As the country re-opens…

Coming out of lockdown

The more we understand about risks the more we can look after ourselves and in doing so help protect those we come into contact with.

Until now we have had very hard and firm guidelines in the UK which have brought the R0 (R-naught = reproduction rate) of the COVID outbreak down to below one. This means on average every 100 people infected with COVID 19 will pass it on to fewer than 100 people. If we could maintain R0 below one the coronavirus will shrink out of existence within a few months.

If you want to find out more about R0 we can suggest two options:

  • the Australian Academy of Science explain about it to show why physical distancing works, click here.
  • the Maths Magazine have an article which explains about the interplay between R0 and herd immunity, though it is for those who are more comfortable with equations, click here.

Physical distancing

Information to help you stay safe in public

However, it is impractical to keep a country in permanently in lockdown and physically distanced. The firm rules we had are becoming more fluid as people are encouraged back to work and more social contact is permitted. We have been asked to use our common sense and, in order to do that, we should try and get an understanding of the risks in different situations and how to avoid them. The 2 metre rule may be impossible to maintain, but there are times when that is OK, times when it is not and times when even being on the other side of s big room might not be safe.

We have found a really informative breakdown which explains the science of how to catch a virus and more importantly how to avoid catching a virus.

  • How safe is it to pass someone in the street closer than 2 metres?
  • How safe is it to sit on the other side of a large office to other people? (it depends on the air conditioning!)
  • Is risk affected by the type of activity people are doing?

The brilliant Erin Bromage is a Comparative Immunologist and Professor of Biology (specializing in Immunology) at the University of Massachusetts Dartmouth. That means he knows his stuff. And like the cleverest of people has a way of explaining it which makes it digestible to those of us who are new to it. He uses some American numbers but the basic behaviour of the coronavirus is the same the world over so the information stands.

If you want to get a better understanding of how to manage the risks, click here and read his explanation.

Staying safe when isolated

If your behaviour means you spend significant amounts of time by yourself please do consider getting and personal alarm system of some sort. We happen to think ours is pretty great, so please do have a look at the Assure.

 

So far the struggle against COVID-19 we have heard about has concentrated on avoidance. Social isolation and social distancing have slowed the transmission of the virus but it is clear that this cannot continue indefinitely. A vaccine will take at least another 15 months and possibly 3-5 years to be widely available.

There has also been work going on about how we can best treat COVID-19 so that those people who do get ill with it can have the best chance of survival and full recovery.

Until now there are no drugs of proven value against COVID-19. Some drugs that might help but only small-scale trials have taken place throughout the world. Whilst the findings may be promising they are not statistically sound enough to base roll out of treatment into the general population.

The National Health Service (NHS) is going to run a large randomised evaluation of a variety of potential pharmaceutical treatments to see which have beneficial effects.

Data from the trial will be regularly reviewed so that any effective treatment can be identified quickly made widely available.

The trial has been named RECOVERY

The RECOVERY Trial will begin by testing some of these suggested treatments:

  • Lopinavir-Ritonavir (commonly used to treat HIV)
  • Low-dose Dexamethasone (a type of steroid, which is used in a range of conditions typically to reduce inflammation).
  • Hydroxychloroquine (related to an anti-malarial drug)
  • Azithromycin (a commonly used antibiotic)

All of these drugs have been used for many years and are expected to have minimal side effects.

To find out more about the trials visit: https://www.recoverytrial.net/

 

If not now, when?

The Coronavirus crisis has brought to a head how interconnected we are. No man is an island and we all rely on a system of interconnections to provide our comfort and wellbeing.

Some of the ways we had of looking out for loved ones are being tested by self-isolation. Perhaps now is the time to explore how you can make sure loved ones can get help when they need it.

The hierarchy of needs

In 1943 Abraham Maslow codified the Hierarchy of needs. We in the developed world have long taken the lower levels for granted. Generally, we are able to enjoy shelter, clean air, clean water and food, if not by our own effort then through the safety net of state provision. The state also legislates and polices our safety and we have been lucky enough that we could focus on nurturing our sense of connection to others and also to our community and how we can become who we want to be (even if that is only to watch box sets).


Sars-CoV-2, the virus that leads to COVID-19 brings us back down the pyramid. We have to consider how we will get our physiological needs served. Those of us in homes have shelter, clothing air and water, but even then getting food (and toilet paper) has become a bit more challenging.

Considering our Safety Needs

Shielding ourselves from the coronavirus does not eliminate the other dangers that we face. People will still fall and all the ‘normal’ illnesses still exist. Some experts consider that having to change our normal routines exposes us to more danger. Reconstructive surgeons are reporting a spike in accidents where people are undertaking at home tasks they might normally have someone do for them, such as gardening and DIY.

