Government and NHS Guidance

Government and NHS guidance for what you need to do in different situations with Coronavirus

Guidance for staying at home

What you need to know

•   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. (See ending isolation section below for more information)

•   if you live with others and you or one of them have symptoms of coronavirus, then all household members 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

•   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

•   for anyone 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. (See ending isolation section below for more information

•   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

•   ask your employer, friends and family to help you to get the things you need to stay at home

•   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

For more information visit: https://www.gov.uk/government/publications/covid-19-stay-at-home- guidance/stay-at-home-guidance-for-households-with-possible-coronavirus-covid-19-infection

Guidance on social distancing and for vulnerable people

Those who are at increased risk of severe illness from Covid-19 should be particularly stringent in following social distancing measures:

•   aged 70 or older (regardless of medical conditions)

•   under 70 with an underlying health condition listed below (ie anyone instructed to get a flu jab as an adult

  each year on medical grounds):

o chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary

disease (COPD), emphysema or bronchitis
o chronic heart disease, such as heart failure
o chronic kidney disease
o chronic liver disease, such as hepatitis
o chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple

sclerosis (MS), a learning disability or cerebral palsy o diabetes

o problems with your spleen – for example, sickle cell disease or if you have had your spleen removed

o a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy

o being seriously overweight (a BMI of 40 or above)  those who are pregnant

Note: there are some clinical conditions which put people at even higher risk of severe illness from COVID- 19. If you are in this category, next week the NHS in England will directly contact you with advice the more stringent measures you should take in order to keep yourself and others safe. For now, you should rigorously follow the social distancing advice in full, outlined below.

People falling into this group are those who may be at particular risk due to complex health problems such as:

•   People who have received an organ transplant and remain on ongoing immunosuppression medication

•   People with cancer who are undergoing active chemotherapy or radiotherapy

•   People with cancers of the blood or bone marrow such as leukaemia who are at any stage of treatment

•   People with severe chest conditions such as cystic fibrosis or severe asthma (requiring hospital admissions

  or courses of steroid tablets)

•   People with severe diseases of body systems, such as severe kidney disease (dialysis)

  What is 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, varying your travel times to avoid rush hour, 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 gatherings, and gatherings in smaller public spaces such as pubs, cinemas, restaurants, theatres, bars, clubs

•   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.

  For those who are over 70, have an underlying health condition or are pregnant, we strongly advise you to follow the above measures as much as you can, and to significantly limit your face-to-face interaction with friends and family if possible.

  This advice is likely to be in place for some weeks.

  Advice for informal carers:

  If you are caring for someone who is vulnerable, there are some simple steps that you can take to protect them and to reduce their risk at the current time. Ensure you follow advice on good hygiene such as:

•   Wash your hands on arrival and often, using soap and water for at least 20 seconds or use hand sanitiser.

•   Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze.

•   Put used tissues in the bin immediately and wash your hands afterwards.

•   Do not visit if you are unwell and make alternative arrangements for their care.

•   Provide information on who they should call if they feel unwell, how to use NHS111 online coronavirus service and leave the number for NHS 111 prominently displayed.

•   Find out about different sources of support that could be used and access further advice on creating a contingency plan is available from Carers UK

•   Look after your own well-being and physical health during this time. Further information on this is available here

There are general principles you can follow to help prevent the spread of respiratory viruses, including:

•   washing your hands more often - with soap and water for at least 20 seconds or use a hand sanitiser when you get home or into work, when you blow your nose, sneeze or cough, eat or handle food

•   avoid touching your eyes, nose, and mouth with unwashed hands

•   avoid close contact with people who have symptoms

•   cover your cough or sneeze with a tissue, then throw the tissue in a bin and wash your hands

•   clean and disinfect frequently touched objects and surfaces in the home

  For more information visit: https://www.gov.uk/government/publications/covid-19-guidance-on-social- distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting- older-people-and-vulnerable-adults

  Guidance for educational settings

  What you need to know:

•   staff, young people and children should stay at home if they are unwell with a new, continuous cough or a high temperature to avoid spreading infection to others. Otherwise they should attend education or work as normal

•   if staff, young people or children become unwell on site with a new, continuous cough or a high temperature they should be sent home

•   clean and disinfect regularly touched objects and surfaces more often than usual using your standard cleaning products

