay at home guidance if you have COVID-19 symptoms. Continue to follow the guidance to prevent the spread of COVID-19: Stay 2 metres apart from anyone not in your household and wear a face covering indoors or on public transport. If indoors, make sure rooms have a flow of fresh air by keeping windows and doors open. Wash your hands regularly for 20 seconds.
Opening of non-essential retail, personal care premises such as hairdressers, beauty and nail salons, and public buildings, including libraries and community centres no earlier than 12 April. Indoor leisure facilities such as gyms and spas will also reopen for use by people on their own or in household groups (but not including saunas and steam rooms, which are due to open at Step 3).
Public buildings such as libraries and community centres will also reopen.
Most outdoor attractions and settings including outdoor hospitality venues, zoos, theme parks, and drive-in cinemas and performances will reopen. Overnight stays away from home in England will be permitted. Self-contained accommodation such as campsites and holiday lets, where indoor facilities are not shared with other households, can also reopen.
Hospitality venues will be allowed to serve people outdoors and customers must order, eat and drink while seated outside (‘table service’). Wider social contact rules will apply in all these settings to prevent indoor mixing between different households. There will be no requirement for a substantial meal to be served alongside alcohol, and no curfew.
While funerals can continue with up to 30 mourners, the number of people able to attend weddings, receptions and commemorative events such as wakes will rise to 15 (in premises that are permitted to open).
People should continue to work from home where they can, and minimise domestic travel where they can. International holidays are still illegal.
The number of care home visitors will also increase to two per resident.
All children will be able to attend any indoor children’s activity, including sport, regardless of circumstance. Parent and child groups of up to 15 people (not counting children aged under five years old) can restart indoors.
A COVID-status certification system will be developed over the coming months which could allow higher-risk settings to be opened up more safely and with more participants. The system will take into account three factors: vaccination, a recent negative COVID-19 test, or natural immunity (determined on the basis of a positive test taken in the previous six months).
Events pilots will take place from mid-April to trial the system. All pilots are checking COVID status. Initially this will be through testing alone but in later pilots vaccination and acquired immunity are expected to be alternative ways to demonstrate status.
In summary, the following changes are made from 12 April 2021:
- Non-essential retail shops can reopen
- Personal care services such as hairdressers and nail salons can reopen, including those provided from a mobile setting
- Public buildings such as libraries and community centres can reopen
- Outdoor hospitality venues can reopen, with table service only
- Most outdoor attractions including zoos, theme parks, and drive-in performances (such as cinemas and concerts) can reopen
- Some smaller outdoor events such as fetes, literary fairs, and fairgrounds can take place
- Indoor leisure and sports facilities can reopen for individual exercise, or exercise with your household or support bubble (but no indoor group exercise classes)
- All childcare and supervised activities are allowed indoors (as well as outdoors) for all children. Parent and child groups can take place indoors (as well as outdoors) for up to 15 people (children under 5 will not be counted in this number)
- Weddings, civil partnership ceremonies, wakes and other commemorative events can take place for up to 15 people (anyone working is not included in this limit), including in indoor venues that are permitted to open or where an exemption applies. Wedding receptions can also take place for up to 15 people, but must take place outdoors, not including private gardens
- Self-contained accommodation can stay open for overnight stays in England with your household or support bubble
- Care home residents will be able to nominate two named individuals for regular indoor visits (following a rapid lateral flow test)
- You should continue to work from home if you can and minimise the amount that you travel where possible.
Step 3: No earlier then 17 May
Will start no earlier than 17 May. The government will look to continue easing limits on seeing friends and family wherever possible, allowing people to decide on the appropriate level of risk for their circumstances.
This means that most legal restrictions on meeting others outdoors will be lifted – although gatherings of over 30 people will remain illegal. Indoors, the Rule of 6 or 2 households will apply and kept under review.
The government will also update the advice on social distancing between friends and family, including hugging. But until this point, people should continue to keep their distance from anyone not in their household or support bubble.
Most businesses in all but the highest risk sectors will be able to reopen. In all sectors, COVID-Secure guidance will remain in place and businesses may not cater for groups bigger than the legal limits. Indoor hospitality will reopen; venues will not have to serve a substantial meal with alcoholic drinks and there will not be a curfew. Customers will, however, have to order, eat and drink while seated.
