This cost analysis was undertaken as part of the first stage of the evaluation of the costs and consequences of the shielding support programme in Wales for the ‘EVITE Immunity’ study. This paper reports the evaluation of the costs of implementing the shielding policy in Wales, UK, to the NHS and local government during the first wave of shielding (from March to June 2020). However, the effects on COVID-19 infection rates and potential benefits are still being evaluated, and the question of whether this novel response to an unprecedented situation provided good value for money remains unanswered. Įvidence of the effects of shielding on mental health, quality of life, social isolation, access to planned and emergency health care and mortality has now emerged. Furthermore, individuals who could not undertake their work without leaving their home were eligible for Statutory Sick Pay and the furlough scheme (paying 80% of wages for most people). Food parcels, prescription delivery, and priority supermarket shopping and delivery slots were provided for people who had no support network. Individuals on this shielding list were strongly advised by a series of letters, text messages or phone calls to self-isolate and to avoid contact with other people wherever possible, including within the home for initially 14 weeks. In addition to introducing “lockdown” measures for the general population to help contain the spread of the virus, centralised routine National Health Service (NHS) data sources, algorithms and individual clinical screening of primary and secondary care records were used to compile a list of CEV people for shielding. The intervention lasted 10 months over two time periods (waves), ending in the spring of 2021. This included people suffering from respiratory disease, cancer or diabetes, and people receiving immunosuppressant medications. The United Kingdom (UK) introduced the “shielding intervention” in March 2020 in response to the increased risk of morbidity and mortality following severe acute respiratory syndrome coronavirus 2 infection in Clinically Extremely Vulnerable (CEV) individuals. The true costs of shielding including its budget impact and opportunity costs need to be investigated to decide whether shielding is a worthwhile policy for future health emergencies. However, no data on opportunity cost was available. This is the first evaluation of the cost of the measures put in place to support those identified to shield in Wales. Therefore the cost per person shielded lies between £102 and £113 per person. The list was adjusted weekly over the 3-month period (130,000 people identified by June 2020). This included the new resources required to compile the shielding list, inform CEV people of the shielding intervention and provide medicine and food deliveries. The total additional cost to support those advised to stay home during the initial 14 weeks of the pandemic was £13,307,654 (£113 per person shielded). ResultsĪt the beginning of shielding, 117,415 people were on the shielding list. with the office of the Chief Medical Officer for Wales). Resources supporting shielding between March and June 2020 were mapped using published reports, web pages, freedom of information requests to Welsh Government and personal communications (e.g. The number of people shielding was extracted from the Secure Anonymised Information Linkage Databank. We report the cost of implementing shielding in Wales. Shielding was intended to protect those at highest risk of serious harm from COVID-19. The EVITE Immunity study investigated the effects of shielding Clinically Extremely Vulnerable (CEV) people during the COVID-19 pandemic on health outcomes and healthcare costs in Wales, United Kingdom, to help prepare for future pandemics. The cost of implementing the COVID-19 shielding policy in Wales
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