Monthly Archives: March 2020

Advice for patients with chronic lung conditions during coronavirus pandemic

Due to the current concerns over coronavirus and increase in demand for inhalers, we would advise our patients with chronic lung conditions to follow the guidance set out by Asthma UK below.

Patients are asked not to request extra inhalers. The Government have issued guidance to General Practice not to alter our prescription processes to ensure we maintain availability for those who need it.

If you have concerns regarding the management of your current lung condition, you may contact the surgery to arrange a telephone consultation with one of our respiratory team.

If you do not currently take inhalers and you are asymptomatic, you do not need to start taking inhalers now.

There is information circulating on social media that asthmatics should be requesting “rescue packs” or “emergency packs”. This is not true. Please follow the advice provided by Asthma UK below.

A summary of the guidance for the high risk severe asthmatics is provided at the end of this document.

Summary of Asthma UK guidance

Full guidance can be found at – www.asthma.org.uk

To reduce your risk of asthma symptoms, the best action you can take is to follow these simple asthma management steps:

  • Keep taking your preventer inhaler daily as prescribed. This will help cut your risk of an asthma attack being triggered by any respiratory virus, including coronavirus.
  • Carry your reliever inhaler (usually blue) with you every day, in case you feel your asthma symptoms flaring up.
  • Download and use an asthma action plan to help you recognise and manage asthma symptoms when they come on.
  • If you come down with flu, a cold, or any other respiratory infection, follow our tips for looking after your asthma when you’re not well.
  • If you smoke it’s vital to quit now as smoking will increase your risk from COVID-19. There’s NHS advice on how to give up smoking here.

If you have asthma and have no symptoms of COVID-19

  • Wash your hands often with soap and warm water.
  • Use tissues to wipe your nose or catch a sneeze, and then put them in the bin straight away.
  • Don’t touch your eyes, nose or mouth if your hands aren’t clean.
  • Avoid unnecessary interactions with other people. This means avoiding large gatherings, shaking hands with people or hugging them, and unnecessary travel, especially on public transport. You should also avoid going to public venues like bars, restaurants and cinemas. If it’s possible in your job, try to work from home.
  • You do NOT need to stay inside your house at all times or self-isolate. You can go for a walk, or to the park, or to the shops if you need to buy things. Just try to cut down the number of people you meet with on a daily basis. And try to keep your distance from people when you see them.
  • Carry on taking all your usual asthma medicines as normal.
  • If someone you live with develops symptoms of COVID-19, you will need to stay in your home for 14 days.

What to do if your asthma is getting worse

If your asthma is getting worse and you have symptoms of COVID-19, please use the 111 online service or call 111. Don’t go to your doctor’s surgery.

When you contact 111:

  • Let them know that you have asthma and that you’re getting asthma symptoms.
  • Explain how often you are using your reliever inhaler and if it’s not working completely or lasting for 4 hours.
  • Follow the instructions given to you by 111.
  • If your symptoms get worse quickly and you’re worried you are having an asthma attack, call 999 and let them know you may have coronavirus and are having an asthma attack. See our asthma attack advice for more information.

If your asthma is getting worse and you don’t have symptoms of COVID-19, make an appointment to see your GP as usual. They may ask to speak to you by phone. If you have an asthma attack, follow the steps on your action plan and call 999 for an ambulance if you need to.

High Risk or Severe Asthma Shielding Guidance

Patients will be contacts directly if they are in the group of patients who are required to follow the most recent guidance on shielding, published by the Government 22/3/20. For asthmatics, Asthma UK have summarised this as follows:

If you are, or your child is, taking:

  • Any biologic therapy, also called a mAb (Xolair/omalizumab, Nucala/mepolizumab, Cinqaero/reslizumab, Fasenra/benralizumab)
  • Steroid tablets or liquid every day
  • Antibiotic tablets or liquid for asthma every week (e.g. azithromycin)
  • Tiotropium
  • A combination inhaler that also contains a long-acting bronchodilator (e.g. Seretide, Fostair, Symbicort) at a high daily steroid dose (see asthma uk list)
  • An inhaler with a high daily steroid dose (see asthma uk list) AND you are taking Montelukast

