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Latest changes in guidance in shielding and protecting people at high risk of Covid-19 including people with diabetes

Latest changes in guidance in shielding and protecting people at high risk of Covid-19 including people with diabetes

At a glance guide to latest recommendations for people living with diabetes to protect themselves from coronavirus.

Published: Jul 08, 2020
Category: Looking after yourself

Public Health England has announced a number of recommendations for people living with health conditions that are classed as extremely vulnerable from Covid-19.

An NHS guide to who is at higher risk from Covid-19 includes people living with diabetes at a moderate risk, or clinically vulnerable.

NHS guidance states that if you are living with diabetes and at moderate risk from Covid-19, you can go out to work (if you cannot work from home) and for things like getting food or exercising. But you should try to stay at home as much as possible.

It is very important you follow the general advice on social distancing. This includes trying to stay at least 2 metres (3 steps) away from anyone you do not live with or anyone not in your support bubble.

A support bubble is where someone who lives alone (or just with their children) can meet people from one other household.

Unlike people at high risk, people with diabetes at moderate risk will not receive a letter from the NHS.

If you are at a higher risk from Covid-19, you can get help from an NHS volunteer with things like getting food, medicines and other things you need.

Call 0808 196 3646 (from 8am to 8pm) to get help from NHS Volunteer Responders.

As previously reported, almost one in three of all deaths from coronavirus among people in hospital in England during the Covid-19 pandemic have been associated with diabetes.

A follow-up NHS report confirmed that people living with diabetes are at a significantly increased risk if they get Covid-19 compared to people without the condition.

The breakdown of figures confirmed that people with type 1 diabetes who are diagnosed with Covid-19 are more likely to die from the illness than people with type 2 diabetes.

The news highlighted the importance for people with diabetes to self-isolate as much as possible in line with government Covid-19 lockdown guidelines.

The Public Health England recommendations emphasise this.

A report by Public Health England found that additional factors could mean you are more likely to get seriously ill from Covid-19.

These include:

  • your age – your risk increases as you get older
  • being a man
  • where in the country you live – the risk is higher in poorer areas
  • being from a Black, Asian or minority ethnic background
  • being born outside of the UK or Ireland
  • living in a care home
  • having certain jobs, such as nurse, taxi driver and security guard

Changes over the next few weeks

Public Health England has announced additional recommendations for people at high risk of severe complications if they get Covid-19.

People who are identified as clinically extremely vulnerable may be at high risk of serious illness if they catch Covid-19.

Clinically extremely vulnerable children and young people (0 to 18) who are cared for just by their GP are very unlikely to need to continue to shield in the future. This includes children with conditions including diabetes.

They have been advised to take additional action to prevent themselves from coming into contact with Covid-19 when transmission of coronavirus in the community is high.

If you’re clinically extremely vulnerable, you are strongly advised to stay at home as much as possible and keep interactions outside to a minimum. This is called ‘shielding’, and the government is currently advising people to shield until 31st July and is regularly monitoring this position.

This guidance is government advice. It is not the law. This guidance will be kept under regular review.

This advice is of a general nature and should be treated as a guide – it does not replace any local public health measures put in place to protect the local population.

If there is an outbreak of Covid-19 within your area, you are recommended follow any guidance set out locally or any specific law which applies to the area you live in.

What changed on 6th July?

From 6th July some changes to government guidance for people who are shielding have been announced following a reduction in cases of Covid-19 in the community.

These changes from 6th July included:

  • You no longer need to socially distance from people you live with
  • You can meet in a group of up to 6 people outdoors, including people from other households, if you wish
  • You may form a ‘support bubble’ with one other household if you want to, but one of the households in the ‘support bubble’ should be a single adult household (either an adult living alone or with children under 18 only). You can all spend time together outside and inside each other’s homes, including overnight, without needing to socially distance
  • The government support offer has been extended: a food box, care and/or medicine can be delivered until 31st July if you want them, and have registered online by 17th July.
  • Latest report figures suggest that the risk of serious illness for most children and young people from Covid-19 is low. All children and young people should continue to shield until 31st July. A clinical discussion with your paediatric specialist or GP will be needed before any child or young person is removed from the shielded patient list. Health services will be in touch with children and their families over the summer, ahead of the new school term, to discuss what the new evidence means for them personally in the longer term. Families, carers and young people do not need to make immediate contact

What will change from 1st August?