Now more than ever it is important to make sure those living alone have an effective system of getting help if and when they need it.

Choosing the right protection

We all like to think that if needed we will get a telephone call from them but if someone is short of breath, in sudden pain, has fallen or even become immobile getting to the phone becomes impossible. Whilst we think the Assure (our solution) will suit many with its easy to wear wristband that is designed to be worn all the time and an array of triggers for comprehensive protection for all of these eventualities, we recognise that there is no one-size fits all when it comes to finding the best personal alarm for the elderly and vulnerable.

We developed a Guide to choosing the right protection for your needs and it is available to download here.

What has become more important with COVID-19 is whether you can get a system active as quickly, safely and simply as possible.

The Assure is simple to set up for yourself or on behalf of someone else. If you don’t want to do it yourself, we can preconfigure it before it is shipped so that it just needs connecting in the house – and we can talk you through that too. Click here to tailor a system to suit your needs and see how much it will cost.
If you’d like to make use us helping to set-up the service please phone us on 0345 25 75 080 as we will need to take the names and phone numbers of the wearer and a couple of responders as well as at least one email address.

 

Once you have done as much as you reasonably can to keep loved ones safe you might want to explore

Ideas for using technology to keep in touch

This article has several ideas for how to keep connected using internet technology. You will probably be aware of a lot of them but one or two might be new.
https://www.acticheck.com/making-the-most-of-social-distancing-and-social-isolation/

 

elderly woman washing hands

What is Self Isolation?

To follow Government guidelines on Coronavirus and public health, everyone within the UK has been asked to stay indoors. But what is self isolation exactly? This article will discuss the details of self isolation along with how best to stay safe throughout the ongoing situation across the country. We will also discuss who is most at risk from Covid-19 along with the importance of social distancing even whilst self-isolating.

What are the government’s guidelines for self-isolating?

At the time of writing, the Government’s Covid-19 Action Plan, is at a stage that has widely been called a lockdown. What this means, is that leaving the house should be strictly for essentials and exercise. Fundamentally, this is limited to minimal journeys for food or medicine along with exercise in your local area. For those that are unable to work from home, lockdown also allows for journeys to and from work. Where possible, journeys for food and medicine should be avoided. Many supermarkets are offering improved delivery services to accommodate demand and pharmacies across the country are delivering prescriptions.

The lockdown is being enforced across the country to reduce all non-essential contact and curb the spread of the virus. That is why the Government has also advised social distancing, meaning that whenever you do need to leave the house or have necessary visitors you stay at least 2m away from them With the virus having an an incubation period of up to 11 days and some people only showing very mild symptoms when they do get it, it is possible that someone that does not look ill could pass it on.

While much is unknown still about the virus, there have been some consistencies amongst those most affected by Covid-19. So far, it is those over the age of 60 that have been most at risk of developing severe symptoms. Here’s some underlying health conditions that can exacerbate the illness.

  • Breathing problems – those with asthma, bronchitis, lung cancer or any other respiratory issues must be particularly careful as Covid-19 affects the lungs.
  • Diabetes – those with both type 1 and type 2 diabetes are at higher risk.
  • Hypertension – high blood pressure  is a risk for anyone developing Coronavirus, particularly those that have had organ transplants.

How to stay safe while self isolating

For those that are particularly vulnerable, self isolation can be particularly daunting. It’s hard enough when you lose lose social visits. Keeping healthy is hard wile mobility is limited and you’re staying inside. It is important that self isolating is done as safely as possible to protect your physical and mental wellbeing. Here are some of the key ways to minimise the risk that might result from self isolating for older people:

Care Visits and Prescriptions

For those that require a carer, it is still important to practice social distancing wherever possible and keep contact to a minimum. Similarly, carers should be taking all hygiene precautions, such as using sanitised gloves and face masks where possible. Should a carer show any symptoms of the illness, such as a dry cough or fever, is is worth requesting a different carer to visit in their place.

Many pharmacies across the country can arrange to have your prescription delivered. It is worth finding out if they provide non-contact delivery services to a person who is at risk. Pharmacies across the country are developing these non-contact delivery services to assist those most at risk.

Personal Safety

With many elderly people living alone in the UK, self isolation can be particularly isolating. For those with health or mobility problems it can also be dangerous. All of the ‘normal’ health threats remain as well as COVID-19. That’s why it is important to keep up regular communication. It’s vital to check in on those that are more vulnerable at this time. Keeping to a regular daily time for calls can help provide some peace of mind throughout the self isolation period.

