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Considerations and principles for shielding people at high risk of severe outcomes from COVID-19 (April 2020)

This brief considers the rationale for shielding individuals at high risk of severe disease or death from COVID-19 in low- and middleincome countries. It provides an overview of proposed approaches to shielding, discusses the categories of individuals who may be identified for shielding, and outlines the likely difficulties of these measures and ways to mitigate them. It should be noted that the authors are not aware of any precedent for targeted shielding of specific groups in low- and middle-income countries during this or any other outbreak. As such, shielding as an approach is untested. We have attempted to provide considerations regarding the feasibility and challenges of this approach, particularly in low- and middle-income settings. Decisions regarding shielding will need to pay particular attention to the local socio-economic context, be made in collaboration with local actors, and be continually adapted in light of emerging evidence about the approach’s effectiveness, the characteristics of COVID-19 and the trajectories of the outbreaks.

This brief was developed for the Social Science in Humanitarian Action Platform (SSHAP) by Anthrologica (Nadia Butler) with advice from Hana Rohan (London School of Hygiene and Tropical Medicine, LSHTM). It aims to provide practical considerations for governments and response partners working on COVID-19 in the context of low and middle-income countries (LMICs). The brief was reviewed by colleagues at the (LSHTM), the Institute of Development Studies (IDS), IFRC, UNICEF CASS and Resolve to Save Lives.
It is the responsibility of SSHAP.