5. COVID-19 scenarios
Self-isolation: Self isolation is undertaken by those people who either have symptoms of COVID-19 OR they are a household contact of someone who is displaying symptoms. For coronavirus symptom information go to NHS Inform. Someone who has symptoms should self-isolate for 7 days from the onset of symptoms. Household contacts should self-isolate for 14 days (from the day the first person in the household became ill). Information on this is available on the Public Health England (PHE) website
Social Distancing: This measure reduces social interaction between people in order to reduce the transmission of the virus. It is intended for those situations where people are living in their own homes with or without additional support from friends, family or carers.
Shielding: This is for people (inc. children) who are at very high risk of severe illness from COVID-1 when an extremely vulnerable person is living in their own home, with or without additional support and those in long term care settings. The aim of shielding is to minimise interaction between individuals and others to protect them from coming into contact with the virus, thereby aiming to reduce mortality in this group. Information on which people are in this category and what to do are on the NHS Inform website.
If a care worker is concerned they have COVID-19
Advice for health and social care professionals on Coronavirus is available on NHS Inform webpages. Staff should check these pages regularly for updates.
If a member of staff is concerned they have COVID-19 they should follow stay at home NHS Advice. As outlined above, this advice states that:
- staff should stay at home if they have symptoms that may be caused by COVID-19 or they live with someone that has symptoms.
- if a staff member lives alone they should stay at home for 7 days from the day symptoms started.
- if a staff member lives with others, the person who has symptoms should stay at home for 7 days from the day their symptoms started.
- all other household members should stay at home for 14 days even if they don’t have symptoms themselves. The 14-day period starts from the first day the person had symptoms.
- if others develop symptoms within the 14 days, they need to stay at home for 7 days from the day their symptoms started. They should do this even if it takes them over the 14-day isolation period.
If the individual being cared for has symptoms of COVID-19
Clients who demonstrate symptoms including a new continuous cough and a high temperature, should be managed as though they have COVID-19.
In this situation, carers should contact NHS24 on 111 to access advice from the newly established local COVID-19 Hubs (see below) and if necessary contact next of kin. It is important not to phone 999 unless it is a medical emergency, or you are instructed to do so by the COVID-19 Hub.
Personal protective equipment (PPE) must be worn when caring for these clients. Advice on what to wear and how to don the PPE is available in HPS guidance and all staff must be made aware of it. This includes the disposal of the equipment.
Clients who are symptomatic should have their anticipatory care plans revisited and explored or discussed by the most appropriate member of the team with relevant family members. Clients whose symptoms improve and resolve after 7 days would be considered non-infectious after this time.
Clinical protocols do not recommend testing patients who are symptomatic in the community unless they are admitted to acute care, so care provision must be on the basis of a clinical diagnosis as advised by the COVID hubs. Care for an acute episode will be directed by advice from the COVID hubs.
Advice on cleaning and laundry is available in the HPS guidance
If neither the individual nor the care worker have symptoms of COVID-19
If neither the care worker nor the individual receiving care and support is symptomatic, then no PPE is required. There have been suggestions that in these circumstances staff should wear PPE but normal good hygiene practices such as hand washing are sufficient. (See further infection control advice in Appendix 2 HPS guidance).
General interventions may include ensuring that the client’s home remains clean with good ventilation whenever safe and appropriate.