The Assure personal alarm bracelet can also be used to monitor the safety of those that are more vulnerable. The wristband provided a combination of alert triggers to provide comprehensive protection.

If the wearer gets short of breath or experiences pain a squeeze of the band will call for help; it can also monitor for severe falls. Te I’m OK checks are the simplest way for the wearer to confirm they are OK periodically throughout the day.

Get in touch

If you have any questions about self isolation or would like know more about the Assure personal monitoring system, please get in touch. Simply call us on 0345 25 75 080 or email us and one of our helpful team will get back to you as soon as possible.

Woman gardening wearing emergency alarm wristband for elderly and disabled

Making the most of Social Distancing and Social Isolation can seem like hard work. We know we have some tough times ahead but we need to look for the silver linings in the clouds and make the best of a bad lot.

Making sure we are aware of what these words mean is important, and actually they refer to physical distancing and isolation.

50 years ago, being physically distant automatically meant someone was socially distant too. A lucky few would have access to a phone and could dial a friend and have a one to one chat, probably sitting by a telephone table in their hallway. That you are reading this online is a testament to how far things have come. Physical isolation does not mean social isolation and may even offer opportunities to reconnect with old friends electronically who we have lost touch with.

What we know about COVID-19 is that it is highly infectious and that it tends to have relatively mild effects in people below the age of 50 who have no existing medical complications, but as the age and medical history increase so does the death rate.

Though nobody can truly be said not to be at any risk, we must all take sensible precautions to try and give the more vulnerable among us the best chance of not being struck down.

This is where ‘social distancing’ and ‘social isolation’ come into play.

Senior Man Doing Crossword Puzzle In Garden

What is Social Isolation

Social Isolation is trying to stop all but the most essential contact. You might have heard of it as Quarantine. At the moment this is self-imposed by households where someone has symptoms or where they have recently returned from a notified area. Those in isolation should not venture outside unless they have to. They should try and have any shopping delivered to their doorstep. There are health benefits to going outside and health secretary, Matt Hancock, has said ‘People should go outside. Yes, walk your pets, but, if you’re in household isolation, do go outside but try to avoid other people.’

‘Lockdown’ is a more aggressive version of Social Isolation where it is enforced by the police or army. We are not there yet (19 March 2020), and hopefully this can be avoided.

What is Social Distancing

Social Distancing is the current instruction. This is a softer version of social isolation where non-essential work is still happening with people travelling to and from work, public transport is still available to all, though we are advised not to use it and it is OK to walk with friends in the open air as long as we keep a sensible distance and keep washing our hands. We are also advised to keep going to the shops but to keep our distance from other shoppers.

However, both of these scenarios involve us being in direct contact with people less and being physically isolated more.

Physical isolation could mean social isolation and before technology was so widely used probably would have done. However, there is so much we can now do to combat that sense of social isolation to minimise the problem, and could even offer a few opportunities, perfect for making the most of social distancing and social isolation.

Making the Most of Social Distancing and Social Isolation
Old technology

If you live in a small community, and are able to, why not start a telephone tree. This needs someone to coordinate it and make sure a printed sheet goes through the door of anyone who is ‘off the radar’ asking them to give you some contact information to be used during distancing/isolation so that the community can be confident everyone is OK. Be explicit about the use and keep these records with sensitivity, but frankly there are bigger fish to fry than full compliance with General Data Protection Regulations at the moment.

Older people are often reluctant to ask for help until a problem turns into a crisis. It may take some convincing to get people to offer their telephone number as they think they will not be affected. Make sure everyone gets a call at least once a day – twice would be better – even if they are feeling fine. Have a few questions to make sure people are alright and have food and other essentials but if anyone is particularly vulnerable make sure you can give them some time so they are reminded there are people in their community who care and are there for them if they need it. Make sure there is a roster of people who can help by getting essential shopping; leaving the shopping on the doorstep does not risk infection.

Using people who are normally socially isolated can be great for the caller as well as the callee. We benefit from having a sense of purpose and the caller is connecting with more people than those receiving a call. Make sure that everyone gets called, including the callers, they might need help too.

Create a community store/resource. If someone needs a food parcel or some painkillers at 8pm on a Sunday night could you muster some up from people in the community or from a store rather than having to wait for the shops to open?

Making the Most of Social Distancing and Social Isolation
New technology

People having access to the internet can be a real boon if you can’t get out. Is there a neighbour who doesn’t have access that you could lend an old iPad to and show them how to do a few basic things. Is their house covered by a neighbours WIFI that they could borrow? If so, you can help them keep up to date with the latest news and be linked more to the village community.

