Mixing with people again (when allowed)

[Lmoss]

Wondering if anyone has some view/experience on when its safe to start to be around people again (once Covid allows). I am tapering on Pred and now down to 9mg - my consultant made it very clear that due to the autoimmune issues I need to "isolate", but am having some challenges with the hospital and GP trying to understand when it may be safe to be with people. Understand that no 2 people are the same, but wondering if there are any underpinning guidelines used too determine this. All my bloods and everything else are pretty much perfect, so no underlying illness issues. Thanks ...

[Constance13]

Going by government rules is a good start.

[Lmoss in reply to Constance13]

Thanks - I am absolutely doing that, was asking more for when the rules are (hopefully) relaxed.

[Coffeebeans]

Absolutely go by the government rules to start with since they should be first and foremost.

And nothing can be said to be safe' try to look in terms of risk.

I'm wary of meeting indoors even when able to and I go by the principle of anything outside is low risk therefore happy to meet people outdoors. If I was inside I would open windows and increase ventilation as much as possible. If indoors keep numbers to an absolute minimum. Consider wearing masks indoors.

Other than that take small steps as the restrictions relax. It's quite overwhelming when you've been shielding for a long time.

[MrsNails]

Were/are you ‘Shielded’ l have been as l’m on a Medium Dose of Pred, Methotrexate & have other underlying issues but even when the Rules were relaxed last Summer l remained very cautious & limited where l went to mainly Garden Centres plus a few trips to M&S

No one ‘knows’ exactly what’s safe, l kept to the Garden for meeting my family & gradually increased in confidence.

Have you had your Vaccination yet? I won’t consider changing my routine until 2weeks plus after my Second Vaccine as we keep saying ‘We’ve got this far, why risk it now?’.....

Everyone is different & ultimately we have to make our own minds up, sorry l can’t give you a more definitive answer.

Kind Regards

MrsN

[Lmoss in reply to MrsNails]

Hi - yes, currently shielding. My issue is knowing (when Covid allows) what to do and when.

[MrsNails in reply to Lmoss]

Have you had your 1st Vaccine yet? I’m sure we’ll be discussing this at length as we get nearer ‘The Day’ but you will have seen in your latest letter that Officially ‘Shielding’ finishes on 31st March & people have to Return to Work if they can’t Work from Home.....

But myself, personally nothing will change very much until 2weeks plus my second Vaccination.

I will however have my Son, DiL & Granddaughter to visit in the Garden, weather permitting from 31st March, Martin & Emma are both Working from Home & MissC is not at School or Nursery, so we are lucky from that point of view.....

MrsN

[Rugger in reply to Lmoss]

Extract from the Government letter received this week: "Until the social distancing rules are eased more widely, it is important that you continue to keep the number of social interactions that you have low and try to reduce the amount of time you spend in settings where you are unable to maintain social distancing."

By the way, if your bloods are "pretty much perfect" it means that the 9mg pred is doing its job of keeping on top of the inflammation caused by your underlying health issue.

Stay safe!

[Lmoss in reply to MrsNails]

Thanks for your reply. Had 1st Jab, second due week 3 April and currently shielding.

[Pixix in reply to Lmoss]

I’m curious...are you officially shielding & receiving ‘personal’ letters about shielding, yet you say the only medical issue you have is PMR & no other underlying conditions, please? Most people, I believe, who only have PMR are not on the official shielding list. Thanks.

[Lmoss in reply to Pixix]

Hi - underlying issue is GCA, being very well managed by Pred. The issue around shielding relates to the effect of the Pred (at least, so I am told).

[Pixix in reply to Lmoss]

Thanks! I was just interested as most people with either GCA or PMR alone, without other factors, have not been officially shielded, I don’t think. Many people have been voluntarily shielding, though, aware of the nature of Pred & what is does to your system! I think it depends on your age, vaccinations, where you live, if you still work & innumerable other items what each person does when the govt rules are relaxed! Also depends on family, too. I shall still continue to quarantine all incoming goods & be acting like shielding us still there, I think, until both of us have had second jab...plus 3 weeks....my weakness would be to go to a plant nursery...preferably an all outdoors one, & but some plants, rather than having to have them delivered as I’ve done for the past 14 months! Everybody will have a different goal of satisfaction, I think...but small steps! 9mg is much safer than 15, 20 or more mgs of Pred!

