National restrictions will be imposed across England from Thursday 5th November. To help contain the virus, the government have advised that everyone who can work effectively from home must do so. Where people cannot do so – including but not limited to – people who work in national infrastructure, construction and manufacturing – they should continue to travel to their workplace. Public sector employees working in essential services, including health, childcare or education, should also continue to go into work. The risk of transmission is substantially reduced provided COVID-19 secure work guidelines are followed closely.

This morning, guidance has been published defining clinically extremely vulnerable groups – Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19.

Clinically extremely vulnerable groups are those individuals likely to require hospitalisation and be at serious risk of death or long-term health complications as a consequence of COVID-19 infection. It is employees who fall into this category who are advised to work only from home. If they cannot work from home, they may be eligible for Statutory Sick Pay or Employment Support Allowance if their normal salary is not continued. The government has indicated they will write to everybody who is clinically extremely vulnerable to set out detailed advice confirming they fall into this category in the coming days.

Same Household: People living in the same household as someone defined as clinically extremely vulnerable, but who are not clinically extremely vulnerable themselves, can still attend work.

Clinically extremely vulnerable children of employees: The government state ‘evidence has shown there is a very low risk of children becoming very unwell from COVID-19, most children originally on the shielded patient list no longer need to be and therefore can still attend school. If they are unsure, parents should contact their child’s usual GP or hospital clinician to check whether they should still be considered clinically extremely vulnerable. If a GP or clinician has advised that a child should remain on the shielded patient list, they are advised not to attend school. Children who live with someone who is clinically extremely vulnerable, but aren’t themselves, should still attend school’.

For clinically vulnerable employees, there is a higher risk of severe illness from COVID-19, but less so than in the group of clinically extremely vulnerable individuals. These employees should be especially careful with hand hygiene, minimise contact with others and be careful to follow strict 2 m distancing in the workplace. Provided these new national restrictions are met, the employee may continue to attend work in a COVID-secure environment. If they cannot be met, even with adjustments to the usual employed role, the employee should work from home on health grounds.

Currently published government guidance is ambiguous in defining clinically vulnerable people. It makes reference to age 60 or over. But within the same document it states:

• Aged 70 or over (regardless of medical conditions)
• Under 70 with an underlying health condition listed below (that is, anyone instructed to get a flu jab each year on medical grounds):
  • Chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
  • Chronic heart disease, such as heart failure
  • Chronic kidney disease
  • Chronic liver disease, such as hepatitis
  • Chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS) or cerebral palsy
  • Diabetes
  • A weakened immune system as the result of certain conditions or medicines they are taking (such as steroid tablets)
  • Being seriously overweight (a body mass index (BMI) of 40 or above)
  • Pregnant.

Our belief is there is an error in the document that will be revised, so watch out for updates. For now, we recommend you implement an age threshold of 60 rather than 70 in the guidance above.

Pregnant employees should be considered as clinically vulnerable, unless they have also been diagnosed with a cardiac disorder or other medical condition that falls within the clinically extremely vulnerable category. These employees may continue to work at least until 28 weeks of pregnancy in a COVID-secure environment. At 28 weeks pregnancy, an occupational health assessment should be considered to stratify their overall clinical risks and to confirm the appropriateness of continuing to attend work. It is not an absolute requirement for all pregnant employees to work from home from Thursday 5th November .

Where Medwyn Occupational Health has already provided a health risk assessment of your employee the grading of moderate or high risk is unlikely to have changed. Please refer to the original risk certificate to confirm if the employee is fit to attend work, requires role adjustments, or should only work from home. There is no need to undertake a new risk assessment unless health status has changed in the last 8 months.

Anxiety and uncertainty around individual health risks is likely to present amongst those employees required to attend work. If these individuals have not already had an occupational health risk assessment you may wish to consider referring to Medwyn Occupational Health for further advice.

Please don’t hesitate to contact the team on 01306 873936, or email admin@medwynoh.co.uk for further support.