COVID Precautions for the extremely vulnerable: Winter 2020

UK government has today announced its strategy to protect UK citizens from COVID-19 infection and to try to reduce virus transmission rates.

Part of these new guidelines refers to the extremely vulnerable eg people who have received the most recent letter or email from advising them that they are clinical extremely vulnerable. If you didn’t receive a letter and are still concerned you should contact your doctor.

75. Under recent national measures, the clinically extremely vulnerable have been advised
to take extra precautions and stay at home as much as possible. Local Authorities
have been working to ensure the right support is available for those that need it.

76. As the national restrictions end, the guidance to the clinically extremely vulnerable
not to go to work or school will also end. The Government will reintroduce the specific
advice for clinically extremely vulnerable people on how they can protect themselves
at each tier. The Government will constantly monitor the latest evidence and the
evolving situation in local areas to keep the advice for clinically extremely vulnerable
people up to date. Support will be available for those who need it, either through
Local Authorities in tier 3 areas or NHS Volunteer Responders. Supermarket priority
delivery slots will also continue for those who have already registered. The
Government has also made free influenza vaccinations available to the household
contacts of those on the Shielded Patients List.

77. A better understanding of the factors contributing to clinical risk has informed the
clinical advice from Medical Officers that most children can be removed from the
Shielded Patient List, following a clinician-parent conversation. It has also led to the
addition of those with Chronic Kidney Disease Stage 5 and of adults with Down’s
Syndrome to the Shielded Patients List, ensuring that they are provided with the best
advice on protecting themselves.

Read the full 2020 COVID-19 Winter Plan here

NHS: COVID-19. What if I’ve already got respiratory condition?

The NHS has published a set of guidelines for people who have a pre-existing respiratory condition and then get a COVID-19 infection. We reproduce some of the guidelines here but to read the full article click here.

We know that people with existing breathing conditions may have some additional concerns about catching the coronavirus. You are at no more risk of catching the virus than anyone else but if you do then you could become more ill. As COVID affects the lungs, it may be more difficult for you to judge what is causing symptoms.

Washing your hands on a regular basis (especially after visiting the toilet and before eating) and social distancing will reduce your risk of exposure to the virus and it is important you do this.

Should I take my medication as usual?

It is important that you continue taking the medication that has been prescribed for you. Otherwise, this could have an effect on your overall condition and possibly make you feel worse. If you have any concerns or queries about your medication please speak to your local pharmacist or your General Practitioner (GP). Your local surgery or pharmacist can organise a delivery for you.

It is very important that you clean your spacer and inhaler, and any masks/mouthpieces at least weekly.

If you do need to be admitted to hospital, please remember to bring your inhalers, and an up to date list of your medication with you.


What should I do if I feel unwell?

Early treatment for a flare-up (exacerbation) of your lung condition may avoid needing to go to hospital, and you may be able to be treated at home.

You should call your doctor who can assess your symptoms and likelihood of COVID. They can prescribe treatment for you.

If you have a community respiratory nurse they can offer further advice and support.

If you are unsure or outside doctors’ hours you can call 111 for advice or 999 if your breathing problem is very severe.


Does it matter if I smoke?

The chemicals and particles in cigarette smoke will irritate and damage your lungs if you do not stop. It is never too late to stop. Help and support is available, and you are four times more likely to stop with help from a stop smoking advisor.


What can I do if I feel breathless?

If you have a ‘rescue’ inhaler you can take that as prescribed.

Using a handheld fan (not in a public place) moved slowly cheek to cheek can be helpful.

Try to slow your breathing (e.g. breathe in and count to four; breathe out slowly and count to seven).

If you have swollen feet and ankles you may have extra fluid in your body so you will should talk to your doctor about this.


What about routine hospital appointments?

Many hospitals have had to make a difficult decision to postpone many of the non-urgent hospital appointments and planned procedures due to the COVID outbreak. These decisions have been in line with national guidance, you will be offered another appointment when it is safe to do so.