There are lots of ways of using the internet to keep connected. You may already be aware of these but if not see if you can get connected to them and try them out. You are better to establish your use early rather than waiting until you need it.

WhatsApp

This is a fantastic way of keeping in touch with family & friends when making the most of social distancing and social isolation

As well as sending messages you can have phone calls and video chats with up to 16 people, but more usually just with one or two people. This medium lends itself to quite intimate conversations as well as general keeping in touch.

WhatsApp needs the user to have a mobile phone even if they use the desktop version. If you don’t yet have it is well worth getting as you can still see people face to face when you can’t see them in person.

Facebook

There are three main advantages of using Facebook
This is a big Social Media platform and has the following uses:

Keeping in touch with family, friends and acquaintances.

You connect with people you want to (and who agree to connect with you) and people share what is happening for them, what is of concern or often just things that have made them smile. You can respond to what people say and start conversations. Generally, the tone of the discussions are like you would have if you bumped into someone in a café or bar. You can get started by joining, finding a few people you know and putting in a friend request. You’ll then be able to get an idea by seeing what is going on before making your own post.
You can also send direct messages to individuals through a facility called ‘messenger’

Keeping in touch with what is going on in a location or interest group.

There are also community-based bulletin boards where information for the benefit of a particular group (geographic or interest) can be shared. Be careful about what you see on Facebook as people can inadvertently pass around false news and rumour, so anything factual or medical should be checked to see if you can find a reliable source saying it.

Online games

In the Facebook ‘explore’ menu there is a link to ‘Games’ if you choose a game to play you can invite specific friends, groups or anyone you know to play an online game with you.
So even if you can’t meet in person for Bridge Night, you can electronically. There are games of all sorts (strategy, action, quizzes) and for different numbers of players. You can use messenger to have a conversation while you play.

Video Conferencing

This lets you speak face to face to anything from 1 to 100s of people. If you don’t have WhatsApp or want to connect with people who aren’t on WhatsApp you can get a free video conferencing account.
Personally, I find www.whereby.com very easy to use as I give people a web address to visit. 4 people can meet in a free account which is often enough. www.zoom.us also have a free plan but this involves downloading and running a small programme which might put some off.

Some of the opportunities for video conferencing:

Coffee mornings

If you can’t meet in the café, you can continue to see each other. There are some advantages too, as you no longer need to spend time and effort getting to the meeting place you can meet more frequently, perhaps three or more times a week where you only used to meet once. You might even think of including people who have moved away as now distance is immaterial, this could be a chance to reacquaint yourself with old friends.

Watching TV together

This sounds odd but when making the most of social distancing and social isolation, provided you watch the same TV programme live, you can share the experience a bit like being in the room together. Whether is adds spice to quiz shows or makes comedy shows funnier (have you noticed that you don’t laugh in the same way when you watch a comedy by yourself?) or just adds a bit of company this is something worth trying out.

Singalongs

Without intending to hark back to the blitz spirit, many of us have seen how the singing from balconies by those isolated in Milan has been uplifting. As video conferencing can have hundreds of participants there are singalongs organised in some communities. You don’t need to be good at singing but can join in for the craic.

Music/Poetry groups

See if you can keep doing those things that give you joy.

Getting help in an emergency

Some people have been waking up finding it is difficult to breathe. Think about how you would get help in such a situation. Telephone trees would be good but might take some time to for people to realise you need help.

Please consider a getting a device like the Assure to make sure that if you are isolated and have any need (non COVID related incidents will continue to happen) you can get help.

We didn’t design the Assure specifically for pandemics but for anyone when spends time alone and could need help, programming an I’m OK check every few hours is such a simple way to confirm you don’t need help and along with its SOS buttons and fall monitor it could be ideal for getting through isolation with peace of mind that if the worst does occur you can easily get help.

Learning remotely

How many people have said ‘I’d love to learn about x, y, or z, if only I had time’.
If you find you have lots of time on your hands there are loads of online courses. There are a few things you can’t learn online, swimming for example, but there are lots of things you can learn, or at least learn the theory side of before getting the practice in once freedom of movement is back.

Futurelearn is a great place to look as it aggregates courses run mainly by UK universities. Access to the course learning is free. Find out more at www.futurelearn.com

If you’d like to get to grips with a language there is a page full of advice at www.bbc.co.uk/languages/learn/

Keeping fit

Getting out is normally a key part of keeping up levels of exercise, if you are stuck indoors it is still important to maintain fitness as best you can. The NHS have some online classes for you to follow where you get to choose the type of exercise that is right for you. 

Visit www.nhs.uk/conditions/nhs-fitness-studio/ to find out more.

