Who should self-isolate for 12 weeks – as coronavirus epidemic spirals? – The Sun

BRITAIN is dramatically stepping up its action plan to fight coronavirus – as cases have surged to 1,543 in the last day.

Just yesterday, Prime Minister Boris Johnson said that up to 1.5 million people with the “most serious health conditions” must avoid almost all social contact for 12 weeks — starting from this weekend.

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It's just one of the government's new measures to tackle the growing coronavirus epidemic – in a bid to stop the death toll reaching 250,000.

The Government guidance is that people who are over 70, have an underlying health condition or are pregnant, are strongly advised to limit social interaction with friends and family, where possible.

It is thought to apply to around 20 million people, including adults under 70 who qualify for a flu jab due to an underlying health condition and people with chronic long-term respiratory diseases, such as asthma.
A further 1.4 million people – those with a suppressed immune system, eg. chemo patients – are advised to self-isolate for 12 weeks, to "shield" themselves from the bug.

Here, we take you through the people who should self-isolate for 12 weeks – as the coronavirus epidemic spirals…

1. People over the age of 70

The elderly set to be hit the hardest by the coronavirus pandemic because their immune systems are weaker – meaning their bodies are less able to fight Covid-19.

Dr Sarah Jarvis, GP and Clinical Director of Patient Access, told The Sun: "We know that as you get older, your immune system becomes less efficient – that’s why older people are at higher risk of serious complications of coronavirus infection.

"If your immune system isn’t strong, it’s more likely that the virus can multiply deep inside your lung, causing inflammation and scarring.

"Your immune system will try and fight it off, and will often destroy healthy lung tissue in the process.

"This makes you more prone to get ‘secondary’ infections like pneumococcal pneumonia."

Pensioners will have to remain in their homes, except for getting medical care, and not go to work, school or public areas.

Experts also say people who are self-isolating need to separate themselves from other people in their home and stay in a well-ventilated room with a window to the outside that can be opened.

If they do not have access to the internet or are not handy with a computer, Age UK recommend that healthy, more active people help with running errands like picking up bits of shopping.

The Government is in talks with major retailers to ensure the elderly and vulnerable can still get access to supplies, such as through a telephone hotline where they can place orders.

It may be worth ensuring that the older people in your life are set up with online shopping accounts now, are able to access social media to stay in touch with other or have been introduced to streaming services such as Netflix.

On top of this, part of the mental battle of isolation is remaining as active as possible – even if this means standing up ten times in one hour and walking between rooms in the house.

If the elderly person you are helping has a garden, encourage them to walk around it – and make sure they are not immobile for long periods of time, watching television for long periods or remaining bed bound.

Anyone who visits an older person should wash their hands before and after they visit.

Ensure carers in homes or those doing regular home visits do not attend if they are sick or displaying symptoms of coronavirus.

2. Pregnant women

The UK government has now classed expectant mothers as those among the "vulnerable" group of society at risk of Covid-19.

Professor Chris Whitty, England's Chief Medical Officer, said that including pregnant women in this group was a "precautionary measure" as experts are "early in our understanding of this virus".

And his deputy, Professor Jonathan Van-Tam, said it's hoped that these new measures will reduce the infection rate and protect those at higher risk.

He told the BBC: "When it comes to this coronavirus, it is a new disease, it's been with humans around the world for just a few months.

"We are being very precautionary in terms of the advice we are giving to pregnant women to increase their social distancing.

"We know that a whole range of normal infections are more serious in pregnancy and the advice we're giving is extremely precautionary."

How will self-isolating affect labour?

As a precautionary approach, pregnant women with suspected or confirmed coronavirus when they go into labour, are being advised to attend an obstetric unit for birth.

This way the baby can be monitored using continuous electronic fetal monitoring, and the mum's oxygen levels can be monitored hourly.

As this can only take place in an obstetric unit, where doctors and midwives are present, it is not currently recommended that you give birth at home or in a midwife led unit, where only midwifes would be present.

The experts also say that there is no evidence to suggest that you cannot give birth vaginally – or that you'd be safer having a c-section.

