How to stay safe and healthy in the coronavirus crisis

“Social distancing” has now entered common parlance – with people urged to keep at least two metres apart from others and groups of more than two people now forbidden in public.

The Local Democracy Reporting Service spoke to former Stockton South MP Dr Paul Williams for the second time with some questions about medicines, exercise and comforting children during the outbreak.

Immuno-suppressive medicine – should I be shielding?

Before the Monday announcement, about 1.5m people in the UK had been told to stay at home for the next 12 weeks to shield themselves from Covid-19.

The group includes those with severe respiratory conditions, such as severe asthma, with many sent a message advising them to cease all social contact.

People with cancer having active chemotherapy treatment are on the list – as well those having immuno-suppression therapies “sufficient to significantly increase risk of infection”.

Questions have been posed over what level of immuno-suppressive medicine puts people into this category.

Dr Williams urged people to “err on the side of caution”.

He said: “If you’ve got a long-term condition that means you’re on a medication that might suppress your immune system then the wise thing to do would be to follow the government advice here.

“If in doubt, the sensible thing to do is to say you’re in a high risk category and to self-isolate – and shield.

“What has happened here is the government has used the data that the NHS holds on people in order to try and work it out. What the computer says is a list of people who are at risk – now the computer doesn’t get it right all the time, and there will be some people who are at high risk the computer has not identified.

“There may also be a few people who get a letter and might be a bit surprised to get one – sometimes the computer can get it wrong or someone might have entered the wrong code into the computer.

“But I think in these times it’s best to err on the side of caution – if you think you’re high risk then it’s better to shield.

“If you’re on a powerful medication that can suppress your immune system it’s best to assume it is suppressing your immune system.”

Can I get my hair cut?

A raft of hairdressers and barbers announced they were shutting up shop for the foreseeable future before Monday’s announcement.

Dr Williams said haircuts should be put on hold for now.

He added: “I got my hair cut a week ago – and if this goes on for much longer I’ll be buying some clippers and giving myself a number two.

“The advice here is if it isn’t essential then don’t do it – and it is never essential to have your hair cut.

“You’re having unnecessary social contact.

“You’re not only putting yourself at risk because the person cutting your hair may well have cut lots of others’ hair.

“One of the difficult things about covid-19 is people can spread it even before they get symptoms.

“You’re putting yourself at risk – but you might also be putting somebody else at risk and you might infect the person cutting your hair.

“The person cutting your hair might have an elderly relative who they’re a carer for.

“You literally could be the person in the chain that passes it on to somebody and causes a death.”

The government stepped in on Monday night to announce the closure of all non-essential stores – including barbers.

Social distancing – can we cuddle our kids?

Avoiding large and small gatherings in public spaces and staying at home have become key pieces of advice during the covid-19 outbreak.

But questions have been posed about how much contact people can have within families and within their own household.

Dr Williams added: “Children are at much less risk of getting severely ill from this condition but it’s so important we reassure our children during this time.

“There are a lot of children out there – if you’re in a child’s brain at the moment, you’re going to feel frightened and confused with lots of things changing.

“In these times, it’s more important than ever that we give our kids a cuddle and we reassure them.

“We need to distance ourselves in family units if at all possible.

“If we’re in a circle of people we’re very close to, we can carry on as normal with them but we need to avoid interaction with other circles of people.

“That’s the key here.

“Children need love and affection – and, more than anything at the moment, they need reassurance. They need certainty of comfort they get from their parents.

“But your children shouldn’t then be playing where they’re coming into contact with other people’s children.

“If they then go and touch other people’s children then those two circles are then interacting with each other – and that’s what we’re trying to break.

“Within your family circle, I’d encourage it.

“If there’s vulnerable people within your family circle, then they need to be shielded.

“Shield the vulnerable – but within small groups in our families and households, children need hugging more than ever.”

The vital importance of social distancing

Large numbers of people flocked to Roseberry Topping and the seaside over the weekend despite government pleas for people to social distance from others to prevent the deadly virus spreading.

It provoked anger and irritation from leaders and health professionals.

Dr Williams said it was absolutely vital people took Covid-19 seriously.

“I’ve been working in the NHS over the weekend and the NHS is gearing itself up for a crisis like we have never seen before,” he added.

“All of us have the power to prevent that crisis if we all act responsibly now.

“That means avoiding any unnecessary social contact and it means distancing.

“It is okay to go out for a walk with members of your family group and people you’re already in a household with.

“But go to a place where other people aren’t – don’t go where other people are. Try to be distant from others.

“I know this is difficult because we’re social animals – we love talking, sharing jokes and having fun with people but the cost of that will be that if we get close to other people, either they will pass it onto us, or we will pass it on to them.

“I went out on my bike with one person and we stayed separate from each other. We stayed two metres apart from each other all of the time and we made sure we were not close enough to be able to infect each other.

“You’ve got to keep that physical distance. You can still talk to people on the phone – you can still talk to people but please keep that distance.

“If we all do it, it has the power to save lives.”

How do we get some exercise?

Exercising responsibly is still key to our mental and physical health.

