Coronavirus / Covid19 Information

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Josh DUK

Josh DUK

Former Online Community and Learning Manager
Staff member
Relationship to Diabetes
At risk of diabetes
The Secretary of State for Health and Social Care, Matt Hancock has launched an expanded public health awareness campaign on COVID-19 (Coronavirus).

coronavirus.JPG

It urges people to wash their hands more often for 20 seconds. You can find their campaign on their social media channels below.
 
Alwyn said:
Apart from diabetes with which I was diagnosed about 8 years ago I am fit, not overweight and walk our dogs 2 miles every day. I take 1 or 2 metformin tablets per day. I am 79.

Reading between the lines of what Diabetes UK has put out it sounds as if the most vulnerable to Coronavirus are type 1. Why would somebody like me be more vulnerable than anybody else of my age in good health?
Click to expand...

Don't think there's enough data to really say. The Chinese studies so far haven't looked at eg HbA1c, BG control etc as independent risk factors - there's just a broad "diabetes" category showing elevated risk.

High blood pressure and existing CV diease are other risk factors so I guess it's likely that keeping BP under control and doing the usual CV-health things will reduce risk, whatever yr diabetes status.

EDIT: This is what the American Diabetes Association has to say

Diabetes and Coronavirus | ADA

www.diabetes.org www.diabetes.org

In general, we don’t know of any reason to think COVID-19 will pose a difference in risk between type 1 and type 2 diabetes. More important is that people with either type of diabetes vary in their age, complications and how well they have been managing their diabetes. People who already have diabetes-related health problems are likely to have worse outcomes if they contract COVID-19 than people with diabetes who are otherwise healthy, whichever type of diabetes they have.
 
We have had a flurry of threads about Coronavirus recently, and several new members have joined specifically looking for information.

It seemed helpful to gather some of the links and resources that people have been posting into one place for ease of reference.
 
This page on the Diabetes UK website has information specifically for people with diabetes

www.diabetes.org.uk

Coronavirus and diabetes updates

All the coronavirus information below applies to the whole of the UK, unless specified. We've noted where are some differences in guidance and diabetes services across the UK.
www.diabetes.org.uk www.diabetes.org.uk
 
Mod edit: Scientific post aimed at HCPs/researchers mainly about high blood pressure and covid19.

...the data/studies so far don't really have the detail or power to say how much extra risk you get from age, high BP, diabetes, CV disease, high BG etc etc independently. A lot of these are correlated.

This is an ongoing review of what is/isn't known for some of these aspects: http://www.nephjc.com/news/covidace2
 
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12 week quarantine.
Once the full implications of tonight’s recommendations have been announced I will post something here. Hopefully later tonight.

Edit: the recommended 12 week quarantine seems to relate more to people affected by cancer, organ transplant, dialysis etc detailed below.
 
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EDIT: This advice has been withdrawn as of 1st May, and has been replaced by the social distancing advice to ‘stay at home and away from others’ (see post #12 below)

Old advice:
Here is a link to the official version of the updated guidance: https://www.gov.uk/government/publi...protecting-older-people-and-vulnerable-adults

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.
This group includes those who are:
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)
 
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Diabetes and Coronavirus | ADA

www.diabetes.org www.diabetes.org

I think this bit is new:

In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus. If diabetes is well-managed, the risk of getting severely sick from COVID-19 is about the same as the general population.

When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because your body’s ability to fight off an infection is compromised.

Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This is also caused by above-target blood sugars, and both could contribute to more severe complications.

When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis), commonly experienced by people with type 1 diabetes. DKA can make it challenging to manage your fluid intake and electrolyte levels—which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with COVID-19 have experienced.
 
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Short video update posted yesterday (Sunday 22nd) by Dr Partha Kar (diabetes consultant and diabetes lead in NHS England) clarifying that people with diabetes are NOT on the list who are currentlyinsfeicted to self isolate.

People with diabetes should carefully follow the ‘social isolation’ guidelines above.

https://twitter.com/x/status/1241813564937175044
 
New website (launching soon) where people who are extremely vulnerable (not just diabetes, but extra complicating factors) and who have been recommended to self-isolate can register to receive help with shopping, medicine supply etc.

www.gov.uk

COVID-19: guidance for people whose immune system means they are at higher risk

Guidance for people aged 12 and over whose immune system means they are at higher risk of serious illness if they become infected with COVID-19.
www.gov.uk www.gov.uk
 
Restrictions on being in public
Looks like the suggestions/rules around being in public are being substantially tightened (not really a surprise after the excesses of last weekend! Updates will be posted here when they have been clarified.
 
