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Covid-19 virus (Coronavirus)

CORONAVIRUS UPDATED 23/6/20

As the Coronavirus pandemic develops, advice from the government and NHS is changing from day to day. On this page we attempt to interpret the latest information and advice into guidance for people with AT and their families and carers.

More information can be found on our Frequently Asked Questions sheet

Telling the NHS about AT and Coronavirus

If you need to contact the NHS about a possible case of Coronavirus in someone with AT, you must tell them about AT. If you are not sure what to say, we have prepared a document to help you here.

Update on shielding advice for England, Scotland, Wales and Northern Ireland

Wherever you live in the UK, strict social distancing, including staying at least two metres apart from others, is still really important. People who are shielding should still avoid all non-essential face to face contact, including going to supermarkets or pharmacies. The support for shielded people remains in place.

The decision to go outside is yours. If you do decide to go out, the best ways to protect yourself are to:
• Keep the number of visits outside to a minimum
• Go on your own if possible, or with members of your household. If you live alone, you can spend time outdoors with one person from another household (this should ideally be the same person each time)
• Go out when there are fewer people around, such as early in the morning
• Ideally spend time in open areas
• Always keep a distance of 2 metres from people not in your household
• Do all you can to minimise contact with people not in your household
• Do not share or exchange personal belongings (such as cups) with other people
• Avoid going into enclosed spaces, as well as shops and other buildings
• Spend as long as you feel comfortable outside.

If you would prefer not to go outside, try spending time with the windows open, to let in fresh air and get some natural sunlight.

Going outside isn’t mandatory and if you don’t feel comfortable going outside, there’s no reason to do so. It might help to discuss the decision with your GP or hospital clinician.

Detailed information on the next steps for the shielding group can be found here.

Please see the latest shielding guidance for each nation below.

England

The new support bubble plan for people in England does not apply to people shielding, or those who live with them.

People who have been advised to shield can now leave their home to walk, exercise or spend some time outdoors.

The government will now regularly assess whether it is possible for the shielding guidance to be eased further in England, based on the latest scientific advice. We believe the next steps will be announced in the coming weeks and the government/NHS will write to everyone who is shielding informing them of any changes to the advice and what support will be available.

In England, people shielding are advised to continue to do so until the end of June.

For full shielding guidance for England please click here

Scotland

Shielding advice in Scotland has been extended to 31st July.

People who are shielding will continue to receive the support they have been getting, including pharmacy deliveries and free weekly food boxes.

From 19th June, people shielding in Scotland can go outside for any amount of time.
• To meet up with one other household per day outdoors, with a max of 8 people in the group
• To take part in non-contact outdoor activities, such as golf, hiking and fishing.

For full shielding guidance for Scotland please click here

Wales

Shielding advice in Wales is in now place until at least 16th August 2020

People who are shielding in Wales can take unlimited exercise and meet people from another household if they want to.  However the advice to strictly follow physical distancing remains the same (2 metres away from anyone not in their household), as does practicing good hand hygiene and avoiding touching things touched by others

Letters are being sent to everyone in Wales who is shielding to explain the next steps. The Chief Medical Officer will then send another letter advising what to do after 16th August 2020.

For full shielding guidance for Wales please click here

Northern Ireland

The new support bubble plan for people in Northern Ireland does not apply to people shielding, or those who live with them.

People who have been shielding are now able to spend time outside with people from their own household or a person from another household if they want to. Social distancing is still very important, along with the other tips at the top of this page on how to protect yourself if you decide to go out.

People shielding in Northern Ireland still need to do so until the end of June. This timing is under review, as well as any extra measures advised for people in this group.  The NI Health Minister announced on the 18th June 2020 that shielding restrictions could be lifted  at the end of July if the ‘r’ rate continues to fall and remain low.

For full shielding guidance for Northern Ireland please click here and here

Children returning to school

In some areas, children are starting to be invited to attend schools again, particularly in years 1 and 6. However this is not the same across the country, and as far as we are aware, it is not a legal requirement that children do go.

A number of families have contacted us to ask about this.

For the moment, we would strongly advise families with a child with AT that, unless there are very particular circumstances, neither the child with AT nor their siblings should return to school.

Once again, we will be discussing the issue with the Nottingham team later this week and will update our guidance after this has happened.

Face masks

We have been asked whether when people do go out, it is advisable to wear face masks.

