Social isolation and social distancing

[LittleGreyCat]

This has been enormously confusing, so I'm having a go at posting a thread just about the words used.
Warning - long thread with a lot of words but please try and wade through it.

https://www.gov.uk/government/publi...protecting-older-people-and-vulnerable-adults

This seems to be the current definitive document which is the source of a lot of confusion.

Firstly, I note that previously there has been a lot of talk about "social isolation" especially for those who are or have recently been infected. Also for over 70s being "quarantined" in the home for 4 months.
This involves not going out at all, avoiding your own family in the home if possible, not having visitors if possible, having groceries delivered. Wash, was, wash.

The above linked document doesn't talk about isolation at all, but only "distancing".

Firstly, the list of those covered is very broad.
Basically anyone who qualifies for a flu jab which includes all diabetics.
So social distancing should apply to us all.
However there is a lot of lack of clarity in the definitions.

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.

However it includes a subset

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 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:

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

As far as I can tell there is nothing there which calls out those with T1 diabetes as being more at risk than the global catch all due to a compromised immune system.
I think that T1s are generally at no more risk from a viral infection than others in the list, as I think that the specific immune problem is their body attacking their own pancreas which is a sign of an over active immune system.
There is a link (which I will try and find later) which says that diabetes doesn't increase the risk of viral infection, just the risk of a bacterial infection.

Further:

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

Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough;
Avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible;
3.Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information;
Avoid large gatherings, and gatherings in smaller public spaces such as pubs, cinemas, restaurants, theatres, bars, clubs
Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media.
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 pragmatic.

This advice seems to be applicable to all people in the general population, not just the ones at higher risk.

This emphatically does not tell people in the higher risk category to stay home from work. Just "where possible". So anybody who can't work from home (teachers for example) is still expected to turn in to work as normal.

Going from this document, T1s who teach and are asking if the Government says should stay at home should realise that the answer is "No".
This document is not a basis for a GP to issue a sick note.

It even says:

For those who are over 70, have an underlying health condition or are pregnant, 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.

This is a million miles away from social isolation.
Just to push the point home, stringent adherence to the advice above includes not travelling during rush hour. It doesn't preclude using public transport.

TL;DR this advice is very wishy washy and as it stands does not provide any basis for not going in to work for even the highest risk categories. It seems aimed at keeping everyone at work.

 

[NicoleC1971]

Personally I have shown up for work and it is errily quiet (work in a gym as a trainer). Although my immune system is strong in that I rarely catch long lasting colds, I am aware that due to my higher blood sugar levels that is where my enhanced risk is.
On balance and with sensible precautions I will continue for now.
Higher blood sugars and having excess body fat (more cell receptors for the virus) are what I understand to be the risk factors for diabetics to be.
DUK seems to have the same fuzzy advice on their website.

 

[Ica291]

Unfortunately the advice is constantly changing, so what we read and acknowledge now may be irrelevant in a few hours. That's the problem with new virus.

It's up to each individual how much they want to risk and what impact it will have on their own body/medical condition.

I'm not prepared to take the risk as a mum of two. So until there is a vaccine or I'm told its unnecessary, I am going to self isolate at home. Can't stop husband going out and bringing something back but I've put as many steps in as possible to reduce my risk of catching it. Just in case.

 

[LittleGreyCat]

The news today is full of "tough new measures" which are the same as posted above.
All the risk is being carried by businesses and individuals.
In "a few weeks time" there may be further more stringent measures announced.

Until there is legislation to close schools, colleges, cinemas etc. there is no claim against insurance and pubs, cafes, etc. just go out of business.

Vulnerable people still have to work or starve.

 

[JohnEGreen]

I really do not understand why the talk of tough new measures there have been no new measures just advise and suggestions no government directives what so ever just Boris saying please don't do this or please do that we are fully at liberty to take his advise or reject it.

 

[Robinredbreast]

no new measures just advise and suggestions no government directives what so ever just Boris saying please don't do this or please do that we are fully at liberty to take his advise or reject it.

Exactly, a lot of wishy washy, airy fairy, advisable's., ps I don't even earn a pittance of an MP's wage.

This country needs proper leadership to get things done, so Boris, take the soft kitty mittens off and put those boxing gloves on, to help us all fight COVID-19 !

 

[SugarBuzz]

I think it's purposely worded in a 'wishy-washy' way so that when it comes down to it - the government can't be held responsible for any possible future compensation claims from businesses, workers etc. as it's merely 'advice'.
From their point of view, any 'shut-downs' by various businesses or 'stay-aways' etc. have been entirely voluntary.

This is to be expected from a government whose 'leader' hides in a fridge. You get what you vote for as they say.

 

[ianf0ster]

I tend to ignore any official health advice/guidelines which have no plausible scientific backing.
Otherwise I wouldn't be in T2D remission.