IMPORTANT:

Most of us are grateful for those in our community who are keeping essential services going. Working in health or social care at the moment is difficult as is trying to keep shops functioning and a myriad of other services that will help us to get through this crisis. When you see someone who is working under pressure, if you are grateful, let them know it.

 

Coronavirus

Understanding COVID-19

Bringing information together from various sources to understand more about COVID-19, why we should be concerned, how to avoid it and what to do if you think you have it.

Why Coronavirus COVID-19 is different from flu

Transmission methods

Flu

Transmission period

According to the US Center for Disease Control & Prevention (CDC), the prime time for transmission for flu is in the first 3 to 4 days of illness though it is possible to spread it a day before the illness becomes evident and up to 7 days after it starts.

Transmission methods

It is transmitted by respiratory droplets – from coughs, sneezes or normal speech landing in the mouths or noses of people nearby.
It can also be transmitted by contact with a surface that has such droplets on it. Contact with the skin is not enough and the recipient would then need to touch their mouth, nose or eyes.
Combined this means that Flu is reasonably difficult to catch provided the following sensible precautions are taken:

  • don’t visit someone who is displaying symptoms unless it is necessary
  • always wash your hands before touching your face and eating
  • encourage others to cough into the crook of their elbow, where any germs are less likely to be passed on.

COVID-19

Representation of Covid-19

Transmission period

Is transmittable for up to two weeks before the person is showing signs of the disease as well as when there are symptoms. Some people are atypical meaning they will never develop symptoms but will be carrying and transmitting COVID-19.

Transmission methods

It is acknowledged that COVID-19 can be transmitted by respiratory droplets. Evidence is also emerging, unusually for the family of viruses known coronaviruses, that it might be possible to transmit through the following methods, as well:

  • Fomites – surfaces on which the virus can survive, such as furniture, sheets, tools and clothes. The latest NHS advice is that ‘Viruses like coronavirus cannot live outside the body for very long.’ However, studies have demonstrated similar viruses surviving for up to 9 days. Thankfully they are easily killed with disinfectant. This has a low risk of infection. (click here for report)
  • Fecal-Oral: essentially touching something that has been touched by someone who has not washed their hand properly, for instance on a toilet door handle and eating. Though this is a new method of transmission for a coronavirus the Wuhan Institute of Virology has found the virus in oral swabs, anal swabs, and blood. (click here for report)
  • Airborne (aerosol), which does not need immediate or recent proximity to an infected person. Though it has a lower risk of infection, if this is true, visiting someone infected at home would carry a risk even if you did not touch anything.
    This has a low chance of contagion but has been noted in China’s clinical guidelines since late last month. (click here for report)

Contagion

The variety of ways that COVID-19 can be spread along with a substantial period when someone can be inadvertently spreading it makes the virus highly contagious. Though we are still learning about the virus, Marc Lipsitch, a Harvard epidemiologist, estimates that within the coming year 40-70% of people will be infected with the virus.

Direct effects of COVID-19

After infection, some people will remain atypical and not show any sign of infection. This is known as some countries have mass screened citizens rather than just those suspected of having the virus.

Early-stage symptoms are fever, cough and shortness of breath. There are many causes of such symptoms and few of us have got through life without experiencing this combination of symptoms, so if they occur follow the latest NHS advice but don’t panic.

With COVID-19 this can persist and develop into pneumonia meaning 20% of those infected will need hospitalisation.

Approximately 25% of those will need intensive care for respiratory support.

Ultimately there are two outcomes from contracting COVID-19, recovery or death.

Mortality rates are very difficult to ascertain as treatment methods improve. It appears that overall mortality is 1-2% but this is hugely skewed towards the older population. Figures released on 29th Feb show no deaths below the age of 9 years, less than 0.5% to the age of 50 and then rising to 14.8% among over 80’s. This is unusually skewed as most viruses have higher mortality rates among both the young and the old.

Flu has 5-7 times the mortality rate in an 85-year-old compared to a 50-year-old whilst COVID-19 is more like 30 times as lethal.
As there are roughly 2.8m people over the age of 80 living in the U, if 40% of them contract COVID-19 that is approx. 1.1m people and could lead to 150,000+ deaths due to the virus, in this age group alone.

To put this in perspective, the report Surveillance of influenza and other respiratory viruses in the UK Winter 2018 to 2019 – Public Health England expects annual deaths due to flu, for all age groups, are generally between 6,000 and 15,000.

Wider effect on Society – side effects

The Government is planning for many possible effects and though they have not yet implemented any changes in behaviour and are encouraging people to carry on as normal, it is highly likely that instructions will have to be issued in the coming days and weeks which mean it will no longer be ‘business as usual’.

