NOT GOING OUT

A Recovery4Life Guide to Self-Isolating & Looking After Your Mental & Physical Health

Why am I being asked to stay at home?

The advice from Public Health England (PHE) for anyone in any setting is to follow these main guidelines.

  1. The most common symptoms of coronavirus (COVID-19) are recent onset of a new continuous cough and/or high temperature. If you have these symptoms, however mild, stay at home and do not leave your house for 7 days from when your symptoms started. You do not need to call NHS 111 to go into self-isolation. If your symptoms worsen during home isolation or are no better after 7 days, contact NHS 111 online. If you have no internet access, you should call NHS 111. For a medical emergency dial 999.
  2. Wash your hands more often than usual, for 20 seconds using soap and hot water, particularly after coughing, sneezing and blowing your nose, or after being in public areas where other people are doing so. Use hand sanitiser if that’s all you have access to.
  3. To reduce the spread of germs when you cough or sneeze, cover your mouth and nose with a tissue, or your sleeve (not your hands) if you don’t have a tissue, and throw the tissue in a bin immediately. Then wash your hands or use a hand sanitising gel.
  4. Clean and disinfect regularly touched objects and surfaces using your regular cleaning products to reduce the risk of passing the infection on to other people.

At the current time and based on our understanding of what is known of COVID-19 and other similar respiratory viruses, it is likely that older people and those with chronic medical conditions may be vulnerable to severe disease. As more information emerges, recommendations may change.

Background and scope of guidance

This guidance is for everyone, including children. It advises 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.We are advising those who are at increased risk of severe illness from coronavirus (COVID-19) to be particularly stringent in following social distancing measures.

This group includes those who are:

  1. aged 70 or older (regardless of medical conditions)
  2. 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):
  3. chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
  4. chronic heart disease, such as heart failure
  5. chronic kidney disease
  6. chronic liver disease, such as hepatitis
  7. chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
  8. diabetes
  9. problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
  10. a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
  11. being seriously overweight (a body mass index (BMI) of 40 or above)
  12. 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 about 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:

  1. people who have received an organ transplant and remain on ongoing immunosuppression medication
  2. people with cancer who are undergoing active chemotherapy or radiotherapy
  3. people with cancers of the blood or bone marrow such as leukaemia who are at any stage of treatment
  4. people with severe chest conditions such as cystic fibrosis or severe asthma (requiring hospital admissions or courses of steroid tablets)
  5. people with severe diseases of body systems, such as severe kidney disease (dialysis)

What is social distancing?

Social distancing measures are steps you can take to reduce social interaction between people. This will help reduce the transmission of coronavirus (COVID-19).

They are to:

  1. Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
  2. Avoid non-essential use of public transport when possible
  3. Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information
  4. 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.
  5. Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
  6. Use telephone or online services to contact your GP or other essential services

Everyone should be trying to follow these measures as much as is practicable.

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, particularly if you:

  • are over 70
  • have an underlying health condition
  • are pregnant

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

Handwashing and respiratory hygiene

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

What should you do if you develop symptoms of coronavirus (COVID-19)

The same guidance applies to the general population and those at increased risk of severe illness form coronavirus (COVID-19). If you develop symptoms of COVID-19 (high temperature and/or new and continuous cough), self-isolate at home for 7 days. You can find the full guidance at stay at home.

Getting assistance with foods and medicines if you are reducing social contacts

Ask family, friends and neighbours to support you and use online services. If this is not possible, then the public sector, business, charities, and the general public are gearing up to help those advised to stay at home. It is important to speak to others and ask them to help you to make arrangements for the delivery of food, medicines and essential services and supplies, and look after your physical and mental health and wellbeing.

If you receive support from health and social care organisations, for example, if you have care provided for you through the local authority or health care system, this will continue as normal. Your health or social care provider will be asked to take additional precautions to make sure that you are protected. The advice for formal carers is included in the Home care provision.What should you do if you have hospital and GP appointments during this period?

We advise everyone to access medical assistance remotely, wherever possible. However, if you have a scheduled hospital or other medical appointment during this period, talk to your GP or clinician to ensure you continue to receive the care you need and consider whether appointments can be postponed.

What is the advice for visitors including those who are providing care for you?

You should contact your regular social visitors such as friends and family to let them know that you are reducing social contacts and that they should not visit you during this time unless they are providing essential care for you. Essential care includes things like help with washing, dressing or preparing meals.

If you receive regular health or social care from an organisation, either through your local authority or paid for by yourself, inform your care providers that you are reducing social contacts and agree on a plan for continuing your care.

If you receive essential care from friends or family members, speak to your carers about extra precautions they can take to keep you safe. You may find this guidance on Home care provision useful.

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, or if you do not have family or friends who can help you, you can contact your local council who should be able to help you.

What is the advice if I live with a vulnerable person?

If you live in a house with a vulnerable person refer to our household guidance.

Looking after your mental wellbeing

Understandably, you may find that social distancing can be boring or frustrating. You may find your mood and feelings are affected and you may feel low, worried or have problems sleeping and you might miss being outside with other people.

At times like these, it can be easy to fall into unhealthy patterns of behaviour which in turn can make you feel worse. There are simple things you can do that may help, to stay mentally and physically active during this time such as:

  • look for ideas of exercises you can do at home on the NHS website
  • spend time doing things you enjoy – this might include reading, cooking, other indoor hobbies or listening to the radio or watching TV programmes
  • try to eat healthy, well-balanced meals, drink enough water and try to avoid smoking, alcohol and drugs
  • keep your windows open to let in fresh air, get some natural sunlight if you can, or get outside into the garden

You can also go for a walk or exercise outdoors if you stay more than 2 metres from others.

