Levels of depression and anxiety remain high and largely unrecognised among an estimated 1.8 million clinically vulnerable people in the UK, many of whom continue to live significantly restricted lives to protect them from Covid 19, according to new research from the University of Bath.

The research – a collaboration between psychologists and political scientists at the Universities of Bath and Liverpool – reveals widespread and enduring psychological distress among people who remain isolated more than six years after the onset of the pandemic.

The study was led by Anna Gray, a trainee clinical psychologist at the University of Bath.

She said: “The psychological impact of extended social isolation is profound. For many, this has been compounded by restricted access to medicines, healthcare and a sense of being forgotten and left behind by wider society. These experiences have not ended with the pandemic – they are ongoing.”

Co-author Dr Luca Bernardi from the Department of Politics at the University of Liverpool, added that people’s experience of restriction has not ended, and “trust in government and feelings of representation among immunocompromised people are hard to recover.”

The worst aspects of shielding

The findings, published in the journal Health Expectations, are based on a national survey launched in 2023 to capture the lived experiences of those still shielding, and focused on 457 immunocompromised or otherwise clinically vulnerable individuals.

The researchers identified a vicious psychological cycle in which fear of infection drives withdrawal from social contact, reducing confidence to re-engage with the world and reinforcing isolation and avoidance.

Participants frequently reported confusion and frustration around inconsistent, unclear or inadequate guidance, contributing to growing mistrust and a shift towards managing risk alone and at personal cost.

The researchers argue that as the risk of emerging infectious diseases increases, these experiences must inform both immediate support measures and longer term pandemic planning.

“These are not lifestyle choices”

Gayle, 57, and her husband, Les, from north of Brighton, have lived a highly restricted life since 2020. Gayle takes immunosuppressant drugs following a kidney transplant and has been told she faces a one in 10 risk of becoming seriously ill or dying from Covid.

Les, a passionate campaigner for those like his wife, said: “People like us are in a situation we have no control over. Gayle and I used to go to live concerts, the theatre and busy pubs, but now we have to avoid them because of the risk to Gayle. Our lives are drastically reduced.

“We ask family and friends to do a lateral-flow test before visiting us, which we provide for free, but some of them decline to. They are done with Covid and never want to think about it again. That isn’t an option for us.”

Dr Jo Daniels, senior author and researcher in the Department of Psychology at the University of Bath, said: “At the start of the pandemic, few of us expected that there would still be a physically and psychologically vulnerable group largely confined indoors more than six years later, carrying such an extraordinary personal burden. But there is – and we must do better to address their needs now, and in future pandemic responses.”

Nikola Brigden, spokesperson for patient advocacy group Forgotten Lives UK, stresses that those who continue to shield are not simply anxious or isolated.

She said: “These are not lifestyle choices: they are the consequence of people being left to manage ongoing risk in the absence of clear policy, consistent protections and timely access to preventative treatments. It is vital that their voices are heard and that future pandemic planning properly recognises the needs of those who remain vulnerable.

“Forgotten Lives UK welcomes this important research, which reflects what our community has been saying for years: for many immunocompromised and clinically vulnerable people, the pandemic did not simply end. Many are still living with significant restrictions, isolation and fear, often with very little public understanding or support.”

Findings of the new study will be presented to the All Party Parliamentary Group (APPG) for Vulnerable Groups to Pandemics. This will be the second time the researchers have submitted research evidence to Parliament on the psychological impact of shielding. Dr Daniels has also submitted evidence to the ongoing UK Covid 19 Inquiry.

Also involved in this research wasProfessor Julie Barnett from the Department of Psychology at the University of Bath.