Other indoor locations such as cinemas, children’s play areas, accommodation including hotels, hostels and B&Bs, and indoor adult group sports and exercise classes will open. The government will also allow some larger performances and sporting events in indoor venues with a capacity of 1,000 people or half-full (whichever is a lower number), and in outdoor venues with a capacity of 4,000 people or half-full (whichever is a lower number). In the largest outdoor seated venues, where crowds can be spread out, up to 10,000 people will be able to attend (or a quarter-full, whichever is lower).
Up to 30 people will be able to attend weddings, receptions and wakes, as well as funerals. This limit will also apply to other types of significant life events including bar mitzvahs and christenings.
Before Step 4 begins, the government will complete a review of social distancing and other long-term measures that have been put in place to cut transmission. This will inform decisions on the timing and circumstances under which the rules on 1 metre plus, the wearing of face coverings and other measures may be lifted. This will also inform guidance on working from home, which should continue wherever possible until this review is complete.
Step 4: No earlier than 21 June
Will start no earlier than 21 June. The government hopes to be in a position to remove all legal limits on social contact.
The government hopes to reopen remaining premises, including nightclubs, and ease the restrictions on large events and performances that apply in Step 3. This will be subject to the results of a scientific Events Research Programme to test the outcome of certain pilot events through the spring and summer. This will also guide decisions on whether all limits can be removed on weddings and other life events.
As we move through each of these phases in the roadmap, we must all remember that COVID-19 remains a part of our lives. We are going to have to keep living our lives differently to keep ourselves and others safe. We must carry on with ‘hands, face, space’. Comply with the COVID-Secure measures that remain in place. Meet outdoors when we can and keep letting fresh air in. Get tested when needed. Get vaccinated when offered. If we all continue to play our part, we will be that bit closer to a future that is more familiar.
Wales, Scotland and Northern Ireland
The Government has released the Government’s plan for recovery to return life to as near normal as possible in order to safeguard livelihoods, but in a way that is safe and continues to protect our NHS. Currently this plan only applies to people living in England.
The UK government pledged to test 500,000 people per day for coronavirus by the end of October 2020.
The test currently available is a PCR test to determine whether you currently have COVID-19. There are also antibody tests to determine whether you have previously had COVID-19 and have immunity to the virus are not yet available.
Patients in hospital with coronavirus symptoms have been tested to find out if they have COVID-19. Going forward, everyone admitted to hospital will be tested, regardless of the reason for their admission. If you are not in hospital and would like to be tested, you must meet certain criteria.
The Government have issue guidance on coronavirus testing (5 October 2020), including who is eligible for a test and how to get tested:
- Who can be tested
- Registering for a home test kit
- The testing process
- Testing in care homes
- List of essential workers and those prioritised for testing (England only)
You can get a throat and nose swab test to see if you currently have coronavirus. This test is most effective within 3 days of the symptoms developing.
Who can be tested
The following groups of people can ask for a test through the NHS website:
- Anyone living in England and Wales who has symptoms of coronavirus, whatever their age
- Anyone living in Scotland and Northern Ireland aged 5 and over who has symptoms of coronavirus.
The following groups of people can access priority testing through the NHS:
- Essential workers in England, Scotland, Wales and Northern Ireland
- Anyone in England, Scotland, Wales and Northern Ireland over 5 years old who has symptoms of coronavirus and lives with an essential worker
- Children under 5 years old in England and Wales who have symptoms of coronavirus and live with an essential worker (this test must be performed by a parent or guardian).
Most people infected with coronavirus (COVID-19) have mild to moderate symptoms and there is no evidence showing that COVID-19 adversely affects the kidneys. A small proportion of patients with COVID-19 develop severe infection and require hospitalisation. Of these hospitalised patients, a small proportion have a decline in their kidney function (glomerular filtration rate, GFR). For more information, please see the COVID-19 page on the Kidney Care UK website.
The Government has issued advice about taking vitamin D supplements during the winter months, particularly if you are self-isolating. If you have kidney cancer or kidney disease, you need to be careful about taking vitamin D supplements. Please talk to you GP or healthcare professional for advice about vitamin D supplements and your condition.
