15 June 2020

Many children with chronic diseases may be able to stop ‘shielding’ and could return to school – but not those with some blood cancers, according to new guidance from the Royal College of Paediatrics and Child Health.

The guidance now lists specific conditions and treatments that require children to continue to shield to reduce their risk of contracting SARS-CoV-2. The guidance has been compiled with the aid of clinical experts, such as the Children’s Cancer and Leukaemia Group.

It now separates children with existing health conditions into two groups. A group of children who must continue shielding, known as Group A, includes those with immunodeficiency and those undertaking immunosuppressive treatments. It also includes recent recipients of stem cell transplants or CAR-T therapy, as well as those receiving antibody treatments for cancer. Children receiving chemotherapy for certain types of blood cancers are also included.

A second group, known as Group B, comprises children who could stop shielding following a discussion with clinicians. This includes haematology patients such as those with sickle cell disease, thalassaemia and Diamond Blackfan anaemia, as well as a range of other conditions.

The guidance says that children with asthma, diabetes, epilepsy, or kidney disease do not need to continue shielding. In addition, those who receive care through primary care are “very unlikely” to need continued shielding.

Dr Liz Whittaker, who co-authored the guidance, said: “We need to get the balance right between clinical risks and the social impact of shielding. 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.”




Royal College of Paediatrics and Child Health: https://www.rcpch.ac.uk/resources/covid-19-shielding-guidance-children-young-people

Children's Cancer and Leukaemia Group: https://www.cclg.org.uk/Coronavirus-advice

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