Copy of letter sent out to NHS GPs re Shielding (03/04/20)

[Pipp]

Sorry Pipp, I didn't mean that as a criticism of you personally at all. For "go out as you did before"read "go out as one did before". I meant it as a general caveat. Today I have found this Lancet article on line, published yesterday. I find it quite frightening.
https://www.thelancet.com/journals/...ampaign=tlcoronavirus20&utm_content=130807822"that even a combination of moderate interventions—such as school closures, shielding of older people, and self-isolation of symptomatic individuals—would be unlikely to prevent an epidemic that would far exceed available intensive care unit capacity in the UK. Intermittent periods of more intensive lockdown-type measures are predicted to be effective for preventing the health-care system from being overwhelmed"

Thanks @Tannith . I wasn’t taking it personally, and understand anyone being anxious. It must be a dreadful choice for you to feel you have to remain indoors. I do find trying to read too many research papers would only add to my anxiety. The scientists are still learning about this new virus, and so any conclusions they reach can only be based on current, limited knowledge. As I doubt there will be a vaccine or treatment any time soon, the choice to remain indoors for as long as that takes seemed to me to be no choice at all. I am fortunate in that I actually enjoy the companionship of my significant other who, although has no underlying health conditions, has decided to protect me by being as isolated as I have been this last few months. Apart from him taking a single, lonely exercise session once a day. We are still not going to shops, or anywhere else where we would mixwith other people. We are not seeing anyone in our garden, either, and that means we cannot see our beloved grown up offspring. That is hard. Yet the small freedom of being able to walk outside for an hour or so each day has already given back some strength, physically and emotionally to carry on. Not being able to exercise and have a change of scenery was, to me, sapping my will to live. I could sense I was going to wither away, unseen in my home. That can’t be ok.
I do hope you can find some peace of mind, and be content in your choice, rather than fearing the unknown.

 

[Tannith]

Wondering is anyone has seen this? Interesting in perhaps moving away from the one size fits all approach. Fully appreciate that there are many on this forum at higher risk so its not in anyway to come across as insensitive. Just shows varying degrees of risk in line with the recent NHS studies. It's about risk assessment and potential return to work but would ultimately apply to decisions around shielding too?

Fully appreciate risk will never be zero and doesn't guarantee outcome but it helps shape out everyday decisions I guess

https://alama.org.uk/covid-19-medical-risk-assessment/

Excellent article A reference in the topics list at the bottom to respiratory illness and the degree of their severity in relation to covid risk was: https://alama.org.uk/covid-19-medical-risk-assessment/respiratory-conditions-and-covid-19/
I recognise the wording as exactly what my GP was reading from when she put me on the shielded list for my copd. She was checking whether the "severity" of mine was high enough to cause me to be included according to the Govt advice for GPs.
Possibly if you look in the same list at the bottom of the article for your own condition, you will see what degree of severity merits inclusion on the list. At the bottom of Jamie's article that is.

 

[JRT]

Thank you for above link to risk assessment,most useful.

 

[Pipp]

I have been out for a walk every day now since Monday, as that is what Boris told us was allowed.
However, I have had no communication from NHS or GP in a follow up letter, and not received a text message, either. So, just wondering if anyone else that had previously had the letters and texts has had any further communications since Boris told us we were now able to go out if we had been shielding?

 

[Mr_Pot]

New I have been out for a walk every day now since Monday, as that is what Boris told us was allowed.

It has always been allowed, just not advised. Do you suddenly feel safer than you were before?

 

[Bluetit1802]

I have been out for a walk every day now since Monday, as that is what Boris told us was allowed.
However, I have had no communication from NHS or GP in a follow up letter, and not received a text message, either. So, just wondering if anyone else that had previously had the letters and texts has had any further communications since Boris told us we were now able to go out if we had been shielding?

I can't think it would be necessary to have such letters or texts. Boris has spoken. It was all over the media. I imagine everyone knows they can now go out with certain conditions attached.

One thing I saw when out the other day in the sunshine were two severely disabled young men in wheelchairs with 3 carers. It was obvious from their faces how much they were enjoying the experience as it was most likely their first day out for months.

 

[Mr_Pot]

Boris has spoken

Why don't I find that reassuring?

 

[Pipp]

It has always been allowed, just not advised. Do you suddenly feel safer than you were before?

My point exactly...
Full context of my previous post is that I was given instructions in two letters and several texts to stay at home. Same as the instructions in the broadcast messages. Though there have been no follow up messages in letters or messages. So, according to Boris, it is now safe for me to go out. According to the NHS letters, and text messages, I am advised to stay home until at least 30th June. I place trust neither, and make my own decision. As for suddenly feeling safer than before, I am quite ambivalent about it.