If you are living with one kidney or you have lost part of a kidney due to a partial nephrectomy but you are otherwise healthy, then your risk of being infected with coronavirus (COVID-19) would likely be similar to someone with two kidneys.
However, every person is unique, and many factors can result in increased risk of COVID-19. If you are worried, you should ask your GP or healthcare team for information about your own individual risk.
The Government are advising people with long-term (chronic) kidney disease to be particularly stringent in following the social distancing guidelines. This is because people with chronic kidney disease are at increased risk of complications if they get COVID-19 infection. Most patients with kidney cancer do not have chronic kidney disease.
Treatments for kidney cancer include the following:
- Targeted therapies such as sunitinib (Sutent), pazopanib (Votrient), axitinib (Inlyta), cabozantinib (Cabometyx), and lenvatinib (Lenvima)
- Immunotherapy treatments include nivolumab (Opdivo), ipilimumab (Yervoy), pembrolizumab (Keytruda), and bevacizumab (Avastin).
The Government has issued guidance to define those people who are extremely vulnerable to severe illness if they are infected with coronavirus (COVID-19). This includes people who are on immunotherapy and/or targeted therapy, such as protein kinase inhibitors, for the treatment of advanced or metastatic cancer. These people should have been sent a letter from their healthcare team asking them to follow the ‘shielding’ guidelines to keep themselves safe.
What will happen to my cancer treatment?
You might have questions about your ongoing cancer treatment, such as:
- Will it be postponed?
- Should I still go to hospital appointments?
- How will my hospital decide whether I am a priority for treatment? Will there be national rules?
- If treatment, including stem cell transplants, are deferred and I begin to relapse will this limit my eligibility for future lines of treatment?
- Should I start chemotherapy treatment (particularly if it is a 2nd/3rd line for “mop up” ) or postpone?
- As a stage 4 patient will I be given life support if I have breathing difficulties due to the virus?
- If I get the virus and recover, will this affect my cancer treatment and outlook?
Essential and urgent cancer diagnosis, treatment and care will continue. NHS staff are working hard to ensure cancer treatments can continue in the safest and best possible way. To do this during the pandemic there may need to be some changes to how treatments are delivered.
- Cancer treatments, especially operations and chemotherapy, are riskier now than before. Cancer and its treatment can weaken the immune system, making a person more vulnerable to the virus.
- In some cases, it may be safer to delay cancer treatment or give it in a different way, to reduce the risk from coronavirus.
- Any decisions about surgery and other treatments will be based on how urgent it is and the level of risk. Your safety is a priority in making any decisions.
Changes are being made to the way services are delivered to keep patients and staff safe.
- Most hospitals have started to use more telephone consultations as a way of helping people to avoid long waits in clinics and for treatment. You may be called to arrange your treatments in this way, and planned treatments may need to be moved to help with running a smooth service.
- Some patients may have their chemotherapy at home or have fewer radiotherapy appointments, to reduce visits to hospital while continuing with their treatment.
- For some people, it may be safer to delay surgery. Your doctor may suggest a different treatment in the meantime, such as chemotherapy or hormonal therapy.
Some patients may start to see their treatment move to a different hospital as the NHS sets up ‘cancer hubs’ to coordinate treatment and ensure it can continue safely.
- In London, a ‘cancer hub’ led by The Royal Marsden in collaboration with University College London Hospital and Guy’s and St Thomas’ NHS Foundation Trust, is co- ordinating cancer services across the capital.
- Similar models are being set up in other parts of the country (e.g. Christie Hospital in Manchester), drawing on learning from Italy, China and London. The hubs will support hospitals across the NHS and independent sector to work together to maximise capacity and ensure that people receive the treatment that they need.
- You will remain under the care of your treating hospital and clinical specialist team and should contact them with any questions about your treatment and care.
Your cancer specialist team should discuss your treatment and care with you, including any changes. Your doctors will always have your safety at the centre of any decisions they make.
Nationally, the NHS has issued advice to clinicians to help inform these conversations with patients (updated 23 September 2020). The advice is also there to help clinicians to manage risks and prioritise treatment on the basis of clinical need.
