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Coronavirus advice for unpaid carers and latest information from the Scottish Government

Monday 16th March 2020

The Carers Policy Unit at the Scottish Government have asked us to share the information below with you. It relates to Coronavirus advice for carers and information from the Scottish Government on measures now in place since we have moved from the containment phase to the delay phase.

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Coronavirus advice for unpaid carers

Anyone providing regular support to a vulnerable friend or relative will want to do what they can to protect their own health and that of those they look after during the coronavirus outbreak.

Like everyone, unpaid carers (including young carers) and people being cared for should familiarise themselves with the public health advice on how to protect themselves from infection. As the situation is changing quickly, the guidance may also change, so carers should therefore check regularly to make sure they are following the latest guidance at:

Carers who do not already have an emergency plan in place may also want to talk with family and friends about who could take over their caring role if they become ill or need to self-isolate – particularly while social work services are under additional pressure during the coronavirus outbreak. It will also be important to make sure you have key information about the person you care for easily available - so that anyone taking over care has all the information they need.

Where carers and family and friends are unable to provide essential care for someone, they should contact their local social work department. Contact details here:

See NHS 24 for advice on coronavirus symptoms; precautions to take; and what to do if you think you may have become ill with coronavirus - www.nhs24.scot

As you will be very much aware, issues relating to the response to the Covid-19 outbreak continue to move at a very fast pace, but at all times guided by expert scientific advice.

Update on Moving to the Delay Stage

This note gives an update on the very latest factual position and provides links to three video clips from Thursday in case you did not see the specific events live - The Cab Sec for Health's Urgent Statement to the Scottish Parliament; The First Minister's post-COBR media conference (with Scottish CMO and Cab Sec Health); and the PM's post-COBR news conference with UKG CMO Prof Chris Whitty and Chief Scientific Adviser Sir Patrick Vallance (all links at the bottom of this note - also links to two news releases issued by SG Thursday).

The three events marked the COBR 4 Nations meeting’s agreement to move from the Contain Phase to the Delay Phase, with a view to delaying the peak by a few weeks and reducing the severity of the peak by stretching it out over a longer period of time. Across the UK it was also agreed to recommend the cancellation of overseas school trips.

In Scotland, the FM also announced that the SG was advising cancellation of all mass gathering events expected to attract attendances of 500+ that require public service or voluntary sector (police, ambulance service, Local Govt, Red Cross etc) support to plan and deliver. This is not being introduced primarily as a health protection measure but as a way of ensuring resilience for front line services as we move into a more intense period where illness absence will stretch their resources. Detailed advice on mass gatherings is being prepared and will be made available before Monday. UKG and other DAs are reviewing their approach.

The key headline information from CMOs, CSA and Governments is:

Current UK RWCS suggests that 80% of population may develop Coronavirus (Infection Attack Rate - The proportion of the population infected over the duration of epidemic). Prof Whitty said that this is very much an estimate and not a prediction. Not all of those who are infected will experience symptoms and the vast majority of cases will be mild disease.

The UKG CMO and CSA say they are more confident of an Infection Fatality Rate of 1% of all infections (of those who show clinical symptoms). This will not be evenly split across the population. Very low %age distribution across children and under 50s; much higher %age distribution in over 70s. This is the reason for Social Distancing measures that will be introduced in the coming weeks for the elderly and those with underlying medical conditions.

Measures brought in from Friday, March 13 ask all those showing even mild symptoms - new persistent cough or fever/temp - to self-isolate for 7 days. No need to call GP or NHS24 unless symptoms significantly worsen or if individual has underlying conditions. Mild illness can be expected to last 4-5 days and should clear thereafter, hence the 7 days isolation then return to normal.

This is intended to delay wider population onset, reduce peak and push it back for a few weeks. It also helps avoid infectious people being in contact with elderly or vulnerable. This will also be the reason to introduce whole household isolation - likely in next few weeks - where one person showing symptoms will result in whole household isolating for a set period.

Each measure could reduce peak by 20-25% (so cumulative effect is up to 50%).

Other measures aimed at reducing serious illness and death amongst the most at risk groups (elderly and those with certain underlying conditions) are also being planned but the most effective time for introduction has not yet been reached. The CSA said that effective introduction of Social Distancing measures such as home isolation or reduced social contact measures – both of which would likely be for three to four months - for these vulnerable groups could reduce deaths by 20-30%.

It is currently forecast by CSA that the UK is approx. 4 weeks behind the epidemiological curve for Italy, and also behind other nations like Germany and France. But we remain on the same curve.

It is estimated that we will reach our peak in the UK in 10-14 weeks or perhaps a bit later. But big rises in cases and impacts can be expected in 4-6 weeks time.

Although 590 cases across the UK have been identified through testing, scientific evidence suggests that the true figure today is probably 5,000-10,000 cases (the vast majority will be mild or no symptoms).

Advice remains that schools should not face a blanket closure – to do so might do more harm than good. If advice does change, to be effective schools would need to close for months not weeks. The advice will be regularly reviewed.

Significant work taking place across NHS to manage the challenges ahead. Cab Sec Health to make parliamentary statement on Tuesday with details of the NHS plans.

Current guidance on staff absences for illness and caring reasons suggests a 21% absence rate nationally during peak weeks. This may vary for individual businesses. Average absence duration of absence may be 14 days. Most cases probably resolve 7 days after symptom start so average absence prediction may be lowered.