[PMRpro Ambassador]

Certainly NOT before a couple of weeks after the second shot of vaccine but even then you will need to take as many precautions as possible. Personally, I won't be mixing until the infection rates have gone down to VERY low levels.

Being on pred or other immunosuppressant drugs is likely to reduce the amount of response by your immune system to the vaccine. It isn't perfect even in young and healthy subjects, it is likely to be less for us and they are still collecting data on the effect in various sub-populations of patients. In addition, the development of the mutations is a very critical question - one may develop that escapes the immune response set up in response to the vaccine. If that happens, it puts things back considerably.

Getting the incidence rate down to a very low level is as important as having had the shot in the first place - higher infection rates of the mutations can still increase the cases and more cases means more opportunity for mutations to happen. Some of the mutations are leading to more infections because they are more infectious but patients have fewer or no symptoms so you don't know if they have it and are spreading it. One of the scariest things here where I live was that they have been doing mass testing of assymptomatic people using the quick tests which aren't as good as the PCR tests so miss cases - but they were finding more cases with them than they found testing symptomatic people. That meant hundreds of people in a relatively small region were going out and about not knowing they were shedding virus on anyone they got close to.

There is no definite answer - and unlikley to be one for a long time yet. And there is no guarantee that mutations won't lead to another spike later in the year. Vaccines aren't a magic answer, just part of it.

[Lmoss in reply to PMRpro]

Thank you - that's a very useful insight.

[Rosbud]

I’ve made the decision that until I’ve had my 2nd jab that I’ll stay as I am , only gong out for my daily walk and doing that , when I can see there are not many people about and sitting in the garden or my daughters garden ( she’s our bubble) , take care and don’t be pressured into doing anything that feels uncomfortable cx

[MrsNails in reply to Rosbud]

With you there Rose, l’m after some more new garden furniture 😘

[Constance13 in reply to MrsNails]

Try the internet!

[MrsNails in reply to Constance13]

I have already chosen it 😉 just waiting for the ‘right moment’ to mention it! 😂

[123-go in reply to MrsNails]

Hilarious 😂😂😂. Oh, those feminine wiles will get us everywhere!

[MrsNails in reply to 123-go]

If you play your cards right! 🤣

[123-go in reply to MrsNails]

I usually beat my husband in card games.

[bussell in reply to MrsNails]

Go ahead and order quickly! All the things I like are now not available until August. Something about 'early birds'......

[MrsNails in reply to bussell]

I know, quite a long waiting list.....

I have The Darling Granddaughter’s Birthday Party Card to play yet! 😉

[piglette]

Basically nobody knows the answer. If they did, things would be a lot clearer to everyone.

[Koalajane]

I will continue to wear my mask for as long as there are large cases of COVID. I am happy to carry on social distancing and will take as many steps as are necessary to keep safe. I have not been told to shield.

[Theziggy]

Some European countries are experiencing a "third Covid wave" - so don't be rushing to get our there again folks!

[Liby57]

Hi this is the guide sent to those shielding

Although clinically extremely vulnerable people will no longer be advised to shield, we still recommend that you take extra precautions to protect yourself while the virus is still spreading in our communities. The updated guidance provides practical steps that cover things like socialising, travel and going to work and school. These are not rules but advice, so you can choose whether you wish to follow them or not. You can find the full guidance at the end of this letter and at gov.uk/coronavirus.

In addition to this advice, you must continue to follow the regulations that are in place for everyone during the pandemic. This includes rules on mixing with people from other households.

Summary of advice that applies from 1 April 2021

Until the social distancing rules are eased more widely, it is important that you continue to keep the number of social interactions that you have low and try to reduce the amount of time you spend in settings where you are unable to maintain social distancing.

Everyone is advised to continue to work from home where possible, but if you cannot work from home you should now attend your workplace. Your employer is required to take steps to reduce the risk of exposure to COVID-19 in the workplace and should be able to explain to you the measures they have put in place to keep you safe at work.

The Coronavirus Job Retention Scheme (furlough) has been extended until 30 September as has the Self-Employment Income Support Scheme (SEISS). You may continue to be eligible throughout this period.

From 1 April you will no longer be eligible for Statutory Sick Pay (SSP) or Employment and Support Allowance (ESA) on the basis of being advised to shield.