Schools may have to close and young children will need to be looked after and parents given time off work to do that so many other areas of life might become short-staffed. The NHS will have a huge burden placed on an already busy service, as potentially thousands of people need intensive care, and may not be able to respond as it normally would to other medical needs.

Bearing in mind the infectiousness of COVID-19 it is not just about treating patients but treating them in isolation to minimise cross-infection. This is a heavy burden and other NHS services that are normally available could suffer as a result.

If interaction with other people is kept to a minimum that will impact the ability of stores to restock and may have knock-on effects into whether interaction that is considered non-essential can continue.

There is a chance that many people will be asked to self-isolate either as they are showing symptoms of COVID-19 or as a quarantine measure as in China. All sorts of services which we expect to be available could be short-staffed and unable to operate as normal.

What can we all do about it

PREVENT

Contact

If you don’t come into contact with the virus you cannot contract the disease. However, as the virus is highly transmittable this is difficult to achieve. You might try to lessen opportunities for infection though.

  • You might like to consider what activities are necessary for you – including those that are needed to keep your spirits up.
  • Walking, alone or with friends, is relatively risk-free and could be a better option than meeting up for a coffee where there are more communal surfaces and items the virus could be transmitted on.
  • Try not to touch anything outside of your control, e.g. let the person hold the photo and show you rather than passing it around.
  • If you have to take things to someone in quarantine, try not to touch anything you haven’t brought. Use your mobile phone to say when you have arrived and get them to open the door rather than touching the door furniture. If you want to greet with physical contact would an ‘elbow bump’ work?
  • Keep some hand sanitiser with you so if there is contact you can wash it immediately.
  • If you are losing regular contact, consider how to make sure you don’t end up isolated in an emergency. Just because COVID-19 is active you will not be less likely to have any of the other illnesses or accidents that would need help. If you have the Assure you can get help easily, but if you don’t you might want to make sure you have methods in place to make sure you don’t end up languishing.

Full advice is available from the World Health Organisation, here.

Plan as if you were going into quarantine

If you do have to isolate yourself do you have what you need to remain comfortable for up to a fortnight? Think about what would happen if the person who normally looks out for you was also in quarantine and unable to visit.

This includes thinking about:

  • Enough canned and dry goods to get you through.
  • Consider what you might use in your bathroom in a fortnight.
  • Think about your pet’s needs.
  • Always having a fortnight’s store of essential medicine (ask your doctor).
  • Entertainment – if you are a very social person how are you going to fend off cabin fever?
  • Letting people know you are OK. If visits become difficult or impossible phone calls can help and the Assure’s I’m OK function is a great way to confirm you are OK periodically throughout the day, you choose the times for the wristband to vibrate and just press a single button to confirm you are OK.

Hygiene

This is general advice but you might be particularly vigilant whilst COVID-19 is active:

  • don’t visit someone who is displaying symptoms unless it is necessary.
  • always wash your hands or use hand sanitiser before touching your face and eating.
  • encourage others to cough into the crook of their elbow, where any germs are less likely to be passed on.
  • mobile phones harbour germs and avoiding contact with your face can help, though it might feel odd speaking on handsfree this could help. You could even turn a phone call into a video call and improve the experience.

If you think you might have COVID-19

Get the latest advice from the NHS.
This is available by calling 111 on your phone or by visiting https://111.nhs.uk/covid-19

DO NOT visit your GP
GP’s surgeries have many medically vulnerable people visiting them and we all have a responsibility not to behave in a way which is likely to spread COVID-19 or any other virus.

Living in isolation

If you are in quarantine it may be that you have tested for COVID-19 or that you are at risk from it. Either way, the following advice stands.

DO NOT take antibiotics for COVID-19
Many of us have spare antibiotics in our homes, perhaps from old prescriptions. Whilst antibiotics can be very effective against bacterial infection, they have no benefits in treating viruses. Use of antibiotics when you don’t need them may lessen their effectiveness when you do need them.

Eat and drink well
Make sure any food you have is sustaining. Though it is a cliché, chicken soup does seem to have curative properties (see New York Times article). Make sure you remain hydrated.

Exercise and sleep
Don’t be a couch potato. Whilst you don’t have to go as far as one person in China who ran a double marathon in laps of his living room, it is worth making sure you compensate for the lack of outdoors activity. Perhaps look for an exercise programme online (perhaps on youtube) or crack out the Jane Fonda DVDs.

Sleep is also important as this is when your body has a chance to recharge and continue its fight to recover.