Your clinical team are best placed to talk with you about your treatment and appointments. They will work with you to determine the best course of action in each individual situation. If you have any concerns or questions about your treatment, please speak to your clinical team.
The Association of the British Pharmaceutical Industry (ABPI) are in regular contact with both the pharmaceutical companies that supply medicines and the Government about any impact that the coronavirus could have on the supply of medicines to the NHS in the UK.
Pharmaceutical companies are not currently reporting any concerns about shortages of medicines or loss of manufacturing capacity as a result of COVID–19 restrictions.
There are robust procedures in place to manage the supply of medicines in the UK, and pharmaceutical companies will be taking all possible measures to secure supply for patients in line with Government guidance.
More information about the ABPI response to the coronavirus outbreak can be found here
The Royal College of Radiologists (RCR) has teamed up with the Society and College of Radiographers, the Institute of Physics and Engineering in Medicine, Cancer Research UK and Macmillan Cancer Support to release tailored coronavirus information for patients undergoing radiotherapy treatment: Protecting people with cancer from coronavirus when going for radiotherapy
Cancer centres have continued to run radiotherapy services throughout the coronavirus pandemic, where safe to do so. It is important that you continue to go for treatment when advised by your cancer team.
The safety of people with cancer and the staff looking after you is a top priority for hospitals. Cancer teams are using a range of precautions to protect you from coronavirus during your visit to the radiotherapy department.
Precautions might include:
- Asking if you have symptoms of coronavirus before you go for treatment, and on arrival in the department
- Changing how to get into the radiotherapy department so that you only move in areas of the hospital that are protected from coronavirus
- Minimising contact in communal waiting areas by arranging seating at least two metres apart or asking you to wait outside the department until your cancer team phones for you to go in. Relatives may have to wait outside the department
- Your cancer team wearing personal protective equipment such as face masks, gloves and aprons. They may also ask you to wear a face mask
- Asking you to wash your hands when you enter and leave the department
- Giving shorter courses of radiotherapy where possible and backed by good evidence. For example, many cancer centres are now giving people with breast cancer fewer radiotherapy doses (which means fewer hospital visits) thanks to the results of recent trials
- Delaying radiotherapy for a short time if it is safe to do so. For example, for prostate cancer, where hormone treatments can safely be used instead.
Are you self-isolating and in need of support? Find out more about how an NHS Volunteer Responder can help you.
We know that some kidney cancer patients have not received a letter to inform them that they are at the highest clinical risk from coronavirus (COVID-19) and they are extremely vulnerable. However, these people are experiencing problems in getting essential shopping and collecting repeat prescriptions, and still require help or support due to shielding or isolation.
If you don’t have support from family or friends, help is available from the NHS Volunteer Responder scheme. If you are currently not supported and need some help with shopping, a prescription collection or a friendly chat, then the NHS Volunteer Responders are ready to help. Please take a look at the following link for details on how to connect:
Help may also be available via your local council; they might have a volunteer scheme running locally. Each council website should have a call centre helpline number for help and support during these challenging times.
The coronavirus (COVID-19) pandemic is having an impact on everyone’s lives. During this time, you may be bored, frustrated or lonely. You may also feel low, worried, anxious, or be concerned about your health or that of those close to you. You may also feel concerned about the economic impact of the pandemic and how this could affect your job or finances. These are all common reactions to the difficult situation we face. Everyone reacts differently to events and changes in the way that we think, feel and behave vary between different people and over time. It’s important that you take care of your mind as well as your body.
Most people will find strategies that work for them and for the difficult feelings associated with the pandemic. Some people, especially those with pre-existing mental health problems, may need extra support.
The Government has provided a guide giving advice on how to look after your mental health and wellbeing during the COVID-19 pandemic.
There is more information on how to stop the spread of coronavirus available.
