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L'înformâtion et les sèrvices publyis pouor I'Île dé Jèrri

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Shielding the severely vulnerable and vulnerable from coronavirus

Severely vulnerable people

If you have an underlying health condition listed below, you are at very high risk of severe illness as a result of coronavirus (COVID-19) and more likely to need hospital treatment if you're infected.

If you have been identified as severely vulnerable, you should have received a letter from your doctor. If you have a condition that you think will make you vulnerable but have not yet heard from your doctor, call them for further advice and clarification. You should isolate at home for 12 weeks from the date your vulnerability is confirmed by your doctor, or until the Government of Jersey advise you otherwise.

COVID-19 FAQs for patients on the Primary Care Body website

People considered to be 'severely vulnerable' are those with health conditions that put them at the highest risk of severe illness from COVID-19.

Conditions that mean people are severely vulnerable are:

  • solid organ transplant recipients
  • people with cancer who are undergoing active chemotherapy or radical    radiotherapy for lung cancer
  • people with cancers of the blood or bone marrow such as leukaemia, lymphoma   or myeloma who are at any stage of treatment
  • people having immunotherapy or other continuing antibody treatments for cancer
  • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
  • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD
  • people with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection
  • women who are pregnant with significant heart disease, congenital or acquired

Contact Macmillan Jersey’s on +44 (0) 1534 498188 for emotional and practical support over the phone if you are affected by cancer in Jersey.

Recommendations for severely vulnerable people

To make sure you're protected and shielded from infection, recommended guidelines are set out below to minimise all non-essential contact. You will need to consider how best to apply this advice in your personal situation:

  • you're strongly advised to stay at home at all times and avoid any face-to-face contact with others
  • within your home, you are safest from COVID-19 if you minimise contact with other members of your household
  • strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and / or new and continuous cough
  • do not attend any gatherings. This includes gatherings of friends and families in private spaces for example family homes, weddings and religious services.
  • do not go out for shopping, work, leisure or travel
  • when arranging food or medication deliveries, these should be left at the door to minimise contact
  • people in home isolation should keep in touch using remote technology such as phone, internet, and social media

Vulnerable people

For people of older ages, and for people with certain medical conditions, there are additional risks if you become infected with COVID-19. Medical conditions that can increase a person’s vulnerability include: 

  • less severe respiratory conditions 
  • chronic heart disease, such as heart failure  
  • chronic kidney disease, such as kidney failure
  • chronic liver disease, such as hepatitis
  • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, stroke, multiple sclerosis (MS), a learning disability or cerebral palsy
  • diabetes type 1 or type 2 requiring insulin or oral hypoglycaemic drugs or diet-controlled
  • problems with your spleen, for example, sickle cell disease or if you have had your spleen removed 
  • seriously overweight (a body mass index (BMI) of 40 or above)
  • currently pregnant

The way people are affected by the virus varies largely across different individuals. In terms of age, the impact will likely be most linked to level of frailty, strength of immunity and the presence of underlying conditions and ill-health, rather than a person’s exact age as a number alone. Individuals should see the risk as higher the older they are, but also be aware that this can vary from person to person. For this reason we are no longer using any particular age as threshold in highlighting vulnerability to COVID-19. 

Recommendations for vulnerable people

People in the vulnerable category are advised to follow the Safe Exit Framework, but to be especially careful to do so owing the higher risk for them should they develop COVID-19.

Pregnancy and heart disease

Women who are pregnant with significant heart disease, congenital or acquired are classified as extremely vulnerable and should follow the advice for isolation for the extremely vulnerable.

You'll receive a letter or be contacted by your doctor to explain the situation. If you think you fall into this category of extremely vulnerable people and have not received a letter or been contacted by your doctor you should discuss your concerns with your GP or hospital clinician.

All pregnant women are classified as vulnerable and should now follow the advice for physical distancing for vulnerable groups.

During this time, it is crucial that all pregnant ladies (including the extremely vulnerable group) continue to receive their antenatal care. Pregnant women should contact their midwife at the Bridge +44 (0) 1534 449139 or the Antenatal Clinic +44 (0) 1534 442495 in the hospital to establish how best to receive this care.

Breastfeeding advice for those with confirmed infection from COVID 19 or with symptoms

There is a wealth of evidence that breastfeeding reduces the risk of babies developing infectious diseases. There are numerous constituents in human milk that boost the immune system of the baby and helps to destroy harmful infection causing organisms. Considering the protection that human milk and breastfeeding offers the baby against viruses, if it is possible then the mother should continue to breast feed the baby. 