•   supervise young children to ensure they wash their hands for 20 seconds more often than usual with soap and water or hand sanitiser and catch coughs and sneezes in tissues

•   posters and lesson plans on general hand hygiene can be found on the eBug website

•   unless you have been directly advised to close by the local Public Health England Health Protection Team,

  we recommend all education settings remain open
  For more information visit: https://www.gov.uk/government/publications/guidance-to-educational-sett…-

  about-covid-19/guidance-to-educational-settings-about-covid-19

  Guidance for staff in the transport sector

  What you need to know:

•   if someone becomes unwell while at a transport hub or on their journey with a new, continuous cough or a high temperature, they should be sent home

•   passengers should wash their hands for 20 seconds before and after they have been on public transport and catch coughs and sneezes in tissues

•   frequently clean and disinfect objects and surfaces that are touched regularly, using your standard cleaning products

•   advise passengers they should not travel if they are feeling unwell with symptoms of coronavirus (COVID-

19) - a new, continuous cough or a high temperature. This will also help to protect others from infection

 use announcements in transport hubs to reinforce key messages, such as washing hands before and after travel, and what to do if unwell

For more information visit: https://www.gov.uk/government/publications/covid-19-guidance-for-staff-…- transport-sector/covid-19-guidance-for-staff-in-the-transport-sector

Guidance for residential care

Steps care home providers can take to maintain services:

Care home providers are advised to work with local authorities to establish plans for mutual aid, including sharing of the workforce between providers, and with local primary and community health services providers, and with deployment of volunteers where that is safe to do so.

Care home providers are invited to consider ways in which they can contribute to keeping people safe across the local area, including the following where possible:

use tools to report capacity for bed vacancies (such as the Capacity Tracker or Care Pulse) to support system resilience
use tools for the secure transfer of information, such as NHSMail, recognising that not all providers currently have access to NHSMail

increase the use of Skype and other tools for secure virtual conference calls, to ensure advice from GPs, acute care staff, and community health staff can be given

Care home providers will routinely be procuring personal protective equipment (PPE) such as gloves and aprons. In addition, there will be a free issue of PPE to support adult social care providers to support compliance with the updated advice. This will be issued from the pandemic influenza stockpile. Arrangements will be put in place for adult social care providers to access further PPE as necessary.

If a resident has symptoms of Covid-19

Care homes are not expected to have dedicated isolation facilities for people living in the home but should implement isolation precautions when someone in the home displays symptoms of COVID-19 in the same way that they would operate if an individual had influenza. If isolation is needed, a resident’s own room can be used. Ideally the room should be a single bedroom with en suite facilities.

All staff will be trained in hand hygiene. Much of the care delivered in care homes will require close personal contact. Where a resident is showing symptoms of COVID-19, steps should be taken to minimise the risk of transmission through safe working procedures. Staff should use personal protective equipment (PPE) for activities that bring them into close personal contact, such as washing and bathing, personal hygiene and contact with bodily fluids. Aprons, gloves and fluid repellent surgical masks should be used in these situations. If there is a risk of splashing, then eye protection will minimise risk.

New PPE must be used for each episode of care. It is essential that used PPE is stored securely within disposable rubbish bags. These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being disposed of as normal. Care homes have well-established processes for waste management.

Clean frequently touched surfaces. Personal waste (such as used tissues, continence pads and other items soiled with bodily fluids) and disposable cleaning cloths can be stored securely within disposable rubbish bags. These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being disposed of as normal.

Do not shake dirty laundry – this minimises the possibility of dispersing virus through the air. Wash items as appropriate in accordance with the manufacturer’s instructions. Dirty laundry that has been in contact with an ill person can be washed with other people’s items. Items heavily soiled with body fluids, such as vomit or diarrhoea, or items that cannot be washed, should be disposed of, with the owner’s consent.

Personal protective equipment

If neither the care worker nor the individual receiving care and support is symptomatic, then no personal protective equipment is required above and beyond normal good hygiene practices.

General interventions may include increased cleaning activity to reduce risk of retention of virus on hard surfaces, and keeping property properly ventilated by opening windows whenever safe and appropriate.