Patients should be contacted by their local hospital teams to see how their appointment has been affected.

Some of the appointments may go ahead and some will be offered either face to face (urgent appointments or via the telephone (virtually).

If you are unsure what has happened to your appointment then please contact your local hospital switchboard or ring the number on the appointment letter.

However, it is important to remember that you should not attend if you have any symptoms of COVID, or have suffered with sickness or diarrhoea in the last 48 hours.


How do I know if I’m on the shielding list?

Please follow the link to the Government guidelines on shielding:


For other useful information about respiratory conditions and COVID please see some useful links below: (British Lung Foundation)

COVID Update November 5th National Lockdown: Shielding

The UK government have announced that England will go into a period of lockdown whereby those that can stay in their homes should do so except when needing to go out for essential purpose or to work. Full instructions are as follows:

Additional instructions for people living in England who are highly vulnerable have been published. This is the group of people who received a letter from their doctor or UK government during the first wave of infections telling them Shield themselves at home as they are at increased risk of experiencing more severe symptoms if they were to become ill with COVID-19.

This document replaces all earlier documents published on ਸ਼ੀਲਡਿੰਗ, and only applies to England. The advice is different depending on the risk level set in your local area by (Medium, High or Very High – see link above)


For people living in the UK outside of England: The UK government has updated its instructions for people living in England to help prevent infection by COVID-19.


Vitamin D and COVID-19

The news media have been extensively covering the publication of research papers over the summer that suggest that vulnerable people should all be taking vitamin D supplements as a precaution against being infected by COVID. If you have been reading these reports you may be wondering what you should do?

Vitamin D is sometimes referred to as the ‘sunshine’ vitamin as we are all able to make it in our skin when the skin surface is lit by the sunlight. Our bodies cannot make it without sunlight so NHS recommendations are for short periods of direct sunlight on our face and arms every day. We can also get vitamin D from our food, principally oily fish, eggs and red meat.

Evidence shows that many of us (20%) in the UK have quite low levels of vitamin D in our bodies, especially during the darker months (October – March) when we don’t get much sunlight shining on our island. There are also people who don’t get much exposure at any time of the year due to their circumstances – for example, they might work at night or they might be unable to get outdoors every day. Sunlight shining through a window is usually insufficient to make vitamin D. People with darker skin pigmentation can also find it difficult to maintain levels of vitamin D.

Foods that contain lots of vitamin D are often not eaten every day, so many people supplement their diet with tablets that contain their daily dose. NHS guidelines are that in general everyone over age 5 should take 10mcg (400UI) Vitamin D per day from October – March. Those people who see very little direct sunlight or who find it difficult to maintain their vitamin D levels should take the supplement all year round. NOTE some people take calcium tablets that are already supplemented with vitamin D, so in that case need no further supplementation.
That said, individuals can be very variable in how much Vitamin D supplement they need so if in doubt see your doctor.

Does vitamin D protect us from COVID-19? So far the answer is maybe but there is not enough evidence to strongly support the suggestion. Studies are ongoing. However as already discussed there is plenty of evidence to suggest that you need to ensure that you get enough vitamin D regardless of COVID-19. Keep your levels up and you will benefit in lots of ways – if we find in the future it is good for prevention of COVID-19 infection, so much the better.

COVID Information for Patients Attending Manchester University NHS Foundation Trust (MFT)

MFT is the Trust that hosts the National Aspergillosis Centre (NAC) in Manchester, UK. MFT is present on 12 sites throughout Greater Manchester including Wythenshawe Hospital which is where NAC is located.

Just like most acute care hospitals in the UK, Wythenshawe and most other sites at MFT have undergone major changes in how they operate outpatient care during the COVID outbreak, and those changes have included how NAC operates so that we can ensure the safety of patients and staff.

For clarity and information MFT have produced a series of webpages that contain all the information you may need if you have an appointment to attend a clinic at any MFT site. The information is updated regularly.

Coronavirus (COVID-19) procedures and precautions for attending MFT as a patient

1 2 3 6