Since this initial guidance on social distancing below, the Government has published updated guidance outlining the principles you should follow to ensure that time spent outside your home is as safe as possible.
It has also published Coronavirus Outbreak FAQs: What you can and can’t do here.
The Government has advised that everyone should be taking social distancing measures – that is, we reducing social interaction between people in order to reduce the transmission of COVID-19. It is intended for use in situations where people are living in their own homes, with or without additional support from friends, family and carers. If you live in a residential care setting guidance is available
The Government is advising those who are at increased risk of severe illness from COVID-19 to be particularly stringent in following social distancing measures.
This group includes those who are:
- aged 70 or older (regardless of medical conditions)
- under 70 with an underlying health condition listed below (ie anyone instructed to get a flu jab as an adult each year on medical grounds):
- chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
- chronic heart disease, such as heart failure
- chronic kidney disease
- chronic liver disease, such as hepatitis
- chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
- problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
- a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
- being seriously overweight (a body mass index (BMI) of 40 or above)
- those who are pregnant
‘Shielded’ or extremely clinically vulnerable patients
The Government issued an update for shielding patients on 31st May – see here for further details
There is a subset of the wider at risk group described above who have clinical conditions which are likely to put them at the highest risk of mortality and severe morbidity from COVID-19. This group has therefore been recommended to undertake shielding measures for their own protection.
In order to be effective these people have to undergo strict social isolation with no contact from the outside world beyond that absolutely necessary, for a period of at least 12 weeks.
The following conditions have been highlighted as putting patients at intermediate, high or very high risk of severe morbidity or mortality from COVID-19:
- Solid organ transplant recipients
- People with specific cancers
- People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
- People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
- People having immunotherapy or other continuing antibody treatments for cancer
- People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
- People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.
- People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD
- People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell disease)
- People on immunosuppression therapies sufficient to significantly increase risk of infection
- People who are pregnant with significant heart disease, congenital or acquired
Most patients in this highest clinical risk group, who have been advised to shield, have been identified and contacted either centrally by the NHS or by secondary care clinicians. We expect more people to be identified shortly as NHS England is validating the centrally-held list against general practice data. People identified through this process will be sent a letter in the post and they will also be flagged in the GP system also.
A number of patients have self-identified as being in the highest clinical risk group on the government website. Practices will soon be sent details of any of their patients who have self-identified in this way and are being asked to review this list and consider if any of them should be included in the highest clinical risk group. If they should be, the practice will send you a letter and add a flag to your medical record.
Secondary care clinicians are reviewing people across specialties such as rheumatology, dermatology, gastroenterology, renal, respiratory, neurology, obstetrics, maternity and patients with severe specific diseases who cannot be identified through the central dataset. These patients will also be flagged on the GP system.
Practices have been asked to immediately review any ongoing care arrangements that we have for the highest risk patients. Furthermore, in the letter sent to shielded patients there is information in relation to getting support with medicine supplies and daily living. It notes that patients who do not have family or friends that can help, can also be directed to www.gov.uk/coronavirus-extremely-vulnerable to register for additional support with daily living tasks such as shopping and social care.
NHS England have produced these FAQs for patients which may be helpful for you to look at if you have questions on any of the above information.
What is social distancing?
Social distancing measures are steps you can take to reduce the social interaction between people. This will help reduce the transmission of coronavirus (COVID-19).
They are:Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19).
- These symptoms include high temperature and/or new and continuous cough
- Avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible
- Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information
- Avoid large gatherings, and gatherings in smaller public spaces such as pubs, cinemas, restaurants, theatres, bars, clubs
- Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
- Use telephone or online services to contact your GP or other essential services
Everyone should be trying to follow these measures as much as is pragmatic. This advice is likely to be in place for some weeks.
To see the full guidance click here. This includes further information on:
how you can get assistance with foods and medicines if you are reducing your social contacts;
what you should you do if you have hospital and GP appointments during this period;
what the is advice for visitors including those who are providing care for you;
advice for informal carers.