Here is the official write-up of the new restrictions on movement announced tonight.

www.gov.uk

[Withdrawn] Staying at home and away from others (social distancing)

www.gov.uk www.gov.uk

The single most important action we can all take, in fighting coronavirus, is to stay at home in order to protect the NHS and save lives.​
​
When we reduce our day-to-day contact with other people, we will reduce the spread of the infection. That is why the government is now (23 March 2020) introducing three new measures.​
​
  1. Requiring people to stay at home, except for very limited purposes
  2. Closing non-essential shops and community spaces
  3. Stopping all gatherings of more than two people in public
Every citizen must comply with these new measures. The relevant authorities, including the police, will be given the powers to enforce them – including through fines and dispersing gatherings.​
 
Diabetes UK- Staying at home and managing your diabetes

We’ve put together these tips to support you in keeping well and managing diabetes while you’re at home, whether you're self-isolating or know someone who is.

We know that this advice may mean you have to completely change your way of life, and we know that may be daunting. We want you to know that we’re right here with you at this difficult time. Click on the link below for additional information:

Staying well during coronavirus

We’ve put together these tips to support you in keeping well and managing diabetes if you’re staying at home more often, self-isolating, spending more time inside or had your routine care postponed. We know that at this time it may be difficult to access your usual diabetes care team so we have...
www.diabetes.org.uk www.diabetes.org.uk
 
Government Advice – Shielding, Self-Isolation & Social Distancing/Stay at home

The basic, high level, advice which applies to everyone can be found on the GOV.UK webpage - Coronavirus (COVID-19): what you need to do - https://www.gov.uk/coronavirus

The government advice covers 3 levels of action.

  • Shielding – this is to protect people who have specific medical conditions (which does not include diabetes). They are described as “extremely vulnerable” and have to stay inside, at home, for the next 12 weeks. They should each have received a letter with specific information from the NHS by 29th March 2020.
Full details are in - Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19 – https://www.gov.uk/government/publi...ng-extremely-vulnerable-persons-from-covid-19

The government advises that visits to provide essential support with health or social care should continue & people who are shielding use family and friends to get shopping, medicines etc. People who are unable to do this can register to receive help on the webpage - Get coronavirus support as an extremely vulnerable person - https://www.gov.uk/coronavirus-extremely-vulnerable This is only available to people who are extremely vulnerable. The service is not for people self-isolating.

  • Self-isolation – this is for people with confirmed or suspected coronavirus and anyone living with them. Broadly, this means staying at home for 7 days from the start of symptoms (14 days if you are living with someone who has coronavirus) but the start dates can vary.
Importantly, some people might be recommended to “self-isolate” by NHS 111 or by their GP even though they do not meet the criteria set out in the government guidance.

Full details are in– Stay at home: guidance for households with possible coronavirus (COVID-19) infection – https://www.gov.uk/government/publi...-with-possible-coronavirus-covid-19-infection .

  • Social distancing and Stay at home – this is for everyone else and broadly means staying at home and keeping away from other people to reduce the risk of infection
Full details are in – Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults – https://www.gov.uk/government/publi...protecting-older-people-and-vulnerable-adults and Full guidance on staying at home and away from others – https://www.gov.uk/government/publi...dance-on-staying-at-home-and-away-from-others

It is important to be aware that there are no “special” rules for people with diabetes. They only fall into the shielding category if they also have one of the specified medical conditions or the self-isolation group if they, or a household member, has coronavirus symptoms or they have been advised to self-isolate by their Health Care Professional or NHS 111.

The only specific mention of diabetes is in the social distancing guidelines where it is listed as one of the underlying health conditions which make people “at increased risk of severe illness from coronavirus (COVID-19) [so they need] to be particularly stringent in following social distancing measures.”