Clinically extremely vulnerable pupils and students should return to their school or other educational settings.

COVID-19 vaccinations

If you are aged 16 or older, you should already have been offered your first dose of the vaccine. If you have not yet received your first dose, please contact your GP.

For children aged 12 to 15 years, vaccination may be appropriate for those with severe neuro-disabilities. This option should be discussed between parents/guardians and the child’s clinician or GP. For other children aged 15 and under, whilst further research is being done, vaccination is not yet recommended.

If you have received your first dose, you should still ensure you take up your second dose of the vaccine when it is offered to you. Having two doses should further increase your level of protection.

No vaccine is 100% effective and therefore even if you have had both doses, there is still no absolute guarantee that you will not become ill from COVID-19. Therefore, you should continue to take the extra precautions set out in this guidance to help protect yourself.

Ongoing advice for clinically extremely vulnerable people (1 April 2021)

Shielding advice is being paused nationally from 31 March. From 1 April you are no longer advised to shield, but you must continue to follow the rules in place for everyone under the current national restrictions.

The government has published ‘COVID-19 Response – Spring 2021’, which sets out the roadmap out of the current lockdown in England. This explains how restrictions will be eased over time. You can find these rules by searching for ‘roadmap’ on gov.uk/coronavirus.

You must continue to follow the national restrictions, which apply to everyone. We are also advising clinically extremely vulnerable people to continue to take extra precautions to protect themselves. You are advised to follow the practical steps described below to minimise your risk of exposure to the virus.

Socialising inside and outside the home

Continue to maintain social distancing, wash your hands regularly and avoid touching your face.

Continue to minimise the number of social interactions that you have. The fewer social interactions you have, the lower your risk of catching COVID-19.

When the rules allow you to meet with others from outside of your household, your risk of catching COVID-19 is lower if you meet them outdoors.

When you are allowed to meet others indoors, keep the area well ventilated with fresh air, for example by opening the window. Please see the COVID-19: ventilation of indoor spaces guidance for more information (gov.uk/government/publicati...

Try to reduce the amount of time you spend in settings where you are unable to maintain social distancing, or where other people’s activities may reduce the likelihood of individuals maintaining social distancing.

You can continue to form or maintain existing support bubbles (gov.uk/guidance/making-a-su... and childcare bubbles (gov.uk/guidance/making-a-ch....

You can find more information online about how to stop the spread of coronavirus (gov.uk/government/publicati....

Work

Everyone is currently advised to work from home where possible.

If you cannot work from home, you should go to work. Your employer is required to take steps to reduce the risk of exposure to COVID-19 in the workplace and should be able to explain to you the measures they have put in place to keep you safe at work. Some employers may introduce regular testing of employees as part of these measures. You may also want to consider how you get to and from work, for example, if it is possible to avoid using public transport during rush hour.

Separate Government guidance has been issued on how employers can make workplaces COVID-safe including how they can maintain social distancing and a system of risk management in your workplace (gov.uk/guidance/working-saf.... The Health and Safety Executive (HSE) has also published guidance on protecting vulnerable workers (hse.gov.uk/coronavirus/work..., including advice for employers and employees on how to talk about reducing risks in the workplace (hse.gov.uk/coronavirus/work....

If you need support to work at home or in the workplace you can apply for Access to Work (gov.uk/access-to-work). Access to Work may provide support for the disability-related extra costs of working that are beyond standard reasonable adjustments an employer must provide.

The Coronavirus Job Retention Scheme (furlough) has been extended until 30 September (gov.uk/government/collectio.... You may continue to be eligible throughout this period, even when shielding is paused, providing your employer agrees. The Self-Employment Income Support Scheme (SEISS) has also been extended until 30 September (gov.uk/government/publicati....

From 1 April you will no longer be eligible for Statutory Sick Pay (SSP) or Employment and Support Allowance (ESA) on the basis of being advised to shield. You may be eligible for SSP or ESA if you are sick or incapable of work, either due to coronavirus or other health reasons, subject to meeting the eligibility conditions. If you have concerns about your health and safety at work you can raise them with your workplace union, HSE or your local authority. Where employers are not managing the risk of COVID-19, HSE and local authorities will take action which can range from the provision of specific advice, issuing enforcement notices, stopping certain work practices until they are made safe and, where businesses fail to comply with enforcement notices, this could lead to prosecution.