Looking after each other

Please look out for others in your community who may be self-isolating. You are probably already aware of your family situation but look out for neighbours. There may be some shopping they need, and leaving shopping by their front door does not break their isolation.

Bear in mind that in ‘normal’ times there are many illnesses/mishaps that can befall a person, so just checking they are OK is valuable. You could do this by knocking on their door, phoning them or – if you have an Assure system – checking on their dashboard.

Informative links

CDC latest information: click here

Johns Hopkins University interactive map showing the latest stats: click here

Informative article with loads of references: click here

BrewMonday

Brew Monday

This is an idea about how we can combat Blue Monday. Today is officially meant to be the most depressing day of the year (at least things can only get better). The Christmas decorations are down, the days are still short and it is a long time until the next significant break for many of us.

London Underground notice board poem about Brew Monday

Just to compound matters we have just started a cold snap. The forecaster’s advice is to check on older or vulnerable people and make sure they are OK.

There is an increased risk of stroke in the cold. Bear in mind that, even if the person is wearing extra jumpers, if the air they breathe is consistently below 18 degrees C they will become more susceptible to respiratory infections. If someone has a broken heating system this is when it might become apparent. With an Assure system you can look online to make sure that the home is warm and even set a minimum temperature so that if the person is at home and the temperature drops below this minimum you will get a message to let you know – we call it the ‘cold at home’ alert.

Many in our communities have fading eyesight as they age making them less confident about going out at night and the long dark evenings can leave them feeling isolated.

Brew Monday

So far Blue Monday doesn’t sound like a bundle of laughs, but ‘Brew Monday’ does its best to ‘turn that frown upside down’. If you were passing through some London Underground stations you might have seen this poem on a notice board.

Instead of feeling blue, connect with someone. Ask a neighbour over, put the kettle on, brew some tea and have a chat. It doesn’t need to be over anything important. If you don’t know what their favourite pasta shape is that could be a starting point. If they are uncomfortable coming out at night, take some cake around and ask if you can share it.

As the poem suggests, it doesn’t need to be at home (is there someone who might appreciate a trip to a pub for a different kind of brew?) and it doesn’t have to be today – but today is as good a day as any!

It is important in the colder weather and long nights that those of us who can look out, for those who need it.

As the Zulu idea of Ubuntu proposes, we are defined by how we relate to those around us (they say ‘I am because we are’). So let’s put in a bit of effort to connect – over a brew.

To find out more have a look at the Samaritans information page.

 

Age Apartheid

Age Apartheid

A new report by ‘United for all ages’ (https://www.unitedforallages.com/) highlights that the UK is one of the most age segregated countries in the world. Intergenerational living, either in the same house or local area, was not unusual. Close proximity could mean seeing elderly relatives several times a week.  In recent times this has become rarer resulting in more older people reporting feeling lonely and generally excluded from their community.

Teenage Boy Helping Senior Woman with Shopping

There are benefits being missed by the younger people too. Being able to pop home for a meal and a chat or having someone who might have the time to wait in for a delivery when you can’t. How many of us enjoyed spending times with grandparents when we were very young? and how helpful was that for our parents.

One of the reasons for this drift (the young to the cities) is that working aged people often find employment in the large urban centres, resulting in them both living and socialising there. They may also prefer the social life afforded by a city. On the other hand, retired people can find a lifestyle they prefer away from the city. They might also find that by swapping their city property for a country one they have more money in their pocket to enjoy.

These tendencies to have been around for some time but have got greater over the last decade as service industries based in offices have dominated employment compared to manufacturing based in factories which were more geographically spread.

What can be done

No doubt there are structural issues in society which could be addressed. With better transport infrastructure more people could stay where they grew up and commute. Even in areas like London, which have good transport coverage, there is difficulty coping with demand. Roads are highly congested and public transport very crowded. Other parts of the country are lacking public transport. Better public transport would enable some workers to live further from their workplace and closer to their family.

What you can do

In the meantime, we have the benefits of the internet age to help keep us in touch. Skype and WhatsApp both enable video calling on a laptop or smartphone. If someone you’d like to feel more connected with doesn’t yet have any IT then Portal from Facebook might be worth exploring.

The point of the report is not be fatalistic but to highlight the sorts of things we can do to improve intergenerational integration. Though families may be dispersed there are still ways of encouraging mixing between the generations with our localities.

Some interesting ideas include:

Our own experience at Acticheck is that there is a massive amount of neighbourliness and people are generally happy to look out for and after each other.

If you’d like to see our communities more linked across the generation do consider signing up for the United for all ages network (www.unitedforallages.com/join-us). This will keep you in touch with what is going on and offer support with local projects.

