Advice about Self Isolation if you have an underlying health condition including Asthma

Advice about whether you should isolate yourself because of underlying health conditions, including asthma


Please read all the information below before you think about contacting the surgery


We hope you will find the answer to your question here.
Please think carefully about whether you really need to ring the surgery
We are dealing with a lot of questions from a lot of people.
We are working as fast as we can. Please bear with us
.


The new guidance from Public Health England identifies two distinct groups of people who might be more vulnerable if they get COVID-19 infection.


Group 1 – People whose age or medical conditions might mean they are at an increased risk of complications if they get COVID-19 infection.


Group 2 – People who are felt to be at particularly high risk of serious complications.


The details about each of these groups, and what they should do, is explained in detail below.


How to know which group you are in:
Please read the detailed descriptions below. It will be very obvious straight away to most people if they are in group 1 or group 2 (or neither). If it is obvious to you which group you are in, please do your best to follow the advice for that group as best you can straight away.


Some people will receive letters from NHS England, or their hospital specialist, or their GP.


People in Group 1 will not be receiving letters at all. These people should follow the general guidance (below) as best they can.


People in Group 2 (those thought to be at especially high risk) will be receiving a letter from NHS England, or their hospital consultant or their GP with some information and advice. Please note that most of these letters will be sent by NHS England and the hospitals, not by the surgery. The Thornton Practice is not in control at all of the time-scale for these. We do not know exactly when these letters will arrive, and we will not be able to tell you even if you ring the surgery!


Please remember that the Thornton Practice gets information and guidance at the same time as the public. We have heard that letters might start arriving from Tuesday 24th March onwards. It is possible that some letters may take significantly longer.


GPs have been asked to identify the patients who we think are in Group 2 but who are not under specialist care; these are the people who will be getting a letter from the surgery. We will do this as quickly as we can. We hope that we will be able to get letters out to most of these patients by the end of the week (Friday 27th March); it might take longer for a small number of patients. Please bear with us.


We will, though, put the letter on the surgery website so that everyone knows now what the letter will tell you.


If at all possible, please do not ring the surgery to ask if you are in Group 1 or Group 2.


Group 1 Vulnerable groups whose age or medical conditions might mean they are at an increased risk of complications if they get COVID-19 infection.
This group of people is as follows:
 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
  • diabetes
  • 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 (and who don’t have a heart condition)

These people are urged to take robust and sensible precautions on social distancing. This includes a number of things such as – avoiding non-essential public transport, working from home if at all possible, avoiding social gatherings etc.


The official guidance can be found here
https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

If you feel confident you are in Group 1 – please follow the official advice as much as you can. You do not need to contact the surgery, unless there is a medical need to do so.


If you are in Group 1 and you think you have signs of COVID-19, please follow the advice on the NHS website
https://www.nhs.uk/conditions/coronavirus-covid-19/

You will not need to call anyone if your symptoms are mild or moderate. Self-isolate for 7 days. If you think you are becoming very unwell first use the NHS111 online service:
https://111.nhs.uk/covid-19/ or if it is urgent ring NHS111

If you need medical attention for illness which is not COVID-19, contact the surgery.


Please also read the next section about people who are thought to be at especially high risk, to check if you might be in group 2 (rather than Group 1).

Group 2 People who are felt to be at particularly high risk of serious complications
This group of people is as follows:
 Solid organ transplant patients
 People with specific cancers …

  • people who are having active chemotherapy or radical radiotherapy for lung cancer
  • cancers of the blood or bone marrow e.g. leukaemia, lymphoma or myeloma 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 cystic fibrosis, severe asthma and severe COPD (this is not all people who have asthma and COPD).
 People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as severe combined immunodeficiency, homozygous sickle cell disease)
 People on immunosuppression treatments sufficient to increase the risk of infection – this includes azathiprine, mycophenolate, cyclosporin, sirolimus, tacrolimus (oral)
 People who are pregnant and have significant heart disease (i.e. not all pregnant women)

If you do not recognise the names of the conditions or drugs in the above list, then you are almost certainly not in this group!