The existing employment rights framework provides protections against discrimination, unfair dismissal and detriment. Specific guidance has been published for employers and workers on work absences due to coronavirus (COVID-19) (gov.uk/guidance/if-you-need....

The Citizen’s Advice Bureau also has information about your rights at work and how to solve problems in the workplace. If you have concerns you can also get advice on your specific situation and your employment rights by visiting the Acas website (acas.org.uk/contact) or calling the Acas helpline on 0300 123 1100.

School, college and other educational settings

Clinically extremely vulnerable pupils and students should return to their school or other educational setting from 1 April 2021. Children who live in a household with someone who is clinically extremely vulnerable are not advised to shield and should have returned to school or college on 8 March.

The use of rapid lateral flow tests allows us to identify individuals with coronavirus (COVID-19) who do not have symptoms, which make up around a third of all cases. Finding asymptomatic cases, along with other infection prevention and control measures such as social distancing, can help us manage the spread of the virus.

Therefore to safeguard the health of the teaching workforce and keep as many staff, pupils and students in school and college as possible, we have made rapid lateral flow coronavirus (COVID-19) tests available to schools and colleges (gov.uk/guidance/rapid-later.... Lateral flow tests can also be accessed directly for households, childcare and support bubbles of primary and secondary school pupils and for households, childcare and support bubbles of primary and secondary school staff. This testing will also help keep safe those in the community who are clinically extremely vulnerable and their families.

In addition to asymptomatic testing, secondary schools and colleges are continuing to put in place a range of protective measures to help minimise the risk of spreading COVID-19 (gov.uk/government/publicati.... These include social distancing, handwashing, use of face coverings in specific situations, bubbles, enhancing cleaning and ventilation and managing confirmed cases.

Travel

If you need to use public transport, you must wear a face covering unless you are exempt (gov.uk/government/publicati.... Consider travelling outside peak hours to reduce the number of people with whom you come into contact.

If you need to travel, walk or cycle if you can. For longer journeys, or if you are unable to walk or cycle, try to minimise the number of people you come into close contact with.

Please do not car share with people from outside your household or support bubble and ensure you use a face covering when using taxis.

Going to shops and pharmacies

While you are not advised to avoid going to the shops, you may wish to continue using online delivery for food and essential shopping, or to rely on family and friends. If you do go out to the shops or pharmacy, consider going at quieter times of the day. You must wear a face covering in all shops unless you are exempt.

If you have already registered for priority access to supermarket delivery slots using the Shielding Support website or through your council by 31 March, then we can confirm that the participating supermarkets will continue to offer priority access until 21 June. After this date individuals can continue to book deliveries from a supermarket.

If you need support to access shopping for food and essentials before 31 March, and are unable to arrange this yourself or through friends, family, or other support networks, you can still register to request priority access to a supermarket delivery slot at the Shielding Support website, gov.uk/coronavirus-shieldin... by 31 March. You will no longer be able to register using this website after midnight on 31 March.

You might still want to ask friends, family or volunteers to collect medicines for you.

The NHS Volunteer Responders programme is still available to help support those who need it. Volunteers can collect and deliver shopping, medication and other essential supplies. Call 0808 196 3646 between 8am and 8pm, 7 days a week to self-refer or visit nhsvolunteerresponders.org.uk for further information. There may also be other voluntary or community services in your local area that you can access for support.

If you require additional care and support

It is important that you continue to receive the care and support you need to help you stay safe and well. Providers of social care and medical services are making every effort to ensure services remain open and as safe as possible.

You should continue to seek support from the NHS for your existing health conditions. You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health professional through an online consultation. To find out more visit nhs.uk/health-at-home, or download the NHS App (nhs.uk/using-the-nhs/nhs-se.... If you have an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.

It is also important to look after your mental health. Go to the Every Mind Matters website (nhs.uk/oneyou/every-mind-ma... for advice and practical steps that you can take to support your wellbeing and manage your mental health during this pandemic and beyond. The Let’s Talk Loneliness website also has a variety of tips, advice and further resources that you may find helpful (letstalkloneliness.co.uk/).

Any carers or visitors who support you with your everyday needs can continue to visit. They should continue to follow social distancing guidance where close or personal contact is not required (gov.uk/government/publicati....