Additional Risk Factors Used to Identify People at High Risk of COVID-19

16/02/2021

New Factors to Determine COVID-19 risk

Additional people to be identified as Clinically Extremely Vulnerable

On 16 February 2021, additional people who may be at high risk from COVID-19 were identified using a risk score based on a wide range of factors that predict a more severe course of COVID-19 or an increased likelihood of getting COVID-19.

The additional factors used to calculate your risk include ethnicity, BMI and where you live. You can see a more detailed list of risk factors used here.

A special online tool led by Oxford University is being used to calculate the risk score called QCovid®. (It is currently only accessible by healthcare professionals).

The priority now is to identify those who are most vulnerable, to prioritise them for vaccination and provide appropriate advice to help individuals identified to protect themselves. Around 1.7 million additional adults are expected to be identified as Clinically Extremely Vulnerable and 800,000 of those will need to be prioritised to receive a vaccine as a priority. If this affects you, you will receive a letter advising you and what you need to do.

Correction 17 Feb 2020: 1.7 million additional people are expected to be added to the CEV group; rather more than the 800,000 we said last night!

Your questions

Why is this approach only being used in England?

The respective governments have a responsibility to agree health policy to best support the specific health needs of their population.
All four nations have contributed to the research behind the QCovid® model and have been jointly exploring how it can be implemented into the respective systems.
The NHS in England is now ready to apply the COVID-19 Population Risk Assessment powered by the QCovid® model to identify a group within the population who may be at increased risk of becoming seriously unwell from coronavirus because of their individual characteristics.

The easiest way for the Government to ensure early vaccination for this group is to include them within the list of those who are clinically extremely vulnerable (also known as the Shielded Patient List).
This addition will also ensure you have access to appropriate advice and support to manage your risk. However, this is always advice and not the law, so you can choose what action you take as long as they continue to follow all the basic rules that we all need to observe through the pandemic.

Does the QCovid® approach replace the list of conditions that identifies somebody as clinically extremely vulnerable?

The existing list of medical conditions used to identify individuals who may be clinically extremely vulnerable to COVID-19 was agreed by the four UK Chief Medical Officers on the basis of the latest available evidence. As we had very little data about COVID- 19 risk factors at the time, this list was based on our understanding of vulnerability to other respiratory viruses such as flu.
Patients being added to the Shielded Patient List using the COVID-19 Population Risk Assessment, powered by QCovid®, are those that may be at increased risk of becoming seriously unwell from coronavirus because of a combination of their individual characteristics and their underlying health conditions based on this new research.
This includes characteristics like someone’s age, ethnicity, BMI and certain medical conditions.
QCovid® provides another way of identifying patients at high risk from Covid-19 and does not replace the two existing routes by which a patient can be identified.
There will be no automatic removals of those already on the Shielded Patient List.

Why am I only being told now that I am at high risk from Covid-19?

Previously it was not possible to systematically identify individuals who may be at high risk of poor COVID-19 outcomes due to multiple risk factors.

At the beginning of the pandemic, the clinically extremely vulnerable group was drawn up based on a list of conditions agreed by UK CMOs and senior clinicians. As there was very little data about COVID risk factors at the time, this list was based on predominantly on our understanding of vulnerability to other respiratory viruses
As further evidence has emerged about the virus, the Government has a better understanding of the importance of a combination of individual characteristics and underlying health conditions that determine someone’s risk of serious illness from COVID-19.
Identifying these individuals as potentially high risk has only been possible now because the QCovid® risk model and NHS Digital’s technology.
Refining the model and working through how it might be applied as accurately as possible, has been complex and challenging. It has been developed at unprecedented pace over some months, whilst simultaneously aiming to meet the highest standards of evidence, clinical safety and technical assurance.
This new approach has made it possible for the NHS to identify more people who may be at increased risk of becoming seriously unwell from coronavirus and prioritise them for vaccination as soon as possible.
The Government wants to provide vaccination more quickly to them and also offer further advice and support. The easiest way for them to ensure early vaccination for this group is to include them within the list of those who are clinically extremely vulnerable (also known as the Shielded Patient List).

Should I call my GP?

If you have been advised you are now clinically extremely vulnerable, you do not need to contact your GP to confirm as GPs have been automatically notified.

Please consider that GPs are extremely busy at this current time and there is no reason for you to contact them about this if you are waiting to hear.
However, if you do not think you are at high risk, or you are concerned about the impact of coronavirus on your health, then you can contact them or the hospital doctor you usually see.

I think I am high risk, how and when will I be told?

If you have been identified as high risk, you will receive a letter with background information on the model that explains why you have been added to the SPL as a precautionary measure to ensure early vaccination. Because of the new research, this group can be considered alongside the clinically extremely vulnerable.

If you have an email address registered with your GP, you may also receive an email.
If you have not already been invited for a vaccine, you will be prioritised for vaccination and receive a separate letter inviting you to vaccination in the normal way.
Individuals may receive an email or letter as early as week commencing 15 February 2021.

When will I get my COVID-19 vaccine?