Shielding during lockdown

What it’s like shielding during lockdown with asthma

Shielding letters went out to thousands of people last month. Urging anyone who is classed as vulnerable to stay at home for 12 weeks. My letter arrived a week after it was dated 10th April 2020 so that means I won’t be able to leave the house until June. I wanted to share my story of what it’s like to shield during a UK lockdown on World Asthma Day.

NHS letter for shielding

Important advice to keep you safe from Coronavirus

Your safety and the continued provision of the care and treatment you need is a priority for the NHS. This letter gives you advice on how to protect yourself and access the care and treatment you need.

The NHS has identified you, or the named person you care for, as someone at risk of a severe illness. if you catch Coronavirus (also known as COVID-19). This is because you have an underlying disease or health condition that means if you catch the virus, you are more likely to be admitted to hospital then others.

The safest course of action if for you to stay at home at all times and avoid all face-to-face contact for at least twelve weeks from today, except from carers and health care workers who you must see as part of your medical care. This will protect you by stopping you from coming into contact with the virus.

If you are in touch with friends, family or support network in your community who can support you to get food and medicine, follow the advice in this letter. If you do not have contacts who can help support you go to www.gov.uk/coronavirus-extremely-vulnerable or call 0800 0288327, the Government’s dedicated helpline.

If, at any point, you think you have developed symptoms of coronavirus, such as new, continuous cough and/or high temperature (above 37.8%), seek clinical advice using the NHS 111 online coronavirus service. If you do not have access to the internet, call NHS 11. Do this as soon as you get symptoms.

Why am I shielding?

I have brittle asthma, which means that I am exceptionally vulnerable to any respiratory illnesses. Not everyone with asthma has to shield. Everyone is different, but although mine is controlled with steroids, Ventolin and other forms of medication. I can still have a life-threatening asthma attack which requires immediate hospitalisation.

Brittle asthma is a rare form of severe asthma. The term “brittle” means difficult to control. Brittle asthma is also called unstable or unpredictable asthma because it can suddenly develop into a life-threatening attack.

Asthma UK

A great source of information is Asthma UK who have spent the whole of this period, updating their website and providing invaluable information about asthma during this pandemic.

Asthma care plan

If you have asthma. Use today as a way of checking your asthma. Make sure you have an action plan. I have an asthma bag for my everyday medication, such as Ventolin inhalers. In my medication box at home, I have a ‘spacer’ (which helps maximise our inhalation of Ventolin) and also a peak flow meter. I also have an emergency supply of steroids (prednisolone) should I become ill. I am under a hospital consultant for my asthma, but it’s important to keep up with your medication during this time, especially if you need to take inhaled steroids or prednisolone.

Who should be shielding?

The vulnerable currently include but are not limited to, those who:

• have a long-term health condition, for example, asthma, diabetes or heart disease, or a weakened immune system as the result of medicines such as steroid tablets or chemotherapy
• are pregnant
• are aged 70 or over
• care for someone with a health condition that might put them at a greater risk

There has been much dispute over whether people aged 70 or over should be under strict lockdown in recent weeks. I can only offer my advice to those who have asthma.

The NHS says that you would be considered at very high risk with Asthma if ALL THREE of these apply to you:

• You have asthma, AND
• You are taking certain extra controller medicines as well as a preventer inhaler (for example, you are taking Montelukast, salmeterol or formoterol, or you are on a combination inhaler like Seretide, Fostair, Symbicort, Flutiform, Fobumix, DuoResp Spiromax, Combisal, Sereflo, Sirdupla, Aloflute, AirFluSal, Relvar Ellipta, Fusacomb or Stalpex), AND
• You are taking continuous or frequent oral steroids.

When did I start shielding?

I started shielding a week before the lockdown was announced. If anything, the official lockdown was a relief for me. I couldn’t decide whether to go home to Bournemouth or stay in London, as I know the infection rate would be higher in London and I lived with several housemates. However, as I was about to start a new job. It made sense to lock myself in my bedroom, where I had set up a desk for my blogging. I guessed I would be looking at a 3-month period for having to safeguard myself. It was just a matter of time for everyone else.

How I have been managing the NHS advice

NHS Guidelines which accompanied my letter have been outlined below. I have abbreviated some of these for the purpose of this blog post. My comments are in italics below to highlight my commentary.

• Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19) &
• To not…
  • leave your home
  • attend any gatherings
  • go out for shopping, leisure or travel. When arranging food or medication deliveries these should be left at the door to minimise contact.

Living life in lockdown in a shared house

I live in a shared house with 6 other people. So, shielding is not easy. However, when we all started lockdown together, we all discussed that if anyone did get sick that we would notify the rest of the house. Two of my house members are also keyworkers.

I shared this letter with them all. Everyone has been so lovely, helping me get medication from the pharmacy and items of food when I run out. There is an unspoken rule that when I come through communal areas I can’t hang around and chat, which is strange still.

Keep in touch with people throughout this period

• Keep in touch using remote technology such as phone, internet, and social media.
• Use telephone or online services to contact your GP or other essential services.