 

Artificial intelligence

Using Artificial intelligence in triage

Artificial Intelligence (AI) is an automated way of processing information. In this case, a computer system has been taught about medical conditions their symptoms. It asks questions to narrow down the possible causes and decide the priority the medics should give to it.

Human machine analysis

If you speak to someone on NHS 111 they will be using AI to take your answers and to ask the next question, until the system makes a recommendation. You can also do this yourself online at www.111.nhs.uk whenever you feel worried about a condition.

The at-home service will become even easier as the NHS has entered an agreement with Amazon so their Alexa platform will be able to answer your health queries. You will get advice just by talking to Alexa. (read more on this here)

There is some debate about how much Alexa should guide an individual’s health. Should it listen for indicators of suicidal thoughts (more here); and what does that do for individual privacy. Even the most ardent protector of personal privacy might soften if someone they loved was saved by an intervention because of ‘listening in’.

Some hospitals, such as Birmingham University Hospitals, are encouraging patients to undertake a two minute “artificial intelligence triage” before they consider attending hospital. This could instead direct people to their pharmacist or possibly advise people to call 999 for rapid assistance (read more here). Some hospitals have booths set up so when you first arrive you can enter your symptoms.

Spotting hidden urgent conditions

Many people have been surprised by the effectiveness of these AI systems.

A&E is often operating under pressure and humans naturally will go towards the obvious need. However, there are a number of conditions that don’t present dramatically but where speed of treatment is vital. For instance, strokes and sepsis are two conditions where early intervention can dramatically improve the outcome and where delay can cause life changing outcomes or even death. You may have heard of the ‘golden hour’ for strokes but many patients may present with cuts & bruises after a fall and not realise they have had a stroke. Likewise Sepsis (www.sepsistrust.org ), which kills 52,000 people a year, often presents as a general lethargy and occasionally people can be sent home to rest when they desperately need medical assistance.

With the pressures on A&E departments, many are missing their targets to see patients within 4 hours, when for some patients being seen immediately is paramount. Having pods where patients go upon arrival to fill in an electronic questionnaire may seem impersonal but it is a very efficient way of getting the information, perhaps because the machine will not get side-tracked by chatting about the weather, last night’s football scores or ‘Strictly’.

Other than the speed of collecting the right information, the major advantage of AI is it has machine learning and can scour through millions of individual’s records for combinations of symptoms that match. By tracking the eventual, confirmed diagnoses of patients with matching symptoms there is a stronger idea of your diagnosis. This is particularly impressive when separating out symptoms that may be due to overlapping issues.

Evin if your pattern of responses to the questions has only been seen 5 times throughout Europe, AI will find them all in seconds and include their end diagnoses and prioritise you accordingly.

Once you are in the NHS system you will then be cared for by professionals (humans) but AI can help get you to the right starting place faster and more reliably.

Staying warm at home

Knowing how warm a house is saves lives

Even if you feel ‘warm enough’, if the air you breathe is less than 18C respiratory infections become likely. A major problem at this time of year is people not realising their home is too cold. The NHS give some useful advice (below) and Acticheck have a ‘Cold at home’ warning which can help.

A forest in winter.

NHS England ‘How to stay warm and well in winter gives the following advice:

  • if you’re not very mobile, are 65 or over, or have a health condition, such as heart or lung disease, heat your home to at least 18C [optimal temperature is 21C]
  • keep your bedroom at 18C all night if you can – and keep the bedroom window closed
  • use a hot water bottle or electric blanket to keep warm in bed – but do not use both at the same time
  • have at least 1 hot meal a day – eating regularly helps keep you warm
  • have hot drinks regularly
  • draw curtains at dusk and keep doors closed to block out draughts
  • get your heating system checked regularly by a qualified professional

Why monitor?

People don’t always realise when they are getting too cold and so the Acticheck ‘cold at home’ warning indicates when there might be a problem. It could be the thermostat needs adjusting or there is a problem with the boiler. If the wearer is at home and the temperature is too low their responders will get an email. In addition, by enabling the ‘frost monitor’, the wearer and all responders will receive a warning email if the temperature falls below 5C when the wearer is not at home.

How to make use of the Acticheck ‘Cold at home alert’

  1. Go to MY BASE and then look at the bottom right of the screen (see below),
  2. Turn the ‘Enable room temperature monitor’ on,
  3. Set your minimum temperature*,
  4. Set the time window to be monitored,
  5. Then press Save (top right).

Settings for Cold at home

*Bear in mind the base station reports on its ambient temperature and you may need to make adjustments if it is not representative of the general household level. You can see the general temperature trend on the chart in MY BASE.

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