The UK advice is strange in 3 ways:
1. A lack of anything other than suggestions/advice is no way to control, flatten the curve, or end Covid19.
2. Where does the advice about pregnant women being more at risk come from? I have combed all stats I can find for China, S. Korea and Italy and can't find anything to support this.
3. Stats from the above countries do show Diabetics (though no distinction between Type and controlled vs uncontrolled) have higher mortality rate for Covid19. However I can't find any plausible science theory as to why this should be the case.

 

[JohnEGreen]

Where does the advice about pregnant women being more at risk come from? I have combed all stats I can find for China, S. Korea and Italy and can't find anything to support this.

Ever heard of Teratogens while researching on the net.

Many viruses can be transmitted to the fetus and cause infection and tissue damage. Five viruses are known to be teratogenic in humans: cytomegalovirus, rubella, herpes simplex, Venezuelan equine encephalitis, and varicella viruses. Other viruses which can infect and produce disease in the fetus are influenza, rubeola, Western equine encephalitis, variola, vaccinia, hepatitis B, echoviruses, and poliovirus.

Covid 19 is new and we do not know if it is Teratogenic or not and if it is, just how dangerous it is. Why take chances with it.

In approximately 9 months or so you may have all the evidence you require though I sincerely hope not.

 

[ianf0ster]

Ever heard of Teratogens while researching on the net.

Many viruses can be transmitted to the fetus and cause infection and tissue damage. Five viruses are known to be teratogenic in humans: cytomegalovirus, rubella, herpes simplex, Venezuelan equine encephalitis, and varicella viruses. Other viruses which can infect and produce disease in the fetus are influenza, rubeola, Western equine encephalitis, variola, vaccinia, hepatitis B, echoviruses, and poliovirus.

Covid 19 is new and we do not know if it is Teratogenic or not and if it is, just how dangerous it is. Why take chances with it.

In approximately 9 months or so you may have all the evidence you require though I sincerely hope not.

Just to clarify do you know if Covid 19 turns out to be Teratogenic then will there be higher likelihood of :
1 miscarriage?
2 Birth defect ?
3 being born with Covid19 even if mother has recovered by that time ?
4 any of the above?
How many millions need to be infected in order to have sufficient pregnancies with Covid19 in order to have statistical evidence one way or the other?

 

[LooperCat]

Ever heard of Teratogens while researching on the net.

Many viruses can be transmitted to the fetus and cause infection and tissue damage. Five viruses are known to be teratogenic in humans: cytomegalovirus, rubella, herpes simplex, Venezuelan equine encephalitis, and varicella viruses. Other viruses which can infect and produce disease in the fetus are influenza, rubeola, Western equine encephalitis, variola, vaccinia, hepatitis B, echoviruses, and poliovirus.

Covid 19 is new and we do not know if it is Teratogenic or not and if it is, just how dangerous it is. Why take chances with it.

In approximately 9 months or so you may have all the evidence you require though I sincerely hope not.

Not to mention Zika...

 

[JohnEGreen]

@ianf0ster

Yes I did know and it's a frightening prospect we have already had one new born with the virus if it was infected while in the womb or not is unclear.

@LooperCat quite so Knew there was one I had forgotten.

 

[Zilsniggy]

I tend to ignore any official health advice/guidelines which have no plausible scientific backing.
Otherwise I wouldn't be in T2D remission.

The UK advice is strange in 3 ways:
1. A lack of anything other than suggestions/advice is no way to control, flatten the curve, or end Covid19.
2. Where does the advice about pregnant women being more at risk come from? I have combed all stats I can find for China, S. Korea and Italy and can't find anything to support this.
3. Stats from the above countries do show Diabetics (though no distinction between Type and controlled vs uncontrolled) have higher mortality rate for Covid19. However I can't find any plausible science theory as to why this should be the case.

I’m thinking that the reason diabetics may be at higher risk for this is the cytokine cascade which occurs. I’m sure I’ve read that this can be worse in those who have any type of autoimmune disorder, and this is what leads to multi organ failure. There us also no recognised treatment protocol for ‘cytokine storm.’

 

[DavidGrahamJones]

I tend to ignore any official health advice/guidelines which have no plausible scientific backing.

I suppose the only real option is to self isolate, the worse that can happen is that you might be lonely for 3 or 4 months.
On the other hand you can carry on as normal and the worse that can happen is that you will get Covid and perhaps something even worse like pneumonia.

Otherwise I wouldn't be in T2D remission.

Just because ignoring diabetic advice has enabled you to be in T2D remission (is that no insulin resistance and a healthy pancreas?) it doesn't mean every piece of medical advice is worth ignoring.

2. Where does the advice about pregnant women being more at risk come from? I have combed all stats I can find for China, S. Korea and Italy and can't find anything to support this.

At least the Royal College of Obstetricians and Gynaecologists say that as this is a new virus, there's no way of knowing how things will turn out for them of their child(ren).