Medical Help/Advice

  • Diabetes UK - Updates: Coronavirus and diabetes - https://www.diabetes.org.uk/about_us/news/coronavirus As well as general information, our webpage covers:
  • What to do if you have coronavirus symptoms
  • If you have hospital and GP appointments
  • If one of your healthcare team is diagnosed with coronavirus
  • How coronavirus can affect people with diabetes
  • Insulin, medicines and diabetes tech
The last section is particularly important as we often get calls from people concerned about medication supply issues and it gives our “official” position.

This webpage also links to our webpage - Staying at home and managing diabetes - https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/staying-home which has useful information on emotional wellbeing, what to eat and how to be active whilst staying at home.

This is a quick & useful guide to what might trigger a hospital admission and who gets to stay at home to recover. It also highlights that only people admitted to hospital are actually being tested at the moment.



Healthcare Workers

  • We have had numerous calls from healthcare workers with diabetes concerned that they are being put at risk because of working in an environment with possible increased exposure to coronavirus. There is nothing specific covering people with diabetes but a risk assessment should be carried out and the possibility of re-deployment discussed for all “health and social care staff at high risk of complications from COVID-19” which would include people with diabetes.
Support for this can be found in ”Infection prevention and control guidance for pandemic coronavirus” a PDF document which can be downloaded from the GOV.UK webpage - COVID-19: infection prevention and control - https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

At page 33, in the section “Occupational health and staff deployment”, it says “A risk assessment is required for health and social care staff at high risk of complications from COVID-19, including pregnant staff.” And goes on to say that employers discuss with people at risk “the need to be deployed away from areas used for the care of those who have, or are… suspected of having, COVID-19” (Information accessed 26/03/2020 – confirm still current before using)



Employment Issues

At present, many of the calls we are getting are around employment issues. This is a difficult area, partly because key terms are poorly defined or inconsistently used across different parts of the government website.

  • Vulnerable/ extremely vulnerable – many calls are from people who are unsure what category they fall into between ‘at risk’ and ‘extremely vulnerable’. Unless the person with diabetes has another underlying health conditions that puts them in the ‘extremely vulnerable’ category they are still being advised to stringently social distance themselves using these guidelines - https://www.gov.uk/government/publi...protecting-older-people-and-vulnerable-adults
If they have another underlying health conditions that puts them in the ‘extremely vulnerable’ category they need to follow the shielding guidance - https://www.gov.uk/government/publi...ng-extremely-vulnerable-persons-from-covid-19


Obtaining Food & Medicines

We also get calls from people without family or friends, struggling to get food or medicines when self-isolating or shielding. The help we can give may be limited as we will not know what is available in their particular area. However, there are some general points we can give them.


General

Carers UK has useful information for people caring for others who are concerned about how to cope with coronavirus. Details can be found on their webpage - Coronavirus guidance - https://www.carersuk.org/help-and-advice/health/looking-after-your-health/coronavirus-covid-19


Government - copies of all the government guidance on COVID-19 (currently 246 documents) can be found via the Guidancelink at the bottom of the Coronavirus (COVID-19): what you need to do - https://www.gov.uk/coronavirus page. Given the volume of information it contains, this is a “last resort” source, if you cannot find information elsewhere or want to check if the government have issued guidance on a particular topic.


Coronavirus FAQ


Advice for Scotland, Wales and N. Ireland


Accessing Benefits


Financial Assistance/Relief


Housing (including hotel/B&B accommodation for families and key workers)


Medical “Myths”


Mental Health


Miscellaneous


Pets/Livestock


Prisons



Residential Care



Visitors to the UK/Visa Applicants


Workplace Issues


Coronavirus (COVID-19): guidance on drivers’ hours relaxations - https://www.gov.uk/government/publi...ovid-19-guidance-on-drivers-hours-relaxations
 
This morning gov.uk have updated the shielding guidance: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19


The public health advice has not changed, however the document has been edited to improve clarity.


Key things that have been edited are:
  • Clearer language: ‘clinically extremely vulnerable’ and ‘moderately vulnerable’
  • It is now clearer who should be following the shielding advice and who should be following social distancing measures
  • Makes clear that everybody needing to receive a letter should have got one now, but if people are unsure or concerned they should contact their GP or hospital clinician
  • Asks ‘clinically extremely vulnerable people’ to register for support even if they do not need it right now – this is so we can log how many people are shielding
  • Clearer advice on what to do if you are shielding and develop symptoms.
 
