INFORMATION ON CORONA-VIRUS DISEASE 2019 (COVID-19) OUTBREAK AND GUIDANCE FOR PEOPLE WITH DIABETES
At the end of 2019, a novel coronavirus (a specific virus that causes human and animal disease) was identified as the cause of pneumonia cases in Wuhan, a city in the Hubei Province of China. It rapidly spread thereafter, resulting in an epidemic throughout China, with quick spread globally, affecting now nearly every continent. Understanding of this novel coronavirus is still evolving.
Coronavirus spreads like any other respiratory disease, through contaminated air-droplets that come out of the mouth of infected persons when talking, coughing or sneezing. The virus can survive in the environment from a few hours to a few days (depending on the surfaces and the environmental conditions) and touching affected surfaces and then the mouth or nose is thought to be the way of transmission. The virus is killed in the environment with alcohol-based solutions.
WHAT TO DO FOR MY DIABETES REVIEW BOOKED WITH THE PRACTICE
Due to the outbreak it is likely that your practice will review your Diabetes remotely over phone or video consultation and will contact you by phone, email or SMS messages. Contact your surgery prior to your appointment and regularly attend the practice website to find out how your practice is planning to manage your Diabetes during the pandemic.
HOW SEVERE CAN THE INFECTION BE?
The good news is that it is usually a mild disease and majority of affected people survive the disease. The majority of cases (>80%) are mild (showing only minimal flu-like symptoms) and people can recover at home. Some cases though (around 15%) are severe and very few (around 5%) can develop critical illness. Some people have no symptoms, or have only mild symptoms of a common cold. But in other people, COVID-19 can lead to serious problems, like pneumonia or even death. This is more common in people who have other health problems, particularly the elderly, those with cardiovascular disease, chronic lung disease and hypertension. People with diabetes are among those high risk categories that can have serious illness (just like the flu) if they get the virus so it is vital that people take precautions such as social distancing to avoid catching the disease.
WHAT ARE THE POSSIBLE SYMPTOMS OF THE ILLNESS?
People affected with COVID-19 can have fever, cough, shortness of breath (trouble breathing), feeling tired and having muscle aches. Problems with breathing happen when the infection affects the lungs and causes pneumonia. Symptoms usually start a few days after a person is infected with the virus, with most cases occurring approximately 3-7 days after exposure. But in some people it can take even longer for symptoms to appear (up to 14 days).
WHAT TO DO IF THERE IS A CHANCE OF INFECTION?
Social isolation is essential to stop the spread of infection. Stay at home if you have either:
- A high temperature – this means you feel hot to touch on your chest or back
- A new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
Do not go to a GP surgery, pharmacy or hospital. Use the 111 online coronavirus service to find out what to do at https://111.nhs.uk/covid-19
- if you have symptoms of coronavirus, you'll need to stay at home for 7 days.
- if you live with someone who has symptoms, you'll need to stay at home for 14 days from the day the first person in the home started having symptoms.
As the guidance will be evolving it is essential that people keep themselves up to date by visiting the NHS website at https://www.nhs.uk/conditions/coronavirus-covid-19/
WHAT TO DO IF INSTRUCTED TO STAY AT HOME?
For affected people who stay at home, patients and families should practice proper measures for infection prevention and control. Management of such patients should focus on prevention of transmission to others and monitoring for clinical deterioration. Affected persons should be placed in a well-ventilated single room, household members should stay in a different room or, if that is not possible, maintain a distance of at least 1 m from the ill person (e.g., sleep in a separate bed) and perform hand hygiene (washing of hands with soap and water) after any type of contact with patients or their immediate environment. When washing hands, it is preferable to use disposable paper towels to dry them. If these are not available, clean cloth towels should be used and they should be replaced when they become wet. To contain respiratory secretions, a medical mask should be provided to the patient and worn as much as possible. Individuals who cannot tolerate a medical mask should use rigorous respiratory hygiene − that is, the mouth and nose should be covered with a disposable paper tissue when coughing or sneezing. Caregivers should also wear a tightly fitted medical mask that covers their mouth and nose when in the same room as the patient.
WHAT SHOULD PEOPLE WITH DIABETES DO IF THEY GET SICK WITH THE VIRUS?
It is better that people with diabetes plan ahead of time about what to do before they get sick, for example have telephone numbers of their health care provider at hand and have adequate stock of medications and consumables for monitoring blood glucose at home, so that they do not need to go out in case of illness or should the situation impact e.g. local pharmacy opening times. If they get sick with the virus, they may see their glycaemic control deteriorate during the illness. They should practice the “Sick day rules” recommended for any stressful situation in order to ameliorate their diabetes decompensation. They should contact their health care provider immediately for advice (on telephone) regarding how often to monitor their blood sugar, get adequate refills for medications (especially insulin) and what adjustments they may need to do in their medicines or diet.
SICK DAY RULES FOR PEOPLE WITH DIABETES
- Keep hydrated
- Monitor your blood glucose
- Monitor your temperature
- If you are on insulin, also monitor your ketone bodies
- Follow your healthcare team recommendations