 

[ianf0ster]

Thanks Zilsniggy, SO that would apply to Type 1 rather than Type 2?
In which case the stats for Diabetes as a co--morbidity seem too high, since even in China there are many times more Type 2 than Type 1.

 

[ianf0ster]

Just because ignoring diabetic advice has enabled you to be in T2D remission (is that no insulin resistance and a healthy pancreas?) it doesn't mean every piece of medical advice is worth ignoring.

Why did you split my statement into 2 parts?
You quote the part about being in remission due to ignoring advice without the previous line which makes clear that the advice I ignored had no plausible scientific backing.

I'm a bit obtuse when it come to reading people's emotions so I ask this as respectfully as I can: Are you trying to provoke a fight?

I certainly don't want one


Edited by moderator

 

[michita]

This has been enormously confusing, so I'm having a go at posting a thread just about the words used.
Warning - long thread with a lot of words but please try and wade through it.

https://www.gov.uk/government/publi...protecting-older-people-and-vulnerable-adults

This seems to be the current definitive document which is the source of a lot of confusion.

Firstly, I note that previously there has been a lot of talk about "social isolation" especially for those who are or have recently been infected. Also for over 70s being "quarantined" in the home for 4 months.
This involves not going out at all, avoiding your own family in the home if possible, not having visitors if possible, having groceries delivered. Wash, was, wash.

The above linked document doesn't talk about isolation at all, but only "distancing".

Firstly, the list of those covered is very broad.
Basically anyone who qualifies for a flu jab which includes all diabetics.
So social distancing should apply to us all.
However there is a lot of lack of clarity in the definitions.


However it includes a subset



As far as I can tell there is nothing there which calls out those with T1 diabetes as being more at risk than the global catch all due to a compromised immune system.
I think that T1s are generally at no more risk from a viral infection than others in the list, as I think that the specific immune problem is their body attacking their own pancreas which is a sign of an over active immune system.
There is a link (which I will try and find later) which says that diabetes doesn't increase the risk of viral infection, just the risk of a bacterial infection.

Further:


This advice seems to be applicable to all people in the general population, not just the ones at higher risk.

This emphatically does not tell people in the higher risk category to stay home from work. Just "where possible". So anybody who can't work from home (teachers for example) is still expected to turn in to work as normal.

Going from this document, T1s who teach and are asking if the Government says should stay at home should realise that the answer is "No".
This document is not a basis for a GP to issue a sick note.

It even says:

This is a million miles away from social isolation.
Just to push the point home, stringent adherence to the advice above includes not travelling during rush hour. It doesn't preclude using public transport.

TL;DR this advice is very wishy washy and as it stands does not provide any basis for not going in to work for even the highest risk categories. It seems aimed at keeping everyone at work.

thank you for this.

 

[JohnEGreen]

A friend of my grandson Keiran is working in a lab in London he has been re tasked from what he was doing to studying the virus he said to Keiran the first time he got a look at it under the microscope came as a bit of a shock as its unlike anything he's seen before.

One thing he said is it's nothing like the flu virus

 

[jjraak]

Just because ignoring diabetic advice has enabled you to be in T2D remission (is that no insulin resistance and a healthy pancreas?) it doesn't mean every piece of medical advice is worth ignoring.
.

I take what you say @DavidGrahamJones
but for me the words from @ianf0ster , seem more to represent don't just take peoples world for no matter what position they hold..( aka eatwell v LCHF)
do some research, dig and find out more, which really has been the story of this.

we are all scrambling for some consensus, the lead hasn't been that strong from government
advice this , suggest that, plan today is X, Ok new plan is now.....Y

yes it is an evolving situation,
BUT if we all just followed the advice day one.(china jan 2020) it
was stay calm...
many aren't do that now thank god, they have Woke, i think the young uns call it.

challenging the information,
finding out if it balances with what other experts around the world are saying,
is it what other nations are doing,
who has had the bests results and by what methods..

All things the government should be doing and don't seem to have been doing very well.

In every fast moving disaster i have ever seen on the television, the stories are usually the same, people panic, people stockpile, & people get scared..and in every scenario the advice is always the same ,
stay up to date with the latest news and be prepared to act fast.

sadly this has only happened here in the uk in the last few days, and we still have the "it's just Flu calm down everybody."

so i make @ianf0ster , right..challenge and find the the best way forward for you,,,
even if it's not with the herd.

it's about survival, not popularity.

Not a dig at you, just a little defence of someone else's opinion
i am beyond caring how other treat this As long as everyone observes the protocols to get rid of it a soon as possible.

stay well
stay safe

 

[Oldvatr]

just seen a news report on TV that the WHO have just put out that garlic is bacteriocidal so may be of some benefit. I am sure that a large dose of garlic will assist the social isolation and social distancing aspect if nothing else.