May 31st: Shielding Advice Updated by Public Health England

Many people with Chronic Pulmonary Aspergillosis were asked to shield themselves from exposure to the coronavirus COVID-19 in March 2020 as they were thought to be especially vulnerable to the consequences of infection by the respiratory virus.

Back in March 2020 the COVID-19 pandemic was progressing rapidly and there was some doubt about how well we might be able to contain it in the UK using a variety of social spacing measures, consequently, it was appropriate for the most vulnerable to be especially protected. We also knew relatively little about the virus and how it is transmitted, which groups might be more vulnerable to infection and severe symptoms.

More recently, by late May 2020 the pandemic in the UK is currently well under control with the number of cases in the community falling rapidly week on week, estimated at 17% between May 10 and 21st (AskZoe).

There is a real risk that extending shielding will have an overall detrimental impact on health, particularly on the mental health of those shielding, so it is important that we limit the numbers of people to those who absolutely have to, and ease up restrictions on those that have to carry on when it is deemed safe enough to do so.

The overall authority in England is Public Health England (PHE) and they released updated guidelines for people who are shielding here on 31st May 2020. 

What has changed

The government has updated its guidance for people who are shielding taking into account that COVID-19 disease levels are substantially lower now than when shielding was first introduced.

People who are shielding remain vulnerable and should continue to take precautions but can now leave their home if they wish, as long as they are able to maintain strict social distancing. If you choose to spend time outdoors, this can be with members of your own household. If you live alone, you can spend time outdoors with one person from another household. Ideally, this should be the same person each time. If you do go out, you should take extra care to minimise contact with others by keeping 2 metres apart. This guidance will be kept under regular review.

Read further information on schools and the workplace for those living in households where people are shielding. This guidance remains advisory.

 

Advice for Wales (updated but there may be some differences to PHE advice)

Advice for Scotland (not yet changed so are now different to England & Wales)

Advice for Northern Ireland (not yet changed but may change on June 8th)

Coronavirus Outbreak 2020 ANNOUNCEMENT: A notice for all patients that attend the National Aspergillosis Centre, Manchester, UK, 10th April.

NAC CARES

A plea to all NAC patients

As you will be aware the NHS faces unprecedented times due to the Coronavirus pandemic. The National Aspergillosis Centre (NAC) team are extremely busy working on the frontline.

We are currently still trying to offer telephone consultations in place of face to face appointments. However, we are currently overwhelmed with the numbers of calls still required. May we politely request again that you call us to postpone all non-urgent telephone appointments.

Chronic Pulmonary Aspergillosis (CPA) Patients

Many patients have also been in contact with us regarding NHS social shielding letters and support. The National Aspergillosis Centre (NAC) has now sent letters to all NAC registered patients (and their GPs) who have a diagnosis of chronic pulmonary aspergillosis (CPA) advising that they are extremely vulnerable and should follow social shielding advice.

For further details on shielding and protecting highly vulnerable people click here.

All patients living in England will be added to the government’s list of extremely vulnerable people and can register for support at https://www.gov.uk/coronavirus-extremely-vulnerable

NOTE: There is separate advice for patients living in Scotland, Northern Ireland and Wales. For country-specific information regarding social shielding please follow these web links or contact you GP:

Allergic Bronchopulmonary Aspergillosis (ABPA) Patients

Patients with Allergic Bronchopulmonary Aspergillosis (ABPA) and Severe Asthma with Fungal Sensitisation (SAFS) requiring to shield should have been identified by the NHS database searches across the UK. These searches were based on the medication you take to control your asthma. If you have not received a letter and you believe you have severe asthma you should first contact your local respiratory consultant or GP for advice. Please note that the National Institute for Health and Care Excellence (NICE) have defined severe asthma for the purposes of COVID-19 as follows:

“asthma that requires treatment with high-dose inhaled corticosteroids (see inhaled corticosteroid doses for NICE’s asthma guideline) plus a second controller and/or systemic corticosteroids to prevent it from becoming ‘uncontrolled’, or which remains ‘uncontrolled’ despite this therapy.”

Aspergillus bronchitis and Aspergillus sinusitis Patients

Aspergillus bronchitis and Aspergillus sinusitis have not been identified as risk factors for serious complications from COVID-19. If you have one of these conditions alone, you should not follow shielding advice. Instead, you should follow social distancing guidelines.

For further guidance on social distancing click here

ANNOUNCEMENT for all patients of the National Aspergillosis Centre

NAC CARES

The National Aspergillosis Centre(NAC)  is situated in the Manchester University NHS Foundation Trust (MFT) at Wythenshawe, Manchester, UK. As the coronavirus SARS-CoV-2 outbreak spreads throughout the UK all hospitals are having to devote most of their activity to help with treating people who have been infected by coronavirus and who are having severe symptoms. Consequently, MFT is shutting down normal outpatient clinics to release staff from their normal duties until at least 1st June 2020. NAC patients are high risk so we have developed our policy to inform and carry on caring for our patents during this time. All patients will get a letter explaining all of this in addition to this note.

NAC Outpatient clinics (26/03/2020)

  • MFT has instructed for all out-patient clinics to be cancelled from 26/03/20.
  • All new NAC patient appointments will be re-scheduled until after 31/05/20.
  • A letter has now been sent to all NAC patients with follow-up appointments from 26/03/20 until 31/05/20 to advise them that their face to face appointment has now been converted to a telephone appointment that will be conducted in the same week as their scheduled appointment.
  • In order to significantly reduce the number of consultations patients have been asked in this letter to call our secretarial team to re-arrange their appointment unless it is absolutely necessary.
  • Two attempts will be made to telephone each patient; thereafter if no contact can be made their appointment will be re-scheduled by 3 to 6 months.
  • If patients are deemed by a consultant to require face to face review following telephone consultation they will be booked into NAC clinic on a Friday morning. No face to face consultations will occur on a Wednesday P.M or Thursday A.M.
  • If a patient requiring face to face review has symptoms suggestive of COVID-19 they will be asked to self-isolate for 7 days prior to being reviewed in the hospital.
  • Telephone consultations will be held during the same week as the patient scheduled appointment. Due to staffing constraints scheduled appointment times cannot be adhered to. Where blood or sputum sampling is required to inform patient management postal packs will be sent out to patient homes.
  • Patients that telephone NAC clinic administrators will be assessed, re-scheduled until after 31/05/20 or passed to a specialist nurse.
  • Patients who contact the booking centre should be directed to email idandnacadmin@mft.nhs.uk
  • Weekly patient Zoom support meetings are now taking place every day 10am. Register at https://zoom.us/meeting/register/uZQocO-trj8pElzq-0Z9wqj4p-xoVd0CGg
  • Monthly patients support meetings at NAC will now take place online at the same address, starting 02/04/2020