Breastfeeding can be continued even if the mother is infected or has symptoms and should be done while undertaking the following precautions: 

  • washing your hands before touching the baby, breast pump or bottles
  • avoiding coughing or sneezing on the baby while feeding at the breast
  • consider wearing a mask while breastfeeding, if available
  • cleaning any breast pump as recommended by the manufacturer after each use
  • considering asking someone who is well to feed your expressed breastmilk to the baby
  • if you are feeding with formula or expressed milk, sterilise the equipment carefully before each use. You should not share bottles or a breast pump with someone else
Guidance on pregnancy and breastfeeding

Essential workers – some ‘essential workers’ may be exempt from this guidance

Essential workers who are over 65 are exempt from this guidance if they do not have a medical conditions which makes them vulnerable, or extremely vulnerable to severe COVID-19 illness.

Essential workers who have a medical condition which makes them vulnerable to severe illness from COVID-19, can continue to work only if they have been told they are able to do so by their doctor.

Essential workers who have a condition that makes them extremely vulnerable to severe illness from COVID-19 must adhere to this guidance and must not work unless they are able to do so from home.

Description of workers considered essential employees

About 'shielding'

Taking the steps above is known as ‘shielding’ as it will give you added protection from being infected with COVID-19. Shielding is for your personal protection. It is your choice to decide whether to follow the measures we advise. Individuals who have been given a prognosis of less than 6 months to live, and some others in special circumstances, could decide not to undertake shielding. This will be a deeply personal decision. We advise calling your doctor or specialist to discuss this.

We know that keeping to this advice will be difficult. You should try to identify ways of staying in touch with others and participating in your normal activities remotely from your home. However, you must not participate in alternative activities if they involve any contact with other people.

We understand this is an anxious time and people considered extremely vulnerable will have questions and concerns. Plans are in place to make sure you can rely on a wide range of help and support, for example to arrange food and medicine to be delivered to your home.

General guidance on home visits for staff that deliver care to people in their own homes

This advice is complementary to any existing professional / departmental / organisational guidance on prevention and protection against COVID-19.

This advice is to help inform staff within Government of Jersey and registered providers who support and deliver care to people in their own homes. 

Guidance for health care professionals

Frequently asked questions

Can I still have visits from people who provide essential support to me like health care workers ?

Visits from people who provide essential support to you such as healthcare, personal support with your daily needs or social care should continue, but carers and care workers must stay away if they have any of the symptoms of Coronavirus (COVID-19). All people coming to your home should wash their hands with soap and water for at least 20 seconds on arrival to your house and often while they are there. They should also try to observe physical distancing guidelines where ever practical.

You should have an alternative list of people who can help you with your care if your main carer becomes unwell.

If you think you have developed symptoms of COVID-19 such as a new, continuous cough and/or fever, seek clinical advice using the coronavirus helpline +44 (0)1534 445566. 

What should you do if you have someone else living with you?

If you have someone else living with you, they are not required to adopt these protective shielding measures for themselves. They should do what they can to support you in shielding and they should stringently follow guidance on physical distancing, reducing their contact outside the home.

If you live with others it is crucial to take the following steps:

  1. minimise as much as possible the time other household members spend in shared spaces such as kitchens, bathrooms and sitting areas, and keep shared spaces well ventilated
  2. aim to keep 2 metres (3 steps) away from people you live with and encourage them to sleep in a different bed where possible. If you can, you should use a separate bathroom from the rest of the household. Make sure you use separate towels from the other people in your house, both for drying themselves after bathing or showering and for hand-hygiene purposes
  3. if you do share a toilet and bathroom with others, it is important that they are cleaned after use every time (for example, wiping surfaces you have come into contact with). Another tip is to consider drawing up a rota for bathing, with you using the facilities first
  4. if you share a kitchen with others, avoid using it while they are present. If you can, you should take your meals back to your room to eat. If you have one, use a dishwasher to clean and dry the family’s used crockery and cutlery. If this is not possible, wash them using your usual washing up liquid and warm water and dry them thoroughly. If you are using your own utensils, remember to use a separate tea towel for drying these.
We understand that it will be difficult for some people to separate themselves from others at home. You should do your very best to follow this guidance and everyone in your household should regularly wash their hands, avoid touching their face, and clean frequently touched surfaces.