I think this advice is so important. I know many people who are in lockdown by themselves. Connecting in a virtual world is a way of not feeling so isolated. Friends have been checking in on me and I have been checking in on them. Virtual quizzes, DJs, Comedy nights all are the new normal as we all adjust to staying at home. FaceTime, Zoom and Houseparty all replacing meetups and nights out.

• Regularly wash your hands with soap and water for 20 seconds. Ask careers or support workers who visit your home to do to the same.
• The rest of your household should support you to stay safe and stringently follow guidance on social distancing, reducing their contact outside the home.

• The rest of your household should support you to stay safe and stringently follow guidance on social distancing, reducing their contact outside the home. In your home, you should:
• Minimise the time you spend with others in shared spaces (kitchen, bathroom, and sitting areas) and keep shared spaces well ventilated
• Aim to keep 2 metres (3 steps) away from others and encourage them to sleep in a different bed where possible
• Use separate towels and, if possible, use a separate bathroom, from the rest of the household, or clean the bathroom after every use
• Avoid using the kitchen when others are present, take your meals back to your room to eat if possible, and ensure all kitchenware is cleaned thoroughly. If the rest of your household are able to follow this guidance, there is no need for them to take the full protective measures to keep you safe.

How to abide by the guidelines

I circulated these guidelines to my housemates when I received it, who have been really supportive. Most of my day is spent in my bedroom; working, sleeping and eating. I don’t eat my meals in communal areas. On a rare occasion, I watch TV in the lounge when no-one else is around. I am fortunate to live in a house with a lounge and dining room, as well as a garden. Although I have had to now start my heavy-duty anti-histamines with hayfever season starting and the windows open.

I don’t live with a partner, so the bed is all mine! I can’t imagine how couples manage this. Who is sleeping in the bed or sofa? Sharing a bathroom means that we clean it properly each week, and I am constantly cleaning taps and door handles. Obviously we have separate towels but it has been a great way of formalising a cleaning rota between us finally!

My landlord has been incredibly supportive. For this, I know that I am really lucky. Always keeping cleaning and toilet roll supplies up-to-date. Putting up signs on the door on how to self-isolate. Making sure we are all ok. Guidelines were circulated, including a reminder to wash our hands before emptying the dishwasher. He even bought anti-bacterial wipes to be kept by the front door for when we accept deliveries. We have a weekly rota enforced by the landlord so at least we know the house is being cleaned each week.

What to do if you need food

Register with the Government to tell them if you need support. You can also get support from the NHS volunteer responders or a local mutual aid network. I registered as a vulnerable person a number of weeks after the lockdown. Both the NHS and Croydon council rang me in the last couple of weeks to ask if I need any additional support. The NHS informed me that I could register to Tesco for priority slots, so I rang Tesco’s COVID-19 vulnerable hotline 0800 917 7359 to ask to be on the priority list. I am now able to order food.

Shielding and employment

Government advice is that employers must support vulnerable and at-risk workers to protect themselves. You can ask to be furloughed during this time, but the employer does not have to do this. If you are able to, work from home.

An employee or worker is protected by law against unfair treatment and dismissal with a health condition, which is considered a disability under the Equality Act. The shielding advice also applies to key workers. NHS Employers’ guidance can be found here.

My Top 3 Tips for lockdown with Asthma

1. KEEP YOUR LIVING SPACE CLEAN & TIDY

I am allergic to absolutely everything, which made growing up fun for my poor mother. We couldn’t have carpets in my bedroom, pets and I couldn’t even have a teddy bear as they collected dust. We had a plastic sheet as a covering for my mattress under my bedsheets, as I was allergic to bed mite. Thus began a lifetime of constantly minimising my interactions with anything I was allergic to began.

I keep a weekly routine where on a Saturday, I clean everything. Including using a wet cloth with an anti-bacterial spray to wipe away dust. I have minimal items in my bedroom and try to keep as much away from where I sleep. Keeping your bedroom clean and tidy also minimises anxiety, which will be quite high right now living under such strict lockdown guidelines.

2. MAKE SURE YOU KNOW YOUR CARE PLAN

Everyone with asthma should have a care plan in place with their doctor. It’s important to know what your daily medication should be, and dosage and what to do in an emergency. If not phone up your surgery and ask for one. You can still ring through and book a phone appointment with your Doctor.

3. SELF-CARE TAKES PRIORITY

Over the last six months, I have been prioritising self-care and my diet. You can’t keep well surviving on medication, but not looking after yourself. Upon my brother Denny’s advice, I downloaded the Cronometer app which then shows me what nutrients I am taking in through my diet and what I am missing. I have been adding vitamins to my diet under lockdown such as Vitamin C and D. Not only that, I have been drinking lots of water. I am trying to introduce healthier habits into my life under lockdown so that I build up my immune system for when we are out and about again.

Anxiety is also a high problem for many asthmatics. I know that having an asthma attack even now is an incredibly frightening experience. Tiredness may also be a problem. I have been looking at ways to keep my anxiety low as well as making sure that I try to get as much sleep as possible. Your mental health is also just as important as your physical health.