If I’m self-isolating do I have to stay inside?

The short and simple answer to this question is no, although there are a few caveats. You can leave your house whilst self-isolating in order to exercise e.g. walking or gardening.  You should, however, avoid coming into close contact with other people. You must maintain a distance of at least 2 metres from others.

How long do I have to stay at home for?

The most up to date advice from the NHS is to remain in isolation for at least 7 days. After this period, providing you don’t have a temperature, you don’t need to stay at home. If you have a persistent cough, you can still go out but only in accordance with the latest government restrictions. A cough can persist for several weeks after the virus is gone. If you live with other people who have symptoms, then you will need to maintain self-isolation for 14 days. If you live with more than one person who has symptoms, you must remain in self-isolation for 14 days after the first person began to show symptoms.

What about work?

Key workers e.g. health and social care staff, communications workers, certain types of retail workers e.g. food outlets will be allowed to go to work, as will people who are unable to work from home until the restrictions set by the government are lifted, Employers should carefully consider if their staff really need to be at work, and if they absolutely do, then they should ensure that their staff are being protected as far is possible from contracting the virus by adhering to the department of health’s guidelines.

What if my symptoms get worse?

For the vast majority of people who need to self-isolate due to Coronavirus, their symptoms will be mild to moderate. A minority of people, however, may need access to a clinical intervention to help them to recover. In the first instance call the NHS 111 service and speak to a clinically qualified advisor.  They will be able to decide what kind of further assistance you will need and inform you of how this will be delivered.

How can I take care of my mental health whilst self-isolating?

Self-isolating can be more challenging on mental health for some people than others. As a species, people have a basic need for contact. It’s important to acknowledge any negative feelings such as boredom, frustration and anxiety, however it’s equally important to tackle these feelings before they mushroom and become potentially overwhelming. Remember that self-isolation is the best way to protect yourself and others from coronavirus, and that’s why you’re doing it.

How can I maintain contact with people whilst self-isolating?

Self-isolation doesn’t necessarily mean that you have to disconnect from your family, friends and work colleagues. Maintaining healthy relationships with people is essential to maintaining your mental health. Stay in touch with people by telephone, text messaging, social media (unless this adds to your feelings of stress and anxiety) and video calls. By maintaining contact in this way, you’re not only helping your own mental wellbeing, but that of other people who probably have the same or similar concerns as you do. If you feel worried or concerned about the current situation, talk to people you trust. If you don’t feel able to talk about your feelings with people you know, there are several statutory and non-statutory services that can provide information and reassurance. This link contains a wealth of services that can provide you with further sources of support: https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/

What other things could help with my mental health?

Unsurprisingly our mental health can be adversely affected by our physical health. If self-isolating, it’s equally as important to look after our bodies as well as our minds. Try to eat regularly and healthily, drink plenty of water and exercise regularly. Remember, you can still go outside as long as you maintain a distance of 2 metres from other people.

Avoid using drugs or alcohol in order to cope with your emotions. Drinking alcohol particularly, may result in any negative or difficult feelings becoming magnified. Furthermore, drinking and using drugs often leads to disinhibition, and you may behave in a reckless or selfish manner such as not maintaining your distance from other people.

Keep up to date with events but limit your exposure to social media or other news sources if you feel that this is adding to any sense of concern or anxiety.

It is also important to get enough sleep whilst self-isolating. The benefits of getting a good night’s sleep are well documented, as are the adverse effects of not. The following link provides advice and guidance on sleep hygiene, and why this is important. https://www.nhs.uk/conditions/stress-anxiety-depression/ways-relieve-stress/

What can I do to manage difficult feelings?

This is an unprecedented time. Being concerned about what’s happening in the world is perfectly normal, but for some people, particularly if they have a history of anxiety, it may be difficult to stay on top of their feelings. If you are becoming anxious about the current situation, try to focus on the things that you can control such as how you respond to anxiety triggers, who you speak to and where you get your information from. Draw on any skills that you have used to manage difficult feelings or situations in your past. One of the most effective methods of managing anxiety is by oxygenating excitement (breathing). The following link https://www.nhs.uk/conditions/stress-anxiety-depression/ways-relieve-stress/ provides useful information on breathing to relieve stress and anxiety.

How will I be able to manage financially if I’m self-isolating?

The DWP have announced that people receiving benefits do not have to attend jobcentre appointments for at least 3 months, starting from Thursday 19 March 2020. People will continue to receive their benefits as normal, but all requirements to attend the jobcentre in person are suspended.

People can still make applications for benefits online if they are eligible.

Unfortunately, Jobcentres are now closed, but continue to support people via the internet or telephone. Queues are likely to be very large due to the anticipated volume of need at this time.  Please be patient when contacting DWP staff.

On Friday 20th March, the government announced a Job Retention Scheme, in which employers will receive up to 80% of their employee’s wages in the form of a grant and that this would be back dates to March 1st. This scheme will operate initially for 3 months; however, it will be extended if necessary.

Universal Credit and Working Tax Credits have been increased by £1,000 per annum.

If you are unable to pay your mortgage, you will be entitled to a 3-month mortgage holiday. Always advise your lender as soon as you think that you will experience difficulty in making a mortgage repayment. If you pay rent on a property, you will be eligible for local housing allowance to cover up to at least 30% of market rents.

To sum up. We are living through events, unprecedented in our lifetime. This is a temporary phenomenon, if we follow expert medical advice, if we wash our hands regularly, if we minimise our social contacts and if we help one another in any way we can, we should prevail and who knows, when this crisis has passed, the world may just be a better place for all of us.

 

 

 

 

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