The government will pause shielding unless the transmission of Covid-19 in the community starts to rise significantly from 1st August.

This means:

  • The government will no longer be advising you to shield
  • The support from the National Shielding Service of free food parcels, medicine deliveries and care will stop
  • NHS Volunteer Responders will carry on delivering the food you buy, prescriptions and essential items to you if you need it
  • You will still be eligible for priority supermarket slots (if you have registered by 17th July)

Expert doctors in England have identified specific medical conditions that, based on what is known about the virus so far, place some people at the greatest risk of severe illness from Covid-19. Disease severity, medical history or treatment levels will also affect who is in this group.

A Public Health England statement said: “You may still be at risk of severe illness if you catch Covid-19, so stay at home as much as you can and continue to take precautions when you do go out.

“You can do this by washing your hands regularly, avoiding touching your face and keeping 2 metres away from people outside of your household or bubble wherever possible and in any case at least 1 metre with protective measures in place.”

From 1st August, the advice regarding going out to more places and seeing more people is:

  • You can go to work, as long as the workplace is Covid-19-secure – however, you should continue to work from home if you can
  • Children who are clinically extremely vulnerable can go back to school (when the rest of their class goes back)
  • You can go outside to buy food, to places of worship and for exercise – keeping 2 metres away wherever possible and in any case at least one metre with protective measures in place

This guidance will be updated with these changes on 1st August.

This guidance is for adults, and children and young people aged up to 18 who are clinically extremely vulnerable.

If you are clinically extremely vulnerable you should have received a letter advising you to shield, or have been told by your GP or hospital clinician directly to shield.

This includes clinically extremely vulnerable people living in long-term care facilities for the elderly or people with special needs.

For more information about who has been classed as clinically extremely vulnerable, please visit the NHS Digital website.

Update - Government notice 31st July - Shielding paused: 

The government has announced they are pausing national shielding guidance from 1st August as average incidence rates across the country remain sufficiently low. This will continue to be kept under close review. In areas where incidence and transmission rates are increasing, the government said they will take a more targeted approach to shielding advice at local authority level. Specific areas where local measures are in place are currently Leicester, Luton and Blackburn with Darwen.

If you want someone to talk to

Use support you might have through your friends, family and other networks during this time.

Try to stay in touch with those around you over the phone, by post or online.

NHS Volunteer Responders are available for you to have a friendly chat with someone new. You can call 0808 196 3646 (8am to 8pm) to set up a conversation – it can be as long as you like.

Support with your mental health

Resources on how to look after your mental health and wellbeing during Covid-19

The Every Mind Matters page on anxiety and NHS mental wellbeing audio guides provide further information on how to manage anxiety.

If you are still struggling after several weeks and it is affecting your daily life, contact NHS 111 online. If you have no internet access, you should call NHS 111.

Hand washing and respiratory hygiene

There are general principles you should follow to help prevent the spread of airway and chest infections caused by respiratory viruses, including:

  • Washing your hands frequently with soap and water for at least 20 seconds or using a hand sanitiser. Do this after you blow your nose, sneeze or cough before you eat or handle food and always immediately when you return home

  • Avoiding touching your eyes, nose, and mouth with unwashed hands
  • Covering your cough or sneeze with a tissue, then throwing the tissue safely in a bin and washing your hands
  • Cleaning and disinfecting frequently touched objects and surfaces in the home

If you develop symptoms

If you have any of the symptoms of Covid-19 self-isolate at home and arrange to have a test as soon as possible.

Read the guidance about the NHS test and trace service, including what happens if you test positive for coronavirus.

NHS guidance on Who is at a higher risk from Covid-19
NHS guidance on Social distancing
Read Public Health England Guidance on shielding and protecting people who are clinically extremely vulnerable from Covid-19
Support DRWF by making a donation here
Find out more about DRWF-funded research here
Read Managing diabetes and looking after yourself during the COVID-19 health crisis

DRWF operations during the Covid-19 health crisis

The DRWF team is now working remotely. Covid-19 guidance, particularly where it aligns or impacts with diabetes guidance, is shared as quickly as possible through the DRWF website and social media channels with the aim of making it as easy to understand as possible and a reliable source of latest news.

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Category: Looking after yourself

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