Important advice to keep you safe from Coronavirus
This information is specifically for patients with Inflammatory Bowel Disease.
Your safety and the continued provision of the care and treatment you need is a priority for the NHS. This letter gives you advice on how to protect yourself and access the care and treatment you need.
I am writing to let you know that the NHS has been giving particular thought to patients with conditions like yours during the Coronavirus (COVID-19) pandemic and the extra steps that we can take to keep you well. The Chief Medical Officer has asked specialist doctors like me to identify patients who are at particular risk from COVID-19 and get in touch with them.
That risk, which affects quite a large number of patients with a range of conditions, comes from the fact that your immune system – your defence against illness – may not be as strong as it would be for people without your condition.
If any of the CRITERIA below apply to you, we believe that you are at a slightly higher risk
- You are over 70 years old AND/OR have other health conditions such as; diabetes, high blood pressure, a respiratory condition, heart disease, IRRISPECTIVE of what medication you take
- You are taking oral prednisolone at 20mg (4 tablets) or more per day
- You have started a new medicine listed in the table below in the last 6 weeks
- You have active Crohn’s disease or Ulcerative Colitis
For patients not meeting these criteria you should still observe strict social distancing anyway.
I know this will be an additional worry, when you may already be concerned and possibly confused by everything that is happening and all the advice that is being given. This has included much about social distancing.
If you meet ANY of the criteria 1-4 described above, I now need to advise you to reduce even more your contact with other people, to lessen your risk of being infected. This means you must self -isolate for the next 12 weeks.
We will be working closely with your general practitioner to ensure you get the medicines and care you need at this difficult time
|Infliximab (Remsima , Remicade, Inflectra)||Methotrexate|
|Adalimumab (Imraldi, Amgevita, Humira)||Sirolimus|
|Biologic medication as part of a clinical trial including stem cell transplantation||Immunosuppressant medication as part of a clinical trial|
If you need to self-isolate, the safest course of action is for you to stay at home at all times and avoid all face-to-face contact for at least twelve weeks from today, except from carers and healthcare workers who you must see as part of your medical care. This will protect you by stopping you from coming into contact with the virus.
If you are in touch with friends, family or a support network in your community who can support you to get food and medicine, follow the advice in this letter. If you do not have contacts who can help support you go to www.gov.uk/coronavirus-extremely-vulnerable or call 0800 0288327, the Government’s dedicated helpline.
If, at any point, you think you have developed symptoms of coronavirus, such as a new, continuous cough and/or high temperature (above 37.8 °C), seek clinical advice using the NHS 111 online coronavirus service (https://111.nhs.uk/covid-19/). If you do not have access to the internet, call NHS 111. Do this as soon as you get symptoms.
You, or the person you care for, should:
- strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature (above 37.8 °C) and/or a new and continuous cough
- not leave your home
- not attend any gatherings. This includes gatherings of friends and families in private spaces e.g. family homes, weddings and religious services
- not go out for shopping, leisure or travel. When arranging food or medication deliveries, these should be left at the door to minimise contact
- keep in touch using remote technology such as phone, internet, and social media
- use telephone or online services to contact your GP or other essential services
- regularly wash your hands with soap and water for 20 seconds. Ask carers or support workers who visit your home to do the same.
The rest of your household should support you to stay safe and stringently follow guidance on social distancing, reducing their contact outside the home. In your home, you should:
- minimise the time you spend with others in shared spaces (kitchen, bathroom and sitting areas) and keep shared spaces well ventilated
- aim to keep 2 metres (3 steps) away from others and encourage them to sleep in a different bed where possible
- use separate towels and, if possible, use a separate bathroom from the rest of the household, or clean the bathroom after every use
- avoid using the kitchen when others are present, take your meals back to your room to eat where possible, and ensure all kitchenware is cleaned thoroughly.
- If the rest of your household are able to follow this guidance, there is no need for them to take the full protective measures to keep you safe.
You will still get the medical care you need during this period. We are considering alternative options for managing your care and will be in touch if any changes are needed. We also advise that:
1. Carers and support workers who come to your home
Any essential carers or visitors who support you with your everyday needs can continue to visit, unless they have any of the symptoms of coronavirus. All visitors should wash their hands with soap and water for 20 seconds, on arrival and often.
It is also a good idea to speak to your carers about what happens if one of them becomes unwell. If you need help with care but you’re not sure who to contact please visit www.gov.uk/coronavirus-extremely-vulnerable.
2. Medicines that you routinely take
The government is helping pharmacies to deliver prescriptions. Prescriptions will continue to cover the same length of time as usual. If you do not currently have your prescriptions collected or delivered, you can arrange this by:
- Asking someone who can pick up your prescription from the local pharmacy, (this is the best option, if possible);
- Contacting your pharmacy to ask them to help you find a volunteer (who will have been ID checked) or deliver it to you.
You may also need to arrange for collection or delivery of hospital specialist medication that is prescribed to you by your hospital care team.
3. Planned GP practice appointments
Wherever possible, we will provide care by phone, email or online. But if we decide you need to be seen in person, we will contact you to arrange your visit to the surgery or a visit in your home.
4. Planned hospital appointments
At this moment, all elective appointments will be cancelled or postponed. We will contact you if any changes need to be made to your care or treatment. Otherwise you should assume your care or treatment is taking place as planned. Please contact us directly if you have any questions about a specific appointment.
5. Support with daily living
Please discuss your daily needs during this period of staying at home with carers, family, friends, neighbours or local community groups to see how they can support you. If you do not have anyone who can help you, please visit www.gov.uk/coronavirus-extremely-vulnerable.
If you need support from the benefit system please call us and we will provide a confirmatory letter. These letters will be evidence, for your employer, to show that you cannot work outside the home. You do not need to get a fit note from your GP. If you need help from the benefit system visit https://www.gov.uk/universal-credit.
6. Urgent medical attention
If you have an urgent medical question relating to your existing medical condition, or the condition of the person you are caring for please contact us directly. Where possible, you will be supported by phone or online. If your clinician decides you need to be seen in person, we will contact you and where necessary organise treatment in hospital.
To help the NHS provide you with the best care if you need to come to hospital as a result of catching coronavirus, we ask that you prepare a single hospital bag. This should include your emergency contact, a list of the medications you take (including dose and frequency), any information on your planned care appointments and things you would need for an overnight stay (snacks, pyjamas, toothbrush, medication etc). If you have an advanced care plan, please include that.
7. Looking after your mental well-being
We understand that this may be a worrying time and you may find staying at home and having limited contact frustrating. At times like these, it can be easy to fall into unhealthy patterns of behaviour, which can make you feel worse. Simple things you can do to stay mentally and physically active during this time include:
- look for ideas for exercises to do at home on the NHS website
- spend time doing things you enjoy – reading, cooking and other indoor hobbies
- try to eat healthy, well-balanced meals, drink enough water, exercise regularly, and try to avoid smoking, alcohol and recreational drugs
- try spending time with the windows open to let in fresh air, arranging space to sit and see a nice view (if possible) and get some natural sunlight. Get out into the garden or sit on your doorstep if you can, keeping a distance of at least 2 metres from others.
You can find additional advice and support from Every Mind Matters and the NHS mental health and wellbeing advice website.
Advice on social distancing
- Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
- Avoid non-essential use of public transport when possible
- Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information
- Avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues are currently shut as infections spread easily in closed spaces where people gather together.
- Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
- Use telephone or online services to contact your GP or other essential services