Coronavirus (COVID-19) Social distancing introduced

24th March: Social distancing measures extended

The government last night asked us all to stay at home to protect each other and reduce pressure on the NHS. 

Full information on staying at home and away from others is available from the government website

People with CPA are classed as extremely vulnerable. Stay at home at all times and avoid any face-to-face contact for at least 12 weeks. More guidance on shielding and protecting people defined on medical grounds as extremely vulnerable is available from Public Health England.

17th March: Social distancing measures introduced

The government has issued guidance is for everyone advising on social distancing measures we should all be taking to reduce social interaction between people in order to reduce the transmission of coronavirus (COVID-19). It is intended for use in situations where people are living in their own homes, with or without additional support from friends, family and carers. If you live in a residential care setting guidance is available.

Government advice is for everyone aged 70 and over, regardless of medical conditions, to follow social distancing measures. Full guidance on the social distancing measures we should all be taking to reduce social interaction between people in order to reduce the transmission of coronavirus is available on gov.uk. This includes information for people with pre-existing health conditions including asthma and COPD. Please read it.

GOVERNMENT ADVICE ON SOCIAL DISTANCING

 

12th March: Precautionary increase in protective measures advised

COVID-19 is starting to spread in an unconstrained manner in the UK with over 460 cases identified. This makes it a little more likely that the virus will spread through the community, increasing the number of cases. UK government measures are slowing this spread down so the total number is still relatively small, with only a handful of cases in each area so the chances any one person will be infected are still really small, but if you are a chronic respiratory disease patient with a disease such as aspergillosis you are at slightly higher risk of infection. Consequently we are recommending that you use additional protective measures.
In addition to frequent handwashing, no touching of your face and limiting direct contact with other people the suggestion is that you start social distancing so that any infectious person will find it very difficult to pass on the virus. The link explains everything in detail but essentially you avoid groups, people with symptoms, close contact ie less than 2 metres away from someone for more than 15mins. Also minimise use of public transport.

 

9th March : YOUR QUESTIONS ANSWERED BY A RESPIRATORY EXPERT

A useful series of questions specifically aimed at bronchiectasis, COPD, asthma, cystic fibrosis and more. Written by European Respiratory Society (ERS) expert Professor James Chalmers. 

Answers to common questions about COVID-19 from the NHS

Public health Advice

British Thoracic Society guidance – UK region specific

BBC information resources on COVID-19

What do I need to know about the coronavirus?

Aspergillosis and Fatigue

People who have chronic respiratory illness frequently state that one of the main symptoms that they find difficult to cope with is perhaps one that doesn’t leap to mind as a major problem for most of us who do not have a chronic illness – fatigue.

Time and time again people who have aspergillosis mention how exhausted it makes them feel, and here at the National Aspergillosis Centre we have determined that fatigue is a major component of chronic pulmonary aspergillosis (CPA – see Al-Shair et. al. 2016) and that the impact of aspergillosis on a patients quality of life correlated well with the level of fatigue suffered.

There are many possible causes of fatigue in the chronically ill: it could partly be a result of the energy that the immune system of a patient puts into fighting off the infection, it could partly be a consequence of some of the medication taken by people who are chronically ill and possibly even the result of undiagnosed health problems such as anaemia, hypothyroidism, low cortisol or infection (e.g. long COVID).

Because of the many possibilities that cause fatigue, your first step in trying to improve the situation is to go and see your doctor who can check for all common causes of fatigue. Once you have established that there are no other possible hidden causes you might read through this article on fatigue produced by NHS Scotland containing lots of food for thought and suggestions to improve your fatigue.

Coping with fatigue

UK Weather Warning 17-18th June 2022

The UK Met Office has issued a warning for hot weather in parts of central and southern England. Temperatures are expected to reach over 30C for a day or two starting Friday 17th and then fall back over the weekend.

This intense heat can be difficult for people who have chronic lung conditions to cope with, especially if they get dehydrated, so the British Lung Foundation has provided guidelines to help people prepare and cope with the temperatures. For others, hot weather can increase symptoms of hay fever.

Go to ‘Looking after your lungs in hot weather’ for more details

Link to BLF website

 

BLF top 10 tips during a heatwave

Here’s how to plan ahead to stay well and keep cool:

Singing for lung health

The breath control needed to sing can also help people who have lung disease breathe better and can help lift mood too which is vitally important for our health and quality of life.

Want to try therapeutic singing?

You may be lucky and find a lung health group locally, however, you don’t have to leave your home to benefit (sessions are run on Zoom), AND you don’t have to be a patient either as the groups are also open to carers.

The Asthma & Lung Health charity has published a page giving some useful information on how you can find a singing group in your area.