And Dr Williams said there were still plenty of safe avenues to explore.

Dr Williams added: “Not only did I work in the NHS this weekend but I got some exercise and I always do exercise every day.

“It’s important that people exercise – it’s so important. If you’re cooped up in your house all day, you’ll find it incredibly frustrating.

“If you can, go for a walk. Stay reasonably close to your home. Going out for a run or on your bike is fine – just don’t go on in a group.

“In the open air, this is a virus spread by physical contact with people or by droplets.

“If you’re in a room exercising with someone, you’re breathing heavily – or coughing and spluttering – then there are going to be millions of particles of this virus in the air which could spread.

“If you’re outside, and two metres away – that’s a safe distance for the virus probably not to spread.

“So two people going for a run, or a cycle, or even just to walk – and being a two metre distance apart together – is, at the moment, absolutely fine and something which will probably do most people more good than harm.”

How are the trusts coping?

The NHS one of the biggest challenges in its 72-year history.

Demand for ventilators is high as the virus spreads but Dr Williams said he hadn’t heard of any capacity troubles at hospitals thus far.

He added: “I was working at the Urgent Care Centre until midnight on Sunday night at North Tees – I’ve not heard we don’t have capacity problems.

“We’re having to change everything around to focus on a problem which is still just around the corner – and it’s getting more apparent all the time.

“We’re mitigating.

“Sadly, thousands of local people are going to have their non-urgent appointments, procedures and procedures cancelled or postponed now.

“That’s going to cause a lot of worry. I understand that. I know the 111 system on the phone is very busy at the moment so I would strongly encourage people to go to 111 online.

“If they can find the answer online, that’s better than calling.”

Managing illness

Dr Williams said he was doing most of his GP duties over the phone.

And he explained working out the difference between covid-19 and other illnesses could be a challenge.

Dr Williams added: “The challenge of this at the moment is people regularly get cough and fever – they’re the symptoms of coronavirus but can also be a symptom of many illnesses.

“If you have got a fever, and are not that unwell, then manage it by yourself with paracetamol, make sure you drink plenty and self-isolate.

“If you’re unwell with it, then you are still going to need some medical advice and you’re either going to need to get it through 111 or your GP.

“If you become severely unwell, then you need to ring 999.

“Our systems are still adapting to be able to manage these people.

“We still have to treat all of the unwell people who don’t have coronavirus as well as managing people who do have it.”

Makeshift hospitals?

The St George Hotel at Teesside Airport has been offered up at a potential site for extra NHS beds if and when the coronavirus crisis worsens.

Dr Williams said the health service would start to be holding “very different” kinds of clinics in the next fortnight – with those unwell but not sick enough to end up in hospital.

He added: “I know there is talk of setting up “hot clinics” in community buildings but I don’t yet know of any contingency plans to open any non-hospital buildings as wards.

“I’ve seen on the news images from Spain of a large conference centre where they’re putting up lots of beds.

“But I haven’t heard of any plans to do that locally.”

PPE is available but frustration on testing

Health secretary Matt Hancock said there had been some challenges in getting personal protective equipment (PPE) out to all NHS staff.

Dr Williams said all four of the workplaces he’d been in the past week had enough PPE for him to carry out his job.

He explained rooms were given a “deep clean” after appointments if a patient had suspected covid-19.

“That is working,” he added. “The frustration is it would be so helpful if we were able to test. The clinical difficulty with this at the moment is just not knowing.

“It’s a massive unknown – and I think it’s frustrating for people as well.

“People will be doing the right thing – and when they get symptoms, they will self-isolating for seven days with their family self-isolating for 14 days.

“But it might not actually be coronavirus – and without having freely available community testing, we’re still in the dark.

“It’s one of many priorities for the Government to get community testing everywhere so we can start to learn more about who has and who hasn’t had this condition.”

Frustration still persists in the lack of testing of NHS staff so far.

Dr Williams added: “The reason I was working last night was I got a call at 7pm and the person who was supposed to be on duty – her child developed a fever.

“Children develop fevers all the time for all kinds of reasons.

“She did the right thing and her family has isolated itself for 14 days – but it suddenly leaves a gap.

“It’s one less doctor and that’s going to happen in lots of households.

“It’s not just NHS staff but families of NHS staff as well and it would be really helpful to know (if we have covid-19).

“It’s not because we want favourable treatment -it’s because we want to stay at work if someone has not got coronavirus.”

Despite some not heeding messages on health in recent days, Dr Williams said he’d been impressed with the reaction of most Teessiders to the coronavirus outbreak.

He added: “A lot of the news at the weekend has been about people who haven’t socially distanced – but almost all the people I’ve spoken to have done it.

“I’d like to give my thanks to them.

“We sometimes focus on the people we consider are being irresponsible but the vast majority of Teessiders are doing the right thing.

“Even though they might not benefit from it much themselves, society benefits and this is a time when we have to do the right thing – not just for ourselves but for the benefit of all of society.”

The NHS 111 service can be reached here https://111.nhs.uk/covid-19

For the latest up-to-date advice on Coronavirus, visit www.gov.uk/coronavirus