COVID-19 risk model to help GPs target shielding at most vulnerable patients

GPs will be better able to identify patients at greatest risk of serious illness from COVID-19, and who may be required to shield in a second wave of the pandemic, using a new risk prediction model.

(Photo: fabio camandona/Getty Images)
(Photo: fabio camandona/Getty Images)

On Monday the government confirmed that patients would no longer be required to shield from 1 August. However it said the shielding list would be maintained in case there was a second spike in infections and the programme needed to be restarted.

Speaking at Monday's press briefing, deputy CMO for England Dr Jenny Harries said that the new model would enable a 'much more individualised way' for patients and their doctors to be able to understand a person's risk.

'In the future, therefore, those we advise to take action may be a slightly different group to those who shielded through this disease peak,' she said.

Targeted advice

Researchers said that the model, which is being developed by a team led by Oxford University, would help GPs and consultants to provide more targeted advice to patients based on their individual levels of risk.

The researchers will collect anonymised data from the health records of 8m adults in the UK to identify factors that could be used to predict those at highest risk of infection and serious illness from COVID-19, including age, sex, ethnicity, deprivation, smoking status, BMI, pre-existing medical conditions and current medications.

Algorithms based on this data, developed in partnership with experts at NHS Digital, will underpin the clinical risk prediction model.

The model could also help to identify which patients should be prioritised for vaccination when this becomes available, the researchers said.

Risk assessment tool

Professor Julia Hippisley-Cox, professor of epidemiology and general practice at the University of Oxford’s Nuffield Department of Primary Care Health Sciences, who is leading the project said: ‘Driven by real patient data, this risk assessment tool could enable a more sophisticated approach to identifying and managing those most at risk of infection and more serious COVID-19 disease.

‘Importantly, it will provide better information for GPs to identify and verify individuals in the community who, in consultation with their doctor, may take steps to reduce their risk, or may be advised to shield.'

England's CMO Professor Chris Whitty, said: ‘The level of threat posed by COVID-19 varies across the population, and as more is learned about the disease and the risk factors involved, we can start to make risk assessment more nuanced. When developed, this risk prediction tool will improve our ability to target shielding, if it is needed, to those most at risk.'

GPonline reported earlier this month that most of the 90,000 children on the shielded patient list would not be required to shield in any future wave of the pandemic. The Royal College of Paediatrics and Child Health has since developed guidance setting out which children can be removed from the list. It advised that most children who are managed mainly in primary care no longer needed to shield.

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