Keeping it in perspective – coronavirus

Updates at bottom of page. Latest update 16/03/2020

It is not often (in fact never!) that I report on a potential pandemic, and I do not want to cause panic or alarm, but we need to be aware of what is happening. And how it might affect your service.

If you look at the deaths from coronavirus it does appear there is a correlation between older people with pre-existing conditions and deaths from coronavirus. This clearly means many of our clients are more at risk than the general population.

However, we need to get this in perspective: Covid 19 has a mortality rate of 1-2%, compared to just over 1% for influenza and is only slightly more infectious (around 2 people, per individual)*. In comparison, Chicken pox, has an infection rate of around 11 but a mortality rate of lower than 0.5%.

Similar to the flu, Coronavirus is a problem mainly for those with pre-existing conditions, although it may make others feel poorly.

We get regular updates as to what’s going on and advice appears to change daily. The difficulty we have is that the advice, based on evidence, appears too simple. This means many people have, or will, choose to disregard it despite clear evidence to say it works.

For example, on average 11,000 people every year die of flu**, which is another highly contagious virus. Every year a free vaccine is offered to all people over the age of 65, and despite advertisements on TV, social media etc and GP surgeries strongly suggesting people have the vaccine, the uptake is low. The 2018/19 flu vaccine prevented 44% of flu cases, compared to just 15% in 2016/17.

What is the current advice?
The advice for Covid 19 is:

  • Wash your hands. Wash them frequently with soap and water, and wash them for 20 seconds.
  • Carry tissues and use them to catch coughs and sneezes.
  • If you have sanitiser gel, you can use it, but washing your hands is enough.

There are two ways the pathogen can get into your body. The first is through droplets in the air, caused by coughing or sneezing. The second is via contaminated surfaces. A high alcohol content (60%+) sanitising spray will clear surfaces and washing your hands properly will clean your hands.

Many of the market-available face masks, including paper masks, have proved to be ineffective due to poor fit and the fact that the virus is very small and can penetrate through the mask.

HM Government and NHS-branded information will appear in radio and print media, as well as social media. Similar to the ‘Catch it, Bin it, Kill it’ campaign used for flu and norovirus, it promotes important hygiene practices, such as regularly washing hands and always sneezing into a tissue, to stem the spread of viruses.

Health and Social Care Secretary Matt Hancock said:

Our highly trained and experienced clinicians are working round the clock to prevent the spread of coronavirus in the UK. The government has detailed plans for how to deal with an outbreak like this. We can all play our part.

Basic hygiene such as washing our hands regularly and using tissues when we cough and sneeze can play an important role in minimising the spread of viruses like this.

We need to be vigilant without panicking. When there is any more guidance from the Department of Health and Health England we will let you know.

What should you do?

  • Make sure you carry a supply of tissues.
  • Wash your hands more frequently than you have before.
  • Use an alcohol-based spray on surfaces at home, if available. This includes door handles and other often used items. (you can ask your caregiver to do this).
  • Avoid touching your eyes, nose and mouth.
  • Avoid shaking hands.

Whereas before, we were looking at reporting contact with people from South Korea, Iran, Wuhan province in China, and Italy, there is now evidence that people who have not been abroad, have been infected. This means that isolation based on travel history alone, is no longer effective.

Luckily, domiciliary care is often an isolating role anyway: our caregivers see a small amount of clients who, in turn, will see a very limited amount of people such as family or friends. This reduces the risk considerably.

NHS advice, if you are unwell, is to call 111. They may arrange for testing and will take action if appropriate. In many cases, this will mean self-isolation for 14 days.

What we are doing
We are monitoring the different sources of information daily. We receive several updates every week from NHS (Chief medical Officer), Dept. of Health & Social Care (and Health England) and Kent County Council, and if the advice changes substantially, we will let you know as quickly as we can.

We will continue to take advice from NHS, government and Health England, and consider whether individuals can do without calls (companionship or home help visits), or whether other procedures need to be put in place (for clients with personal care needs).

What is likely to happen
The government has a four-point plan when dealing with pandemics. The first stage was ‘containment’ and we are now in the second phase which is ‘delay’.

This means transmission via community now outweighs transmission from those who have visited affected areas, so the aim is to reduce the spread by (and I make no apologies for repeating it) following good hygiene practices. By delaying the spread, the peak flow of cases (those who are infectious) will reduce quickly.

Without wishing to resort to clichés, “keep calm and carry on” really is the order of the day. However, please take the hygiene advice to heart, as it is the best way to prevent infection. If you have any queries, call us and we will try to answer your questions.

Maddie and Hazel.

* Office for National Statistics (Office for national Statistics)

** The Telegraph

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Update 16th March 2020
Coronavirus and Ibuprofen

Hi all, I’ve just been made aware (thanks Joy!) of a FB post that seems to be doing the ’rounds regarding avoiding ibuprofen during the coronavirus pandemic.

This link explains it well and avoids scare tactics.

In essence, ibuprofen has more side effects than paracetamol which is why it might be unsuitable for some people, but NHS still suggests both paracetamol and ibuprofen can be used by most people.

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Coronavirus Bulletin Friday 13th March 2020 11.15am

Today, the advice has changed. We have received notification from the NHS this morning about best practice in going forward:

From today the public are being advised to stay at home (self-isolate) without any testing for COVID-19, regardless of travel history or contact with confirmed cases, if they have:

  • A new continuous cough
  • OR
  • High temperature (of 37.8 degrees centigrade or higher)

Individuals should stay at home (self-isolate) for 7 days from the onset of symptoms following the current advice. If someone has serious symptoms they cannot manage at home they should use NHS 111 online (people should only call NHS111 if they cannot get online).

After 7 days of self-isolation, people who feel better and no longer have a high temperature can return to their normal routine.

If they have not had any signs of improvement after 7 days and have not already sought medical advice, they should use NHS111 online (people should only call NHS111 if they cannot get online) before they leave their home or let visitors in.

It is important to note that a cough may persist for several weeks in some people, despite the coronavirus infection having cleared. A persistent cough alone does not mean someone must continue to stay at home for more than 7 days.

Testing will not be offered routinely to individuals staying at home.

Healthcare workers who come into contact with a COVID-19 patient whilst not wearing
personal protective equipment (PPE) can remain at work. If they display any symptoms of
lower or upper-respiratory tract infection they must immediately stay at home for the
duration of the illness or 7 days, whichever is longer.

Healthcare workers do not need to be tested for COVID-19, prior to returning to work

What does this mean for us?
On March 5th, the government listed Covid 19 as a notifiable disease. This means that if we become aware of anyone (client or staff) who have tested positive, we have a duty to notify Health England.

Currently, testing is being increased from 1500 per day to 10,000 per day. Testing is arranged via NHS111 online and, we believe, there are testing stations at all hospitals.

A positive test for coronavirus still requires 14 days isolation.

What does this mean for us?

  • We continue to operate in the community, as before.
  • We have stopped taking new clients for the interim, and are concentrating on meeting the needs of our existing clients.
  • Caregivers are continuing to follow Best Practice and wash their hands frequently.
  • All staff are aware of the need to observe strict infection control practices, including using gloves and handgel where appropriate, and disinfecting surfaces more often.
  • All staff are aware they need to report any symptoms immediately.

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