Latest statistics on coronavirus deaths in people with diabetes

Statistic coronavirus deaths

Updated 21st May: We now know more detail about the people with diabetes who have died from coronavirus in hospitals in England, between March and May 2020. We’ve broken down the new data for you here.

www.diabetes.org.uk

NHSE statistics on coronavirus deaths in people with diabetes

A study from NHS England revealed that one in three people (33.2%) who have died in hospital in England following a diagnosis of coronavirus also had diabetes. We know this statistic raised a lot more questions than it did answers, and it may have left you feeling increasingly worried.
www.diabetes.org.uk www.diabetes.org.uk
 
updates to government advice to people who are shielding.

“People who are shielding remain vulnerable and should continue to take precautions but can now leave their home if they wish, as long as they are able to maintain strict social distancing. If you choose to spend time outdoors, this can be with members of your own household. If you live alone, you can spend time outdoors with one person from another household. Ideally, this should be the same person each time. If you do go out, you should take extra care to minimise contact with others by keeping 2 metres apart.”



Work and employment for those who are shielding
If you usually work, you should talk to your employer as soon as possible if you:

  • have been advised to start shielding
  • think you might need to start shielding
You should make every effort to work from home and your employer is expected to help you to do this.

If you are unable to work from home, you should discuss and agree your options with your employer.

At times, it may be appropriate for you to take up an alternative role or adjust your working patterns temporarily.

Some employers may also be able to offer different types of leave. Beyond your statutory annual leave entitlement, this will be at the employer’s discretion.

If you were employed before 19 March 2020, you may be eligible for the Coronavirus Job Retention Scheme, under which you can be furloughed at 80% of your salary (maximum of £2,500 per month) up to the end of August after which time employers are paying an increased proportion of furloughed staff salaries until the furlough scheme ends, as currently planned, at the end of October.

Statutory Sick Pay is available as a safety net in cases where you are unable to work or to be furloughed under the Coronavirus Job Retention Scheme.

Employees have protections against unfair dismissal and may have certain entitlements around redundancy. It is breaking the law to discriminate, directly or indirectly, against anyone because of a protected characteristic such as age, sex or disability. Employers also have particular responsibilities towards disabled workers and those who are new or expectant mothers. Find out more about the rights you have at work.

To support the self-employed through the coronavirus outbreak the Government has announced the Self-employment Income Support Scheme.

www.gov.uk

Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19

www.gov.uk www.gov.uk
 
Update to guidance for England.

From Saturday (13/6) “single adult households – in other words adults who live alone or with dependent children only – can form a ‘support bubble’ with one other household. All those in a support bubble will be able to spend time together inside each others’ homes, including overnight, without needing to stay 2 metres apart.”. Full details are set out in the GOV.UK guidance - Meeting people from outside your household (Published 10 June 2020) - https://www.gov.uk/guidance/meeting-people-from-outside-your-household


Clinically vulnerable “you should continue to take particular care to minimise contact with others. You should bear this in mind when deciding to form a support bubble”. This guidance also applies to anyone who has a higher risk of catching coronavirus e.g. frontline healthcare workers and includes the advice “If you are at a higher risk of exposure to those with coronavirus (for example, if someone in your house is a healthcare or care worker that interacts with patients that have coronavirus), you should take particular care when deciding whether to form a support bubble and who with.”

Clinically extremely vulnerable (shielding) “we cannot advise anyone who is shielding to form a household bubble at this stage…….. Those who are shielding are still advised to maintain strict social distancing and stay 2 metres apart from others – including those they live with.” The guidance indicates that the government will be setting out further advice for this group next week.

 
For the latest summary of advice on coronavirus / covid 19 we recommend visiting this page

www.diabetes.org.uk

Coronavirus and diabetes updates

All the coronavirus information below applies to the whole of the UK, unless specified. We've noted where are some differences in guidance and diabetes services across the UK.
www.diabetes.org.uk www.diabetes.org.uk
 
Updated guidance for any members in England who are classified as ‘Clinically Extremely Vulnerable’ (eg those who received a shielding letter from the Government or their GP) including information about the new 3 tier system

www.gov.uk

COVID-19: guidance for people whose immune system means they are at higher risk

Guidance for people aged 12 and over whose immune system means they are at higher risk of serious illness if they become infected with COVID-19.
www.gov.uk www.gov.uk
 
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