While there is evidence that face masks help prevent people carrying the virus from spreading it, wearing a mask will not necessarily protect you from catching it from other people.

For families that have been shielding, there is little risk of their passing on the virus. Wearing a mask when you go out may reduce the risk a little of catching it, but as it certainly does not eliminate it. This really makes it an issue for individuals to decide for themselves, The important thing therefore is that if you do wear a mask, you take all the same steps you would have in any case to avoid the possibility of infection and don’t let the mask lull you into a false sense of security.

Supporting your children’s education during coronavirus (COVID-19):

Information, guidance and support for parents and carers of children who are learning at home.

Due to the coronavirus (COVID-19) outbreak, schools, colleges and childcare providers will remain closed until further notice (except for children of critical workers and vulnerable young people). The UK government has stated that schools will only reopen when scientific advice indicates it is safe to do so. The approach to reopen schools will be decided jointly with the relevant education/care sector organisations.

We recognise the challenges these closures bring to both parents and teachers and the concerns it raises about the potential impact this will have on young people’s development and overall wellbeing. For this reason, the government and the BBC have produced a library of resources to cover a variety of subjects for all key stages, including tips on how to provide structure to a young person’s day and suggestions for fun activities. This also includes SEN resources.

Parents are not expected to act as teachers, or to provide the activities and feedback that a school or nursery would. There are so many practical and emotional difficulties to navigate in these demanding times. Just do your best to help support your children’s learning and focus on taking care of yours and your families wellbeing.

Links:

SEND guidance during Covid-19 school closure

Mainstream/siblings guidance during Covid-19 school closure

BBC bitesize daily links

‘Extremely Vulnerable’ NHS letter

By now, everyone with an A-T diagnosis in the UK should have received information from the NHS regarding being included in the ‘extremely vulnerable’ group.

The NHS information will be sent either by text, email or letter and contain details about the importance of undertaking ‘shielding’ strategies for 12 weeks. It will also include information on how to access support to get food and medicines etc. if you don’t have family or friends nearby to help you. You can register for additional support by visiting www.gov.uk/coronavirus-extremely-vulnerable.

If you are living alone or without local support, we strongly urge you to reach out to neighbours, local community groups/organisations (including religious groups) and ask for help. There are many, many people in every community who want to help. So please ask and allow them to give you the support you need.

People with conditions closely related to AT

We now have some good news for children and adults in the UK with a diagnosis of AT, AT like disorder, AOA1 or AOA2. As previously reported, we raised the issue with both clinics and NHS commissioners that many people were not being contacted by the NHS coronavirus service to advise about shielding measures, or the extremely vulnerable person central register. We asked that families let us know if they had not been contacted by the NHS. We then passed this information onto the AT clinical leads.

We are now delighted to announce that those children with any of the above conditions have been added to the central register. Letters of confirmation will be sent out from Nottingham on Friday 3rd April (to those who have not yet received info from the NHS ). Our warmest thanks to Dr Suri for his energy in resolving this issue.

The same process is being undertaken for adults by the Papworth team, but registration will take a couple more days. Please watch this space for further updates.

If you haven’t received communication from the NHS that you or your child is in the extremely vulnerable group, AND you haven’t let us know, please do so as soon as possible. You can ring us on 01582 760733, or email support@atsociety.org.uk.

Financial help and advice

Martin Lewis, Money Saving Expert, has been updating their website to answer questions that you may have around your financial situation and the rights you have. For more information visit  www.moneysavingexpert.com/news/2020/03/uk-coronavirus-help-and-your-rights/

Staying safe

People with AT

People with AT are included within the 1.5 million people considered by the NHS to be who are at very high risk of severe illness from coronavirus (COVID-19) because of an underlying health condition. The advice for this group, and thus for everyone with AT, is that you undertake the rigorous protection regime known as “shielding”. You can find out about this here

We urge people living with AT to follow the shielding guidance as seriously and closely as you possibly can.

Kay Atkins, the Society’s Family Support Manager, recorded a message to explain the importance of shielding and staying at home.

We do not know how much more vulnerable to the virus people with A-T may be, and it would be great if we never had to find out. If shielding causes you particular difficulties, please do contact us to see what we can do to help.

Most of the advice for people living with AT on shielding that we have published to date has been produced by the NHS in England. While the approach is pretty standard across the whole of the United Kingdom, Scotland and Wales have produced their own specific guidance and there is also advice from the Irish Government. These can be found via the following links.