Also, I still am wondering anyone else has had a letter or text confirming what Boris said about those shielding could now go out?

 

[DCUKMod]

My point exactly...
Full context of my previous post is that I was given instructions in two letters and several texts to stay at home. Same as the instructions in the broadcast messages. Though there have been no follow up messages in letters or messages. So, according to Boris, it is now safe for me to go out. According to the NHS letters, and text messages, I am advised to stay home until at least 30th June. I place trust neither, and make my own decision. As for suddenly feeling safer than before, I am quite ambivalent about it.

Also, I still am wondering anyone else has had a letter or text confirming what Boris said about those shielding could now go out?

Pipp - Not sure if you have seen this, but it's the official line:

https://www.gov.uk/government/publi...ng-extremely-vulnerable-persons-from-covid-19

 

[ringi]

It has always been allowed, just not advised. Do you suddenly feel safer than you were before?

The last set of ramdom tests of the population showed about 1 in 1000 infection rate, and some of these people will be self ioslating, hence the risk of a ramdom person you walk past being infected is under 1 in 1000.

 

[JohnEGreen]

Troubling is the fact that the R number is now above one in the Northwest and the South West of England so do those statistics hold true homogeneously across the country.

 

[Pipp]

Pipp - Not sure if you have seen this, but it's the official line:

https://www.gov.uk/government/publi...ng-extremely-vulnerable-persons-from-covid-19

Yes, thanks.I do follow the government publications.

My concern is more that those who have previously had letters and text messages may be expecting that to continue. Perhaps their specific information / advice ought to come from the same source?. I have had online conversations with people told to shield through the letters and texts, who are confused about the updated advice.
Some thought that Boris had advised they could start to meet up to 5 other people in open space. Some are waiting until they get another personalised letter or texts.

Even people who have not been in shielding category are confused. Some don’t know that there are subsets: ‘Clinically vulnerable’ who generally have been advised to just follow same social distancing rules as majority of population, and ‘Clinically extremely vulnerable’ , who were originally advised by letter to avoid all face to face contact with others, use separate bathroom (where possible) to others in household, prepare food separately, and basically isolate as much as possible from others in the household.
Some folks I know have been in touch to see if I would now like to meet them for a socially distanced walk with two or three others, following the announcement by Boris that we extremely clinically vulnerable could now go out, not realising that he meant only with members of own household, or if living alone, could meet with one other person.
It really is no wonder some folks are terrified, and others appear blasé about it all.

 

[UK T1]

My letter only arrived this week but told me to shield for 12 weeks from date of receiving the letter. It also says to check latest updates on the gov website, in a way which to me says I won't be getting updates by post/text from them, but I can understand others expecting updates especially if they don't use the Internet (thinking about some members of my family for example).

As said, it has always been advice, and I do find it amusing how many I've heard treating it like a prison sentence rather than advice (especially given how much other advice the general public ignore, eg advised alcohol limits for example ). Personally it changes nothing, and I won't be going against medical advice just because Johnson has said so. I understand why people would be confused as I did find it unclear, but then I have found most of the press briefings unclear and often contradictory.

I would say it depends on your personal situation and location. For example, the southwest has had comparatively few cases so far, but they're now seeing a rise since lockdown measures have eased. Do what you think keeps you safe and happy according to your personal circumstances is what I'd say. I don't know if they will consider localised lockdown or go by national stats.

 

[Pipp]

Thank you, @UK T1 .
It appears letters have not been giving the same info / advice.

I do agree that we each have to do what we think is best for our own personal circumstances. I also think that recent events and statements from the Government televised briefings, have suggested personal circumstances mean people can use common sense too. I think it is sad that some folks have been scared to submission by the letters, and also sad that some people have been inconsiderate of the needs of everyone to keep some sense of perspective, and to keep their social contacts to a minimum.

 

[Daphne917]

Troubling is the fact that the R number is now above one in the Northwest and the South West of England so do those statistics hold true homogeneously across the country.

I’m wondering if the South West figures, which still has the lowest number of cases, has been affected by the people flocking to the beaches and the Covid outbreak at Weston Hospital.

 

[UK T1]

I’m wondering if the South West figures, which still has the lowest number of cases, has been affected by the people flocking to the beaches and the Covid outbreak at Weston Hospital.

I have no doubt it has been influenced by hot sunny bank holiday and half term and people feeling able to drive longer distances. Many reports of complacency and no social distancing in seaside resorts and national parks for example, and while we shouldn't be going to holiday or second homes it isn't being discouraged as strongly as before so this will all play a part I'm sure.