Then you should follow the shielding advice, which means:

  • Stay at home at all times and avoid any face-to-face contact with others for at least 12 weeks.
  • Get food, medicines and other essential items delivered, and have the person delivering them leave them at the door. You can ask friends and neighbours to help with this, or use delivery services. If you can’t do this, public services and charities are gearing up to help people who have to stay at home. From Tuesday 24th March you can register for extra services from Government.
  • Use phone or online services to contact your GP or other services if needed.
  • Inside your home, minimise all non-essential contact with other people you live with.
  • People who provide essential support for you, such as healthcare or support with your daily needs or social care, can still come to your home. But if they have symptoms of COVID-19, they should not come. You should make a plan for how your care needs will be met if your carer becomes ill.
  • If you get symptoms of COVID-19, which means a fever or a new continuous cough, use the NHS 111 online coronavirus service or call 111 as soon as you get symptoms. Do not wait for your symptoms to get worse.
  • If someone else lives with you, they do not have to follow the shielding guidance. They should follow the social distancing guidance very closely and do what they can to support you with shielding.

Full guidance is here – www.asthma.org.uk

FAQs – March 2020

How can I access advice from a GP?

If you need medical advice please either use e-consult our online service which can be accessed via our website alternatively please phone the surgery and a clinician will return your call.

Can I come to the surgery if self-isolating?

If you are self-isolating please do not attend the surgery, contact the surgery online or on the phone.

How can I register with the surgery while self-isolating?

Please complete an online registration form you do not need to come to the surgery with documentation

I have a fever and flu like symptoms can the GP visit me?

GPs are not able to visit patients with flu like symptoms please call the surgery and you will be advised.

I need a certificate to state I have been self-isolating?

Please use the facility on the 111 website for this.

Can I get advice on-line?

Yes please go to our website and use the e-consult link where you will find self-help advice about a number of conditions and are able to complete a form to access advice from your GP / Nurse / Surgery Pharmacist, we aim to reply by the end of the following working day.

What can I do if my medications review if overdue?

We will ensure that you still have your essential medications, either our pharmacists will contact you or we will extend your review date.

What should I do if I am self-isolating and develop an unrelated medical problem?

Please contact the surgery either online using e-consult which can be accessed from our website or by phone.

I want to make an advance appointment but the receptionist says there are none with my preferred Dr

We have reduced access to most pre-bookable services and GPs may be working differently over the coming weeks, please contact us online or on the phone and a GP who has access to your medical records will be able to advise you.

I am not sure if I should be self-isolating what should I do?

Please look at the government website where the advice is update.  This will advise what to do if you develop symptoms yourself, if a family member develops symptoms or if you have been in contact with a known case.

How can I get a test for Covid-19?

Please do not attend A+E for a test; we are also unable to test at the surgery.  Patients will be tested when needed based on clinical need usually these will be patients who have been admitted to hospital.

For further information on self isolating, please see the link below to the government website:

www.gov.uk

I need a letter for my employer as I am in an at risk group

You should not need a letter for your employer and we do not have capacity to write letter for all patients in at risk groups. Clinicians are needing to provide medical care and advice to those who are unwell.

I have heard I should not take naproxen if I have coronavirus

There is insufficient evidence to say whether NSAIDs negatively impact treatment/recovery from coronavirus. The advice therefore is to use paracetamol in preference to NSAIDs for fever in coronavirus treatment until further evidence is available. People should continue taking NSAIDs if they are already using them for a clinical reason.

 

Coronavirus (Covid-19)

If you have been tested for coronavirus (COVID-19) the hospital will contact you directly with your result when it is available – DO NOT call the practice.

In line with NHSE recommendations Sit and Wait clinics will be suspended from Monday 9 March.

If you are concerned about coronavirus please access the NHS 111 online service.

For other medical issues please call the surgery as usual if your need is urgent and you will be added to a telephone clinic, a clinician will call you and either manage your problem on the phone or arrange a same day appointment if needed.