What can help your mental health and wellbeing
The following advice is given to help you with your mental health and wellbeing. More information is available in the Government’s guide:
- Think about your daily routine
- Consider how to connect with others, for example if you live alone form a support bubble with another household. The NHS Volunteer Responders can also provide a free telephone ‘check in and chat’ if you are feeling isolated. Call 0808 196 3646 to register for this service
- Help and support others
- Talk about your worries. Sharing with family and friends how you are feeling and the things you are doing to cope can help. If you don’t feel able to do that, there are people you can speak to via NHS recommended helplines
- Look after your physical wellbeing. Visit One You for advice on improving your health and wellbeing, including ideas for healthy meals you can cook at home. Doing exercise and other physical activity can have a positive impact on your mood, improve your sleep, and reduce stress and anxiety. You can find free, easy 10-minute workouts from Public Health England (PHE) or other exercise videos to try at home on the NHS Fitness Studio. Sport England also has tips for keeping active at home.
- Seek advice and support if you smoke or use drugs or alcohol. NHS Better Health provides information and advice on quitting smoking and helps you find a package of support that’s right for you. You can also talk to an adviser on the National Smokefree Helpline on 0300 123 1044 (call charges may apply). One You provides advice and resources to help with cutting back on alcohol. You can also call Drinkline on 0300 123 1110 (call charges may apply) for advice and support and Down Your Drink provides interactive web-based support to help people to drink more safely. If you are concerned about drug use, FRANK offers information and advice, including where to get help, and provides an advice line on 0300 123 6600 (call charges may apply)
- Look after your sleep. Try to maintain regular sleeping patterns and good sleep practices, such as creating a restful environment and avoiding caffeine close to bedtime. The Every Mind Matters sleep page provides practical advice on how to improve your sleep.
- Try to manage difficult feelings. The Every Mind Matters page on anxiety and NHS mental wellbeing audio guides provide further information on how to manage anxiety
- Get the facts. Gather high-quality information that will help you to accurately determine your own or other people’s risk of contracting COVID-19 so that you can take reasonable precautions. Find a credible source you can trust such as GOV.UK, or the NHS website, and fact-check information you get from newsfeeds, social media or other people.
- Do things you enjoy
- Set goals to give a sense of purpose
- Keep your mind active to help you feel in control and less worried, e.g., read, write, play games, do crossword puzzles, sudokus, jigsaws or drawing and painting
- Take time to relax and focus on the present to help with difficult emotions, worries about the future and generally make you feel better. Relaxation techniques can also help some people to deal with feelings of anxiety. For useful resources, see Every Mind Matters and the NHS mindfulness page.
- If you can, get outside. If you can’t, bring nature in.
The coronavirus pandemic has been the main priority for the NHS since the outbreak began. There are millions of people living with cancer who still need the right care, treatment and support. NHS workers are doing their absolute best to deal with coronavirus under very difficult circumstances, but it’s vital that cancer diagnosis and treatment continues as much as possible.
The Government have told local NHS leaders that they have certain duties towards people living with cancer during this time. Macmillan have produced a guide designed to help you to understand and act on your rights, as part of Macmillan Cancer Support’s Forgotten ‘C’ campaign.
Download the guide here: Cancer and Coronavirus – know your rights in England
Everyone’s help is needed in the fight against COVID-19. The National Institute for Health Research (NIHR) have partnered with the NHS to launch a new service that will allow people across the UK to sign up for information on the new COVID-19 vaccine studies.
There are a number of vaccines being identified and safety-tested at the moment, but only large scale studies can give scientists the information needed about how effective they are. The new NHS COVID-19 vaccine research registry will help speed up scientists’ search for people willing to be involved in vaccine studies. This could potentially lead to an effective vaccine against coronavirus being identified and made available to the UK public earlier.
The service is available to anyone aged 18 or over, living in the UK. By registering, you are not signing up to take part in a specific trial or study. Instead, researchers who are working on vaccine studies supported by the NIHR will be able to search for volunteers who have signed up to the service and contact them with further information.
We need as many people to sign up as possible in order to speed up research against COVID-19.
Key up-to-date information from the government (updated 5 November 2020)
- NHS coronavirus advice
- GOV.UK: Coronavirus (COVID-19): What you need to do
- GOV.UK: Coronavirus (COVID-19): Guidance
- GOV.UK: Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19
- GOV.UK: Coronavirus restrictions: What you can and cannot do
- GOV.UK: Guidance for parents and carers on supporting children and young people’s mental health and wellbeing during the coronavirus (COVID-19) outbreak
- GOV.UK: Stay at home: Guidance for households with possible coronavirus (COVID-19) infection