Edited to add: we were always told there is roughly a two week lag behind transmission and confirming cases, so the current rise directly coincides with the bank holiday and half term sun.

 

[Tannith]

When I used to do risk assessments for work we had to consider a) the level of risk (which as you rightly point out in this case is now down to 1/1000 instead of 1/400, as it was back in April). And b) the gravity of the risk, which in my case is probable death given my age and co morbidities. We are also always uncertain of the risk at any given time in any area as the figures are always behind the reality. And we have to trust Boris not to be playing down the risk because he wants to get everyone back to work. Even if you don't die of covid have you seen the films of the poor emaciated people recovering from it who can still barely walk without a frame after weeks? Many of them have had strokes etc as well. Not a prospect I find enticing. And Pipp - I only ever had the one letter. No text messages ever, - presumably because I don't use my mobile phone or give out its number other than to family. Mr Pott I quite agree, we were only ever advised to stay indoors, it was never a requirement. Personally I did not stay indoors because of anything the Government said, I just chose to. I have found the weekly government food boxes being on the supermarket priority list as a result of my shielding letter, most helpful, as the only member of my family who drives has no car, so click and collect was not possible.I don't know how I could have managed without. But it was my own choice to shield, and I shall continue to do so until I decide it is safe to stop, regardless of anything Boris says.

The last set of ramdom tests of the population showed about 1 in 1000 infection rate, and some of these people will be self ioslating, hence the risk of a ramdom person you walk past being infected is under 1 in 1000.

 

[Pipp]

Thank you @Tannith. The fact you have only had one letter, and have been receiving help in the form of food boxes, and priority orders for supermarket deliveries suggests to me that there are inconsistencies in how those deemed to be ‘clinically extremely vulnerable’ are being supported. This is something that I am curious about, and appreciate the information.
My own situation is that I have had two letters, the first one telling me to register for government support only if I had nobody to help and support me. So I didn’t register. The second letter, and several text messages urged me to register, regardless of whether I needed support or not, so I registered. That made no difference when I tried to place orders with supermarkets. I just have to join the Rest of the customers without the priority access to try to get a delivery slot. No food boxes either. Not complaining, as we have sourced local independent suppliers. Just interested in how the ‘clinically extremely vulnerable’ people are being supported and kept informed.

stay well and safe, Tannith. I do understand how and why you feel so anxious. I am certainly limiting my time outside, and no contact with anyone but the bloke I live with.

 

[Tannith]

It has always been allowed, just not advised. Do you suddenly feel safer than you were before?

"After 10 weeks, shielders in England and Wales have been told they can leave their homes, providing they maintain social distancing while out.

... The UK government initially said on 31 May that it was because “covid-19 disease levels are substantially lower now than when shielding was first introduced”.

But that was wrong. While infections are falling, the UK is still seeing about 1500 new confirmed cases a day, compared with about 1000 a day in March, when the first letters were sent to shielders. The total number of new cases a day is likely to have been higher in both March and May, as not everyone gets tested."

Read more: https://www.newscientist.com/articl...rs-in-the-uk-to-go-outside-now/#ixzz6Otn6lA9b

 

[DCUKMod]

"After 10 weeks, shielders in England and Wales have been told they can leave their homes, providing they maintain social distancing while out.

... The UK government initially said on 31 May that it was because “covid-19 disease levels are substantially lower now than when shielding was first introduced”.

But that was wrong. While infections are falling, the UK is still seeing about 1500 new confirmed cases a day, compared with about 1000 a day in March, when the first letters were sent to shielders. The total number of new cases a day is likely to have been higher in both March and May, as not everyone gets tested."

Read more: https://www.newscientist.com/articl...rs-in-the-uk-to-go-outside-now/#ixzz6Otn6lA9b

Tannith - I have no interest in trying to persuade you to do something you have no wish to, but whilst I am fortunate enough not to be, or have been in the sheilding group, I have still had a very healthy interest in what is going around us all, but with a keen eye on my local area.

As well as other publications, the BBC publishes both the national numbers, but also allows you to search your postcode for the current COVID updates.

I live in Leicester shire, and this is what I see for there;

Yesterday here had been 1,340 cases, so 4 new cases today.

That information comforts me somewhat in that the newly diagnosed case numbers are reducing day on day, by-and-large.

Tannith, I do hope your wait for some comfort is not too long, but unfortunately I doubt it will be a while. As time moves along, I do hope you can manage to sort out all your various clinics and reviews, as continual monitoring of our health is very important.

I really do have worries for those whose health becomes a collateral casualty of lockdown. COVID is a condition cruel in so many ways.