Therefore your birth plan should be followed as closely as possible based on your wishes.

However, if your respiratory condition suggested that urgent delivery would be needed, a caesarean birth may be recommended.

The experts added: "There is no evidence that women with suspected or confirmed coronavirus cannot have an epidural or a spinal block.

"However, the use of gas and air may increase aerosolisation and spread of the virus, so your maternity team will discuss all the options with you in early labour to ensure you are aware of the pain relief options available to you."

He added: "The early signal, and it is only an early signal, is that the highest risk is only going to be towards the end of the third trimester, so from the 34th week, that kind of position in the pregnancy.

"But we are being very precautionary and saying that because we don't know enough about this disease yet.

"We haven't got enough information on the disease in pregnant women, that the best thing to do is take a precautionary approach and advise social distancing and to identify that this is strongly advised for pregnant women as a whole group."

According to the Royal College of Obstetricians and Gynaecologists (RCOG), the large majority of women will experience only mild or moderate symptoms.

These include a cough, fever and shortness of breath.

3. People with severe chest conditions

People with severe chest conditions such as cystic fibrosis will have to self-isolate for 12 weeks.

This includes people with severe asthma who require hospital admissions or courses of steroid tablets.

This is because people with chest conditions are generally more likely to pick up infections, and are more vulnerable to complications if they do develop an infection such as coronavirus.

Professor Kevin Southern, from the UK's Cystic Fibrosis Trust Medical Association, said: "It is important to continue to pursue a fit and healthy lifestyle and to be up to date with immunisations, including ‘flu’, even though this is a different virus.

"If a person with CF develops cold or ‘flu-like' symptoms (muscle aches, fever etc), speak with your CF team about starting a recommended back-up antibiotic treatment."

4. Cancer patients

People with cancer are among those at higher risk of complications from Covid-19 – because cancer and treatment can weaken their immune systems.

The immune system protects the body against illness and infection caused by viruses like coronavirus.

Some people with cancer have a weak immune system which reduces their ability to fight these infections.

This is because some treatments, like chemotherapy, can stop the bone marrow from making enough white blood cells, which are part of your immune system.

This is most likely to happen during a course of cancer treatment, but the effects can last for some time afterwards.

Some types of cancer can also lower your ability to fight infection. This is usually cancer that affects your immune system like leukaemia or lymphoma.

When your ability to fight infection is lowered the symptoms of any infection can be much more severe and may become dangerous.

Cancer Research UK urge those with the disease to talk to your cancer team and follow NHS advice.

5. Those with Primary Immunodeficiency (PID)

Primary immunodeficiencies are disorders in which part of the body's immune system is missing or does not function normally.

This leaves them with reduced or no natural defence against germs such as bacteria, fungi and viruses – and that is likely to be true with Covid-19.

Susan Walsh from the PID UK said they were advising people to follow Public Health England guidelines.

She told The Guardian: "We are also telling people that if they do feel ill they should contact a doctor promptly with details of their diagnosis, medication and immunology centre.

"It’s a balance between raising awareness, but not creating great fear. It needs to be handled very carefully."

6. People with severe diseases of body systems

Someone with a severe disease of a body system is more likely to have a less robust immune system – meaning their body's response is not as strong a response when exposed to viruses.

In particular, based on early reports, 40 per cent of hospitalised Covid-19 patients had cardiovascular disease.

The bug's main target is the lungs but that could affect the heart, especially a diseased heart, which has to work harder to get oxygenated blood throughout the body.

That could exacerbate problems for someone with heart failure, where the heart is already having problems pumping efficiently.

Similarly, those with severe kidney disease (dialysis) should also be particularly cautious and self-isolate.

Kidney Care UK says those having dialysis will still get dialysis sessions they just may be asked to come in at a different time and some people may be asked to do two sessions a week rather than three, provided it is considered to be safe for you do so.

Public Health England say those with clinical conditions that put them at a high risk of severe illness from Covid-19 will be contacted by NHS England next week.

They will be told the stringent measures they need to take in order to keep themselves and others safe.

For now, they should rigorously follow the social distancing advice from the government in full.

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