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Corona virus – Latest advice from Government 13 March 2020

March 13, 2020

Novel Coronavirus: Advice for the NHS in England
Issued by NHS Central Alerting System – 12 March 2020

We are now in the delay phase of our response to COVID-19. This entails significant changes to how
we identify and manage potential cases of COVID-19. Advice for NHS organisations is now as follows:
1. From today [12 March 2020] the public are being advised to stay at home (self-isolate) without any testing for COVID-19, regardless of travel history or contact with confirmed cases, if they have:
• A new continuous cough;
OR
• High temperature (of 37.8 degrees centigrade or higher).

The geographic element of the case definition has now been removed. Travel and contact history are no longer important for diagnosis, which is on the basis of symptoms alone. If people who have travelled do not have symptoms they do not need to stay at home, regardless of their travel history.

Individuals should stay at home (self-isolate) for 7 days from the onset of symptoms following the current advice. If someone has serious symptoms they cannot manage at home they should use NHS 111 online (people should only call NHS111 if they cannot get online).

After 7 days of self-isolation, people who feel better and no longer have a high temperature can return to their normal routine. If they have not had any signs of improvement after 7 days and have not already sought medical advice, they should use NHS111 online (people should only call NHS111 if they cannot get online) before they leave their home or let visitors in.

Cough may persist for several weeks in some people, despite the coronavirus infection having cleared.
A persistent cough alone does not mean someone must continue to stay at home for more than 7 days.

Testing
Testing will not be offered routinely to individuals staying at home.
Patients who require overnight admission to hospital should still be tested regardless of travel history if they present with;
• either clinical or radiological evidence of pneumonia
or
• acute respiratory distress syndrome
or
• influenza like illness (fever ≥37.8°C and at least one of the following respiratory symptoms,
which must be of acute onset: persistent cough (with or without sputum), hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing).

Clinicians should be alert to the possibility of atypical presentations in patients who are immunocompromised.

NHS 111
Up to date information can be found on http://www.nhs.uk/coronavirus. We expect the health service
to be exceptionally busy in the coming days and weeks. If people have serious symptoms that they cannot manage at home they should use NHS111 online. They should only telephone NHS111 if they
cannot go online.

Infection prevention and control measures whilst awaiting test results, including isolation and cohorting of patients,should be implemented in line with your Trust seasonal influenza operational plan.

Guidance for healthcare workers
• Healthcare workers should wear the appropriate personal protective equipment (aprons, gloves and a fluid repellent mask whilst assessing and treating patients; gowns, gloves, FFP3 masks and eye protection whilst performing aerosol generating procedures);
• Healthcare workers should follow the guidance for the general public and stay at home for 7 days if they develop any symptoms;
• Healthcare workers who come into contact with a COVID-19 patient whilst not wearing personal protective equipment (PPE) can remain at work. If they display any symptoms of lower or upper-respiratory tract infection they must immediately stay at home for the duration of the illness or 7 days, whichever is longer;
• Healthcare workers do not need to be tested for COVID-19, prior to returning to work;

PHE in collaboration with the NHS has published guidance covering the following:
• Initial assessment and investigation of cases;
• Guidance on diagnostics , which includes updated guidance for diagnostic laboratories testing for COVID-19.

Guidance for primary care
The three important principles to bear in mind in hospital settings are to:
• Identify possible cases as soon as possible;
• Isolate or cohort to prevent transmission to other patients and staff;
• Avoid direct physical contact unless wearing appropriate personal protective equipment.

Professor Stephen Powis
National Medical Director
NHS England and NHS Improvement

Professor Chris Whitty
Chief Medical Officer for England

Professor Sharon Peacock
Director – National Infection Service
Public Health England

 

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