For more information visit: https://www.gov.uk/government/publications/covid-19-residential-care- supported-living-and-home-care-guidance/covid-19-guidance-on-residential-care-provision

Guidance for supported living provision

Steps that supported living providers can take to maintain services

To maintain service delivery, providers of supported living are advised to:

1. review their list of clients, and ensure that it is up to date, including the levels of informal support available to individuals. Providers should consider how they could share this information electronically, if they receive a legitimate request, including what the dataset might be.

2. work with local authorities to identify people who fund their own care and help them to establish the levels of informal support available. It may be helpful for providers to share the number of hours of care they provide to help with planning, but they will want to satisfy themselves that it is lawful for them to share that information.

3. map all care and support plans commissioned by the local authority, to inform planning during an outbreak.

4. work with local authorities to establish plans for mutual aid, including sharing of the workforce between supported living and home care providers, and with local primary and community health services providers; and with deployment of volunteers where that is safe to do so.

5. note the arrangements that local authorities and CCGs and NHS 111 are putting in place to refer vulnerable people self-isolating at home to volunteers who can offer practical and emotional support.

Personal protective equipment

The risk of transmission should be minimised through safe working procedures. Care workers should use personal protective equipment for activities that bring them into close personal contact, such as washing and bathing, personal hygiene and contact with bodily fluids.

Aprons, gloves and fluid repellent surgical masks should be used in these situations.
In particular cases, if there is a risk of splashing then eye protection will minimise risk.

New personal protective equipment must be used for each episode of care. It is essential that personal protective equipment is stored securely within disposable rubbish bags.

These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being put in the usual household waste bin for disposal.

If neither the individual in supported living nor care worker have symptoms of Covid-19

If neither the care worker nor the individual receiving care and support is symptomatic, then no personal protective equipment is required above and beyond normal good hygiene practices.

General interventions may include increased cleaning activity to reduce risk of retention of the virus on hard surfaces, and keeping property properly ventilated by opening windows whenever safe and appropriate.

For more information visit: https://www.gov.uk/government/publications/covid-19-residential-care- supported-living-and-home-care-guidance/covid-19-guidance-for-supported-living-provision

Guidance on home care provision

Steps for home care providers to maintain delivery of care

Home care providers are advised to:

•   review their list of clients, and ensure that it is up to date, including levels of informal support available to individuals. Providers should consider how they could benefit from sharing this information electronically with local partners, if they receive a legitimate request, including what the dataset might be

•   work with local authorities to establish plans for mutual aid, taking account of their business continuity plans, and consider arrangements to support sharing of the workforce between home care providers, and with local primary and community services providers; and with deployment of volunteers where that is safe to do so

•   note the arrangements that local authorities, CCGs, and NHS 111 are putting in place to refer vulnerable people self-isolating at home to volunteers who can offer practical and emotional support

  Home care providers will routinely be procuring personal protective equipment (PPE) such as gloves and aprons. In addition, there will be a free issue of PPE to support adult social care providers (residential care and domiciliary care) to comply with the updated advice on use of PPE to support management of symptomatic patients presenting in these settings. This will be issued from the pandemic influenza stockpile. Arrangements will be put in place for adult social care providers to access further PPE as necessary.

  Personal protective equipment

  Care workers should use personal protective equipment (PPE) for activities that bring them into close personal contact, such as washing and bathing, personal hygiene and contact with bodily fluids.

  Aprons, gloves and fluid repellent surgical masks should be used in these situations. If there is a risk of splashing, then eye protection will minimise risk.

  New personal protective equipment must be used for each episode of care. It is essential that personal protective equipment is stored securely within disposable rubbish bags.

  These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being put in the usual household waste bin.

  If neither the individual in supported living nor care worker have symptoms of Covid-19

  If neither the care worker nor the individual receiving care and support is symptomatic, then no personal protective equipment is required above and beyond normal good hygiene practices.

  General interventions may include increased cleaning activity to reduce risk of retention of the virus on hard surfaces, and keeping property properly ventilated by opening windows whenever safe and appropriate.

  For more information visit: https://www.gov.uk/government/publications/covid-19-residential-care- supported-living-and-home-care-guidance/covid-19-guidance-on-home-care-provision

Guidance for health care professionals

Advice for a wide range of health care professions can be found at:

https://www.gov.uk/government/collections/wuhan-novel-coronavirus