These people are urged to take much stricter and more serious precautions to avoid all contact with other people, unless it is absolutely essential. The current advice is that this will need to be for 12 weeks. The 12 weeks is, at the moment, a best guess about the time it will take for this wave of the pandemic to be over, and for the risk to largely pass. This time estimate may well change as time goes on, as we understand how the situation is unfolding.


The people in this group will be getting a letter from NHS England, or their hospital specialist, or their GP to say that we think they are in this group.


This kind of self-isolation is very hard to do. The letter explains exactly what this means. Essentially it means not leaving your home at all, only having essential visitors (who are giving you care), asking someone else to do our shopping etc.


If you are in Group 2, and if it feels possible for you to take these very strict measures, then please do so straight away. You do not need to speak with a GP if you are clear about which group you are in and what you need to do.
For a few people, the decision about whether to do this strict isolation or not might be very difficult. Whether or not you try will depend on individual circumstances. This is when it might be helpful to talk it through with either your specialist or a GP. We think that most people will not need to speak with a GP about it. If you feel you really need some support with the decision let us know (see below how you can do this).


The letter you will get if you are in Group 2 is on the surgery website. Please read it. It gives you detailed advice about what to do in different circumstances, but briefly:

 Routine care related to your underlying problem remains very important. Where possible this will be done by phone, email or online. It may still be necessary for you to attend appointments at the surgery or the hospital; and this does count as essential contact. If you do need to come to the surgery we will tell you what we are doing to reduce your contact with other people to make this as safe as possible.
 If you have urgent issues relating to your underlying health conditions you should contact your specialist in the first place (this is often the specialist nurse first). If that is not possible you can contact the surgery and we will help you as best we can. As we always do, we will assess whether we can help you on the phone, or whether an appointment in surgery is needed. Home visits will be arranged if there is no alternative. Please bear in mind that we will be working with very reduced resources.
 If you think you have signs of COVID-19, you should contact NHS111 straight away even if your symptoms are mild.

First try to contact NHS111 through the online service at https://111.nhs.uk/covid-19/
but if you do not have access to the internet, or if there is a long delay, ring NHS111.

If you are becoming very unwell very quickly and you cannot get through to NHS111 we would suggest you ring 999 (you must tell them about your background conditions and that you think you might have COVID-19)

 If you need medical attention for illness which is not COVID-19 nor your underlying health condition, contact the surgery as usual.

There is guidance about how to approach self-isolation, and how to get help with care and support:


https://www.gov.uk/coronavirus-extremely-vulnerable
https://www.gov.uk/universal-credit
https://www.nhs.uk/oneyou/every-mind-matters/
https://www.nhs.uk/conditions/stress-anxiety-depression/

A special word about asthma and COPD
The question about asthma seems to be causing particular confusion and worry.


There is useful advice for asthmatics on the Asthma UK website at
https://www.asthma.org.uk/advice/triggers/coronavirus-covid-19/

Asthma is clearly on the Group 1 list.
It might be a bit difficult for you to know if your asthma or COPD is counted as severe enough to put you in the Group 2 list.


We will be writing to all patients who we feel, from our records, have severe asthma and severe COPD.


It will be clear to many patients if their condition is classed as severe. If you are really not sure:
 for the moment please follow the advice for group 2 people as closely as possible, straight away
 wait to see if you get a letter from the hospital or your GP surgery
 if you have not received a letter in the next few days and you are really unsure if you are in this group or not, you can:

  • email us on [email protected] We will do our best to answer as soon as we can.
  • Text us on 07800007625
  • if you can’t email or text, then you can ring the surgery. We will get back to you as soon as we can with either an answer to your question, or to offer you an appointment to speak with a doctor about your situation.

Please could all patients who have asthma and COPD please read the section about requests for salbutamol inhalers in FAQ section. Thank you.

Coronavirus

Further Information