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Covid-19

This section covers

  • General Guidance during Covid 19 Pandemic
  • Self-isolation guidance
  • Employment and self-isolation
  • Routine vaccinations
  • Statement regarding Ibuprofen or anti-inflammatory medications

The NHS and Public Health England (PHE) are extremely well prepared for outbreaks of new infectious diseases. The NHS has put in place measures to ensure the safety of all patients and NHS staff while also ensuring services are available to the public as normal.

Current guidance is that everyone should be using ‘social distancing’ whenever possible in order to protect themselves and vulnerable people. This is particularly important for over-70s, pregnant women and people under-70 with specific underlying health conditions. You can find full details of what you should do and who needs to take particular care on the Gov.uk website.

Stay at home if you have coronavirus symptoms. If you have either:
– A new continuous cough (this means you’ve started coughing repeatedly)
– A high temperature (37.8 or higher (you feel hot to touch on your back or chest))

Do not go to a GP surgery, pharmacy or hospital. You do not need to contact 111 to tell them you’re staying at home. Testing for coronavirus is not needed if you’re staying at home.

Stay at home for 7 days if you live alone. If you live with others, everyone in the household needs to stay at home. After 14 days everyone in the household who does not have symptoms can return to their normal routine. If anyone else in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start, even if it means they’re at home for longer than 14 days.

If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.

If you have to stay at home together, try to keep away from each other as much as possible.

Read the advice about staying at home.

Use the NHS 111 online coronavirus service if you feel you cannot cope with your symptoms at home, your condition gets worse or your symptoms do not get better after 7 days.

Use the 111 coronavirus service https://111.nhs.uk/covid-19/

Only call 111 if you cannot get help online.

Self isolation guidance

The gov.uk website has excellent guidance for those who are staying at home due to COVID-19, which is regularly updated.

  • if you live alone and you have symptoms of coronavirus illness (COVID-19), however mild, stay at home for 7 days from when your symptoms started. (The ending isolation section below has more information)
  • if you live with others and you are the first in the household to have symptoms of coronavirus, then you must stay at home for 7 days, but all other household members who remain well must stay at home and not leave the house for 14 days. The 14-day period starts from the day when the first person in the house became ill. See the explanatory diagram
  • for anyone else in the household who starts displaying symptoms, they need to stay at home for 7 days from when the symptoms appeared, regardless of what day they are on in the original 14 day isolation period. The ending isolation section below has more information, and see the explanatory diagram
  • it is likely that people living within a household will infect each other or be infected already. Staying at home for 14 days will greatly reduce the overall amount of infection the household could pass on to others in the community
  • if you can, move any vulnerable individuals (such as the elderly and those with underlying health conditions) out of your home, to stay with friends or family for the duration of the home isolation period
  • if you cannot move vulnerable people out of your home, stay away from them as much as possible
  • if you have coronavirus symptoms:
    • do not go to a GP surgery, pharmacy or hospital
    • you do not need to contact 111 to tell them you’re staying at home
    • testing for coronavirus is not needed if you’re staying at home
  • plan ahead and ask others for help to ensure that you can successfully stay at home and consider what can be done for vulnerable people in the household
  • wash your hands regularly for 20 seconds, each time using soap and water, or use hand sanitiser
    if you feel you cannot cope with your symptoms at home, or your condition gets worse, or your symptoms do not get better after 7 days, then use the NHS 111 online coronavirus service. If you do not have internet access, call NHS 111. For a medical emergency dial 999

Employment and self-isolation

The current Government Guidance for employers and businesses on coronavirus (COVID-19) states;

“By law, medical evidence is not required for the first 7 days of sickness. After 7 days, employers may use their discretion around the need for medical evidence if an employee is staying at home.

We strongly suggest that employers use their discretion around the need for medical evidence for a period of absence where an employee is advised to stay at home either as they are unwell themselves, or live with someone who is, in accordance with the public health advices issued by the government.”

The Practice will not provide a medical certificate for patients requiring self-isolation for coronavirus. If needed, please use the letter below as evidence for your employer.

http://www.gpwebsolutions-host.co.uk/4829/files/2020/03/COVID-19-14-day-self-cert-sicknote.pdf

Routine vaccinations

Update: 18 March 2020 – Current guidance is that routine vaccinations and immunisations for children and adolescents should continue as usual until advised otherwise. Please book appointments with our practice nurse as usual.  If the child or accompanying adult develop a cough or fever or are in contact with a confirmed case or in a household under self-isolation, cancel the appointment and do not attend the surgery. Rebook for at least 14 days later. There are no problems in giving vaccinations later than the planned schedule.

Infant paracetamol availability:

We are aware that some parents are having difficulties in obtaining infant paracetamol suspension. Given the risk of the serious infections that the vaccines protect against, Public Health England are recommending that the routine primary immunisation schedule should not be delayed. Whilst parents should continue to try to obtain and administer infant paracetamol if possible, infant vaccines can and should still be given even if it is not possible to give prophylactic paracetamol.

Parents who have been unable to obtain infant paracetamol should be advised as follows:

• Fever can be expected after any vaccination but is more common when the MenB vaccine (Bexsero) is given with the other routine vaccines at eight and sixteen weeks.

• In infants who do develop a fever after vaccination, the fever tends to peak around six hours after vaccination and is nearly always gone completely within two days.

• Ibuprofen can be used to treat a fever and other post-vaccination reactions. Prophylactic ibuprofen at the time of vaccination is not effective. • Information about treating a fever in children is available from the NHS UK webpage “Fever in children” at www.nhs.uk/conditions/fever-in-children/

• If an infant still has a fever 48 hours after vaccination or if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111.

• The diseases that the vaccines protect against are very serious and therefore vaccination should not be delayed because of concerns about post-vaccination fever.

Cause of fever following immunisation:

We have also been made aware of concerns that parents will not know whether a fever in their infant following immunisation is due to their immunisations or to COVID-19. Indications to date suggest that COVID-19 causes mild disease in infants and children. As has always been recommended, any infant with fever after vaccination should be monitored and if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111.

The same advice applies to teenagers who are due their routine adolescent immunisations. Teenagers are less likely to develop vaccine reactions such as fever and if they do, these are generally short lived and resolve quickly. COVID-19 is associated with a more prolonged course of illness with respiratory symptoms, especially cough, which would not be expected following vaccination.

Statement regarding Ibuprofen or other anti-inflammatory medications

Update 18 March 2020

Statement from Professor Stephen Powis NHS England Medical Director

We are aware of  concern about the use of non-steroidal anti-inflammatory medications (NSAIDs) in relation to Covid-19 following a statement by the French Health Minister (a clinician) advising against the use of ibuprofen. This statement was based on provisional information reported from French care settings which UK authorities have not seen and is, to date, unpublished.

There is no current literature on the impact of NSAIDs use in Covid-19. There appears to be some evidence for SARS 1 that there may be an adverse impact on pneumonia. There is also some literature suggesting NSAIDs may increase complications from simple acute respiratory infections or slow recovery. However the evidence is not conclusive overall.

There appears to be no evidence that NSAIDs increase the chance of acquiring Covid-19. In view of the current lack of clarity the Committee of Human Medicines (an advisory body of MHRA) and NICE have been asked to review the evidence.

It is therefore suggested that, in the interim, for patients, who have confirmed Covid-19 or believe they have Covid-19, that they use paracetamol in preference to NSAIDs.

Those currently on NSAIDs for other medical reasons (e.g. arthritis) should not stop them.

This position will be kept under constant review.



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