This week the government have announced further measures across England following a rise in cases of Covid-19.
With a surge in new cases of Covid-19 reported in recent weeks the government has prepared a list of measures recommended to protect people from the spread of the virus.
During the Covid-19 pandemic people with diabetes have had an additional health concern to consider – healthcare professionals advise to look after yourself as best as you can as an additional safety measure against contracting the virus this winter.
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 news highlighted the importance for people with diabetes to self-isolate as much as possible in line with government Covid-19 lockdown guidelines.
Diabetes and additional health complications can increase the risk of serious complications
Dr Mayank Patel, Consultant in Diabetes, University Hospital Southampton and DRWF Editorial Advisory Board member said: “We are persuading people with diabetes to take more personal ownership of their diabetes care where possible, appropriate and if indicated.
“The virus has taught us to date that BAME (black and minority ethnic groups), and management of the condition in people with diabetes in older age and obesity present particular risks when diagnosed with Covid-19.”
Make yourself “winter-proof”
With cold weather approaching, Dr Patel stressed that it is never too late to “winterproof”.
Ways people with diabetes can prepare for the winter season include:
Have a flu jab if advised
Be familiar with sick day rules – especially if prescribed to take metformin and if on ‘flozins’ – the flozin treatments (e.g. dapagliflozin) are a particular one to watch and stop taking if unwell, due to the risk of developing ketones which could progress to DKA (diabetic ketoacidosis)
Ensuring you have working meters, enough ketone testing sticks and appropriate supply of medications, etc
Good footcare and footwear
Stay well hydrated, and take care if drinking alcohol (as excess amounts can cause dehydration)
Seek advice early if unwell and ensure to have some skills in insulin dose adjustment where appropriate
Read 'Sick day rules' in the DRWF leaflet Managing diabetes when you are ill
Dr Patel added: “If admitted to hospital and feeling unwell, there may be a need to be put on steroids as part of Covid-19 treatment, which could destablilise blood glucose levels and result in a potential need for short or longer term insulin (in people with type 2 diabetes) depending on usual degree of diabetes control.”
What is the risk to people with diabetes?
The NHS advises that people with diabetes are at a moderate risk (clinically vulnerable) from Covid-19.
The recommendations for people with diabetes at a moderate risk are that you can go out to work (if you cannot work from home) and for things like getting food or exercising.
However, it is advised that you should try to stay at home as much as possible.
It is also very important to 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.
Unlike people at high risk, you will not get a letter from the NHS.
If you're at a higher risk from coronavirus, you can get help from an NHS volunteer with things like getting food, medicines and other things you need.
The government advice published on 22nd September read as follows:
It is critical that everybody observes the following key behaviours:
Hands - Wash your hands regularly and for at least 20 seconds
- Face - Cover your face in enclosed spaces, especially where social distancing may be difficult and where you will come into contact with people you do not normally meet
- Space - Stay 2 metres apart where possible, or 1 metre with extra precautions in place
Face coverings – Wear a mask
Customers in private hire vehicles and taxis must wear face coverings (from 23rd September)
Customers in hospitality venues must wear face coverings, except when seated at a table to eat or drink. Staff in hospitality and retail will now also be required to wear face coverings (from 24 September)
- People who are already exempt from the existing face covering obligations, such as because of an underlying health condition, will continue to be exempt from these new obligations
- Guidance stating that face coverings and visors should be worn in close contact services will now become law (from 24 September)
- Staff working on public transport and taxi drivers will continue to be advised to wear face coverings
Working from home
To help contain the virus, office workers who can work effectively from home should do so over the winter.
Where an employer, in consultation with their employee, judges an employee can carry out their normal duties from home they should do so.
Public sector employees working in essential services, including education settings, should continue to go into work where necessary.
Anyone else who cannot work from home should go to their place of work.
The risk of transmission can be substantially reduced if Covid-19 secure guidelines are followed closely. Extra consideration should be given to those people at higher risk.
- Businesses selling food or drink (including cafes, bars, pubs and restaurants), social clubs, casinos, bowling alleys, amusement arcades (and other indoor leisure centres or facilities), funfairs, theme parks, adventure parks and activities, and bingo halls, must be closed between 10pm and 5am. This will include takeaways but delivery services can continue after 10pm (from 24 September)
- In licensed premises, food and drink must be ordered from, and served at, a table
- Customers must eat and drink at a table in any premises selling food and drink to consume indoors, on site (from 24 September)
- Businesses will need to display the official NHS QR code posters so that customers can ‘check-in’ at different premises using this option as an alternative to providing their contact details once the app is rolled out nationally (from 24 September)
- Businesses and organisations will face stricter rules to make their premises Covid-19 Secure (from 28th September):
- A wider range of leisure and entertainment venues, services provided in community centres, and close contact services will be subject to the Covid-19 Secure requirements in law and fines of up to £10,000 for repeated breaches
- Employers must not knowingly require or encourage someone who is being required to self-isolate to come to work
- Businesses must remind people to wear face coverings where mandated
Meeting people safely
- Support groups must be limited to a maximum of 15 people (from 24th September)
- Indoor organised sport for over 18s will no longer be exempt from the rule of six. There is an exemption for indoor organised team sports for disabled people (from 24th September)
- There will be a new exemption in those areas of local intervention where household mixing is not allowed to permit friends and family to provide informal childcare for children under 14 (from 24th September)
- Weddings and civil partnership ceremonies and receptions will be restricted to a maximum of 15 people (down from 30). Other significant standalone life events will be subject to the ‘rule of six’ limits, except funerals (from 28th September)
Government has announced an initial £60 million to support additional enforcement activity by local authorities and the police, in addition to funding that has already been awarded.
The spread of the virus is also affecting our ability to reopen business conferences, exhibition halls and large sporting events, so we will not be able to do this from 1st October.
The government’s expectation is the measures described above will need to remain in place until March 2021.
These measures apply to England – but there may be different rules if you live in an area under local lockdown: and you should check local lockdown rules. If you are in Wales, Scotland or Northern Ireland, different rules may apply.
Read NHS guidance on who is at risk from Covid-19
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Read Latest changes in guidance in shielding and protecting people at high risk of Covid-19 including people with diabetes
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.