Everyone in your household should stringently follow advice on physical distancing and minimise the risk of spreading the virus within the home by following the advice above.
Handwashing and respiratory hygiene

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

If you develop symptoms of COVID-19 (a new and continuous cough and/or high temperature above 37.8°C) seek clinical advice using the coronavirus helpline on +44 (0) 1534 445566. Other symptoms could include fatigue, headache, muscle aches, gastrointestinal symptoms. Other symptoms could include fatigue, headache, muscle aches, gastrointestinal symptoms, blocked-nose, sore throat or loss of sense of taste or smell.

In an emergency, call 999 if you are seriously ill. Do not visit your doctor, pharmacy, or a hospital.

To help the health service provide you with the best care if you need to go 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 and so on)
  • an advanced care plan, if you have one

What is the advice for parents and schools with extremely vulnerable children?

The advice also applies to extremely vulnerable children .

How can you receive support with food and medicines delivery to your home if you are extremely vulnerable and following this guidance?

If you need help receiving essential supplies to your home, such as food or medicine, please contact the corona virus helpline on +44 (0) 1534 445566 or call your Parish Hall and ask about Connect Me. 

Connect Me is a Government initiative with Parishes and other voluntary agencies and the business sector to compile a list of information to address needs that you might have. These services are provided by businesses, who you can access and pay directly for their services.

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

In accordance with the Stay at Home measure and for your safety, you should not have any visitors to your home unless they are providing essential care for you (essential care includes things like help with washing, dressing or eating).

If you receive regular health or social care from an organisation, inform your care providers that you are shielding and agree 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. Speak to your carers about backup plans for your care in case your main carer is unwell and needs to self-isolate.

I am an informal carer  for someone who is extremely vulnerable, what advice should I follow?

If you are caring for someone who is extremely vulnerable to severe illness from COVID-19, 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
  • only care that is essential should be provided
  • 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 or provide care if you are unwell and make alternative arrangements for their care
  • provide information to the person you are caring for on who they should call if they feel unwell

What should you do if you have hospital or doctor 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 doctor or specialist to ensure you continue to receive the care you need and determine which of these appointments are absolutely essential.

It is possible that the hospital may need to cancel or postpone some clinics and appointments. You should contact the hospital or clinic to confirm appointments.

What steps can you take to stay connected with family and friends during this time?

Draw on support you might have through your friends, family and other networks during this time. Try to stay in touch with those around you over the phone, by post or online. Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing and you may find it helpful to talk to them about how you are feeling if you want to.

Remember, it is okay to share your concerns with others you trust and in doing so you may end up providing support to them, too.

How do you look after your mental wellbeing?

Isolating yourself from others, reducing exercise and physical activity, and changes in routine around support with daily living, ongoing care arrangements, and support with medication can all contribute to increasing stress. Many people including those without existing mental health needs may feel anxious about this. If you are receiving services for your mental health, or have a learning disability or autism and are worried about the impact of isolation, please contact your key worker or care coordinator to review your care plan. If you have additional needs please contact your key worker or care coordinator to develop a safety or crisis plan.

Understandably, you may find that isolation, or shielding, 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:

  • look for ideas of exercises you can do at home
  • spend time doing things you enjoy – this might include reading, cooking, listening to radio programmes or music, watching TV, engaging in on-line classes, on-line choirs, or on-line social groups
  • try to eat healthy, well-balanced meals, drink enough water, exercise regularly, and try to avoid smoking, alcohol and drugs
  • try spending time with the windows open to let in the fresh air, arranging space to sit and see a nice view (if possible) and get some natural sunlight, or get out into any private space, keeping at least 2 metres away from your neighbours and household members if you are sitting on your doorstep.

Constantly watching the news can make you feel more worried. If you think it is affecting you, try to limit the time you spend watching, reading, or listening to media coverage of the COVID-19 outbreak. It may help to only check the news at set times or limit this to a couple of times a day.

Try to focus on the things you can control, such as your behaviour, who you speak to and who you get information from. Every Mind Matters is an online resource which provides simple tips and advice to start taking better care of your mental health.

If you are struggling with your mental health, you can call The Listening Lounge, which offers a free confidential service for resident adults aged 18 or over who want early support for mild to moderate mental health conditions. You can call the Listening Lounge on +44 (0) 1534 866793 from 10am to 10pm daily.

You can also contact MIND Jersey on 0800 7359404, who are running a free hotline from 8am to 6pm every day, to support people through these difficult times.

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