Scotland bit.ly/shieldingscotland

Wales bit.ly/covid19wales

Irish Republic bit.ly/Covid19Ireland

What steps should we take to protect someone with AT?

The email received by a parent of a child who has A-T says:

Remain at home for a minimum of 12 weeks. Home is the safest place for you. Staying in helps you stay well and that will help the NHS too. You can open a window but do not leave your home, and stay 3 steps away from others indoors. Wash your hands more often, for at least 20 seconds.

It also refers for advice to the wepage: www.gov.uk/coronavirus-extremely-vulnerable-guidance.

The advice is for a form of protection that they are calling ‘Shielding’. This is in their words a “practice used to protect extremely vulnerable people from coming into contact with coronavirus.”

You are strongly advised to stay at home at all times and avoid any face-to-face contact for a period of at least 12 weeks from the day you receive your letter. Please note that this period of time could change.

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).

There is more detailed guidance on the link above, which we won’t repeat here. If you have any difficulty accessing the guidance, please contact us urgently.

What does this mean for parents and other family members?

The guidance includes measures regarding other family members such as that people shielding should:

  • Minimise as much as possible the time they spend in shared spaces such as kitchens, bathrooms and sitting areas
  • Aim to keep 2 metres (3 steps) away from people they live with and where possible use a separate bathroom from the rest of the household. If they do share a toilet and bathroom, it is important that they are cleaned after use every time.
  • If you can, you should take your meals back to your room to eat.

However, in the case of children or people who require help with moving, feeding or personal care this is clearly impractical. If all family members are able to remain within the home, this is maybe not such an issue, but if any continue to have to leave the house, for work or other reasons, we would recommend where possible that a principal carer undertake the shielding along with the person with AT and that other family members, who do go out, keep their distance as above.

Obviously, these rules are not written in stone and will have to be adapted to the circumstances of individual families, using common sense. However the AT Society strongly advises adhering to the principle:

People with AT and their families should undertake the most rigorous regime of shielding from the Coronavirus that they possibly can.

If a person with AT or one of the family develops symptoms of the virus

If someone with AT (or a close family member) shows any symptoms of the virus, contact 111 as soon as possible. Explain that the person has AT and what that means (refer them to our website).

We also strongly advise that you let us know via support@atsociety.org.uk or by phoning 01582 760733 so that we can make sure you have the relevant information and support. If you have contact details for the Nottingham and Papworth clinics you can contact them directly.

If you have concerns about your child’s health

We have received a message from the British Association of Childhood Disability, forwarded to us by the team at Nottingham. It says that many paediatricians are concerned that children are presenting late to paediatric emergency departments due to worries about exposure to Covid-19 or not wanting to be a drain on NHS resources. There is a risk that delays may be dangerous for the child and also increase the demand for critical care.

They have asked us to underline that paediatric emergency departments are safe and functioning well. If parents have serious concerns about their child’s health they should contact their GP and not be afraid to use the paediatric emergency department when it is required.

It is particularly important where children have long term or recurrent respiratory problems and difficulties with chest clearance to make sure you know who to call in the event of a deterioration when admission to hospital might be advisable. If you have any concerns about this, please do contact us on 01582 760733.

Clinical trials and studies

Organisers of the clinical trials and studies currently taking place will be in contact directly with participants. However, it is our understanding that while the CATNAP 2 study has been put on hold for now, the ATTeST (EryDex) and Intrabio trials are for now going ahead.

The ATteSt trial has been designated ‘essential’ as the active treatment may, we hope, prove life-saving/extending, and there is no realistic alternative at present. Some UK participant families have decided to omit some transfusions for now so their child can stay at home, reducing the risk of catching coronavirus. They are being supported in this and kept in the trial, with recorded protocol deviations, as suggested by the UK regulator the MHRA. Other parents, after discussing the risks, are continuing for now. Measures are being taken to reduce their risks as far as possible, and some procedures may be adapted to minimise staff, as available staff numbers reduce. Again, protocol deviations for covid-19 will not be classed as major breeches by the MHRA.

And finally…

This page provides the latest information and advice that we have. However, we cannot cover every aspect of the condition and as we have said there is a lot that is not yet known.

So our last piece of advice is to read what you can and then use your common sense. The AT Society will be here right through the emergency to talk to, to give information and guidance and, where we can, practical support. If you do have further questions or want to talk anything though, please contact us.