TY - JOUR T1 - Exit strategies from the COVID-19 lockdown for children and young people receiving home parenteral nutrition (HPN): lessons from the BSPGHAN Intestinal Failure Working Group experience JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 348 LP - 353 DO - 10.1136/flgastro-2020-101598 VL - 12 IS - 4 AU - Andrew Robert Barclay AU - Christina McGuckin AU - Susan Hill AU - Sue Protheroe AU - Akshay Batra Y1 - 2021/07/01 UR - http://fg.bmj.com/content/12/4/348.abstract N2 - In response to the novel COVID-19 pandemic, rapid and unprecedented public infection control measures were undertaken by all four nations of the UK culminating in ‘lockdown’ with the majority of the population being asked to stay at home other than for a few designated essential activities. In addition, identified vulnerable members of the population were required to participate in ‘enhanced social distancing’ or ‘shielding’, remaining strictly housebound, dependent on outside assistance for essential items and isolating from members within their household. This was proposed for 12 weeks in the first instance.1–4 Necessity for shielding was considered on the basis of relative burden of chronic disease and known risk factors for severe COVID-19 infection; however, young age conferred a protective association with infection.5 Although central government described the principles of enhanced distancing measures, the framework for the degree of measures employed and to which distinct patient groups was largely devolved to national expert bodies. As such, multiple national expert bodies considered adults with long-term intestinal failure (IF) with an ongoing need for home parenteral nutrition (HPN), as significantly vulnerable enough to warrant ‘shielding’.6 7 The Royal College of Paediatrics and Child Health (RCPCH), in consultation with multiple paediatric specialty groups, published advice on the principles of ‘shielding’ for children. The advice outlined the unique challenges faced by families and carers delivering socially distanced care to dependent children who have specific conditions, and also the impact of ‘shielding’ on children.8 The RCPCH and the British Society for Paediatric Gastroenterology Hepatology and Nutrition (BSPGHAN) endorsed ‘shielding’ for a number of key chronic gastrointestinal conditions, with a stratified approach in some conditions such as inflammatory bowel disease. The consensus of the BSPGHAN Intestinal Failure Working Group (BIFWG) was that children and young people receiving HPN should participate in shielding.8 … ER -