Higher covid-19 death rates among people shielding have been linked to catching the virus in hospital.

Analysis by Public Health Scotland found admission to hospital for a non-coronavirus reason was the ‘most important risk factor for severe covid-19 in the shield group’.

Death rates adjusted for age in this group were 74% higher than the general population; infection rates were nearly twice as high.

Public Health Scotland has stressed that the higher levels of deaths do not mean the shielding programme was ineffective, but that people in the group were simply more vulnerable if they did catch the virus.

Due to their underlying health conditions, shielders were five times more likely to be admitted to hospital for a non-covid reason than the rest of the population.

‘Future programmes may benefit from considering more fully the risk of hospital-onset infections,’ the analysis states.

Overall, the research concluded it was ‘not possible to give a conclusive answer’ as to whether shielding had protected vulnerable groups.

Speaking yesterday, Nicola Sturgeon said everyone on the shielding list who was over 16 would receive their first dose of the vaccine by mid-February and future advice would reflect this.

The First Minister said: “In addition, the Scottish Government no longer issues advice to people on the shielding list which is quite as restrictive as it was in the first wave of the pandemic.

“This is in line with the recommendation in the report that we should not return to full shielding – instead, we must help people who are shielding to make an informed choice about their actions."

“But today's report is a reminder, if anyone needed, of the scale of the sacrifice that we asked from people who were shielding during those early months of the pandemic.”

Shielding advice has varied from asking people to adopt the most stringent measures from March to July, followed by a ‘pause’ and then a return to a less restrictive mode of shielding when community transmission rose again in December.

Outdoor exercise was advised against in the first lockdown, for example, but is now deemed to be safe.

Around 180,000 people were included on the shielding list, making up about 3% of Scotland’s population.

The most common reasons were severe respiratory conditions, being added to the list by a clinician, and immunosuppression.

Assessing the period up to August 2020, when shielding had been paused for a month because of lower levels of community transmission, the research found the requirement was ‘challenging and at times impossible for people’.

This was due to practical difficulties such as living with key workers, having caring responsibilities or needing to access healthcare.

Large numbers were able to access support however, with nine in ten in contact with their local authority and six in ten signing up to regular SMS updates.

There were also more than 50,000 sign-ups for both free food boxes and priority online shopping slots for supermarkets.

A total of 622 people on the shielding list died with covid-19 up to the end of August, compared to 4,230 in the population at large, meaning deaths in the shielding group accounted for 15% of all virus-related deaths.

Adjusting for age, PHS says this works out at a death rate of 244 individuals per 100,000 in the shielding group and 140 per 100,000 in the rest of the population.

Asthma UK and British Lung Foundation Scotland said a “poor track record” on respiratory health before the pandemic had contributed to the death figures.

The charity’s head, Joseph Carter said: “Over 83,000 lives across Scotland have been put on hold due to the danger posed to them with their poor respiratory health.

“Had the focus on prevention, diagnosis and treatment been greater over the past few decades, as it has been with other disease groups, this number would have been significantly fewer.”

Health Secretary Jeane Freeman said “While the principle of protecting those at higher risk of infection remains valid, there are a number of lessons we can take forward from the shielding programme which will help us inform and strengthen our future policies to protect at-risk groups.

“For example we are not, at this stage, asking people on the shielding list to go back into the very restrictive form of shielding we saw last March because we know how difficult that was, and how much of a detrimental impact on mental and physical wellbeing it had.”

Ms Freeman said anyone in the shielding category could still sign up for regular text alerts.

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