Monkeypox outbreak

As we are sure many of you are aware, there is widespread news coverage regarding Monkey Pox, with the UK Health Security Agency (UKSA) today reporting a further eleven cases.
We understand this may cause concern amongst many of you, particularly as this is happening in the wake of Covid-19. However, we would like to highlight that current UKHSA guidance is that the virus does not usually spread easily, and the risk to people is low. Investigations are ongoing, and contact tracing is underway to look at possible modes of transmission and prevent further spread.

What is Monkeypox?

Monkeypox is a zoonotic (can be spread from animals to humans) viral infection that is endemic in parts of the west and central Africa.

How is monkeypox spread?

The virus is spread through close physical contact with an infected individual or through contact with blood, bodily fluids, or cutaneous or mucosal lesions of infected individuals or animals. It can also be spread through contact with clothing or linens used by an infected person. 
It is worth noting that monkeypox is NOT predominantly a respiratory virus so will not spread in the same way as COVID-19 and is unlikely to affect people with pre-existing respiratory disease in the same way.

Symptoms

Initial symptoms of monkeypox include:
  • fever
  • headache
  • muscle aches
  • backache
  • swollen lymph nodes
  • shivering
  • exhaustion
A rash usually appears 1 – 5 days after the first symptoms, often beginning on the face and then spreading to other parts of the body, particularly the hands and feet.
The rash (which can look like chickenpox) starts as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs which later fall off. Symptoms are usually mild and self-limiting and typically clear up in 2 to 4 weeks.
Anyone with concerns that they could be infected with monkeypox is advised to contact NHS 111 or a sexual health clinic.
More information can be found via the link below.

Drug Induced Photosensitivity

What is drug-induced photosensitivity?

 

Photosensitivity is the abnormal or heightened reaction of the skin when exposed to ultraviolet (UV) radiation from the sun. This leads to skin that has been exposed to the sun without protection becoming burnt, and in turn, this can increase the risk of developing skin cancer.

There are a number of medical conditions like lupus, psoriasis and rosacea that can increase a person’s sensitivity to ultraviolet light. A more comprehensive list of known conditions can be found here.

Drug-induced photosensitivity is the most common type of skin-related adverse drug reaction and can occur as a result of topical and oral medications. Reactions happen when a component of the medication combines with UV radiation during sun exposure, causing a phototoxic reaction that appears as severe sunburn, identified by swelling, itchiness, profuse redness and in the worst cases, blistering and oozing.

The images below demonstrate a reaction to sunlight whilst on voriconazole. The patient who provided these images had minimal exposure and was wearing factor 50 suncream on their feet.  

A foot showing blistering to the right big toe.

Day 1 Skin reaction to sunlight whilst on voriconazole

A foot showing blistering to the right big toe.

Day 2

A foot showing blistering to the third toe of the left foot.

1 Week

Left and right feet showing blistering to the right big toe and third toe of the left foot.

1 month

 

Patients taking antifungal medications, in particular, Voriconazole and Itraconazole (the former being more widely known for causing reactions), are often aware of the increased risks of photosensitivity; however, these are not the only drugs that can induce an abnormal response to UV exposure. Other drugs that have been reported to cause photosensitivity are:

  • NSAIDs (Ibuprofen (oral and topical), naproxen, aspirin)
  • Cardiovascular medication (furosemide, ramipril, amlodipine, nifedipine, amiodarone, clopidogrel – just a few)
  • Statins (simvastatin)
  • Psychotropic drugs (olanzapine, clozapine, fluoxetine, citalopram, sertraline – just a few)
  • Antibacterial medications (ciprofloxacin, tetracycline, doxycycline)

It is essential to note that the above list is not exhaustive, and reported reactions range from rare to frequent. If you think a medication other than your antifungal is causing a reaction to the sun, speak to your pharmacist or GP.

How to protect yourself

In most cases, patients can’t stop taking the medication that can predispose them to photosensitivity. Staying out of the sun isn’t always possible either – quality of life is always an important consideration; therefore, extra care should be taken to protect their skin while outside.

There are two types of protection:

  • Chemical
  • Physical

Chemical protection is in the form of sunscreen and sunblock. However, it is important to remember that sunscreen and sunblock are not the same. Sunscreen is the most common type of sun protection, and it works by filtering the sun’s UV rays, but some still get through. Sunblock reflects the rays away from the skin and prevents them from penetrating it. When buying sunscreen, look for a sun protection factor (SPF) of 30 or above to protect against UVB and at least a UVA protection rating of 4 stars.

Physical protection 

  • NHS guidance advises staying in the shade when the sun is strongest, which in the UK is between 11am and 3pm from March to October
  • Use a sunshade or umbrella
  • A wide-brimmed hat that shades the face, neck and ears
  • Long-sleeved tops, trousers and skirts made of close-weave fabrics that stop sunlight from penetrating
  • Sunglasses with wraparound lenses and wide arms that conform to the British Standard
  • UV protective clothing

 

Links to further information

NHS

British Skin Foundation

Skin Cancer Foundation

 

 

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