Two Years On and Responding to Changes in SARS CoV2 Guidance: What can you do now to impact your transmission risk

Its pretty much 2 years today since a pandemic was declared. A lot has changed since then and there are very big other things happening on the global stage. Its tempting to think that with so much going on that COVID-19 is effectively over. I don’t want to be the voice of doom and gloom here, but I do wanted to take a moment to point out that just because the legal situation has changed it doesn’t mean that the pandemic is over.

For us working in healthcare actually nothing has changed at all, I had to do a briefing last week where I basically said the phrase ‘nothing has changed’ on repeat for 45 minutes. In fact although the legal side of things have changed in the community the actual guidance hasn’t changed at all, it’s just its no longer a police matter. The government website still says:

Although nothing has changed, apart from not being fined for non compliance, this doesn’t seem to have been the focus of communication. SARS CoV2 levels are still high in the community, in fact they are likely even higher than being reported as many people aren’t reporting positive lateral flow tests and so these aren’t included in any numbers. The latest ONS survey numbers are looking like ~1 in 25 people are back to bring positive, with the numbers much higher in some regions.

What Can We Do As Individuals to Prevent Spread?

As the government have decided to make the political decision to remove legal measures and the communication strategy in terms of maintaining public health measures is poor, what can we do to have an impact and reduce risk to ourselves and others?

Know the current symptoms

I have regular calls with people who aren’t aware that the omicon symptoms are pretty different, even when speaking to healthcare professionals. The current  variant often has much more generic symptoms associated with it than those seen when we first encountered SARS CoV2. This means that we need to change our risk assessment and also be much more aware of what to look out for, rather than relying on the triumvirate of Anosmia (loss of taste and smell), temp >38 and new onset cough.

I know how tricky this is because actually so many respiratory viruses have similar symptoms. In many ways its starts more like a general ‘flu like’ illness. Using testing to support making decisions is therefore still going to be really important in working out the cause.

Ensure you have capacity to test

Sadly we are losing the ability to access the more sensitive and specific way to test i.e. PCR, as you can’t order these in advance, store and keep for when needed. Even the free provision of lateral flow kits (LFTs) ends at the end of the month, but for right now you can still order a new 7 day kit every 72 hours.

Make sure that you have ordered enough for you and your family. How many depends on your circumstances, which drive your need to test (see list below).

Being able to test is important for a few situations:

  • Enables you to test before you see people who are vulnerable, regardless of whether you have symptoms
  • Supports risk assessment by enabling you to test if you get generic symptoms so you know when to self isolate
  • Helps you know when you are safe to see others again if you test positive. Your risk will be lower (though not non existent) if you are lateral flow negative. I would also advise being symptom free.

NB I am not supporting stock piling here just being sensible.

Remember that if you test positive you should (under guidance but not law) be undertaking daily LFTs to reduce your risk to others and you will need enough in case this happens to you.

Having testing supplies is especially important if you are a healthcare worker. Currently if you are a SARS CoV2 contact you still need to get an exemption to work and LFT test daily. You should also still be testing twice weekly and I haven’t heard how these will be supplied post switch from .Gov ordering.

Remember that not socialising with others when you feel unwell is key

Visualising how viral spread works can sometimes be tricky, afterall viruses are invisible to the naked eye. Most people can imagine coughs and sneezes spreading as we’ve all been in a room where a cloud has been visible when someone has sneezed. I think its harder with Omicron, where you might just have a runny nose and sore throat, to imagine how it could spread so far. Myth Busters have done a great job of this in the video below. They set up a 30 minute dinner party and show just how far the virus could spread.

It’s really important that we are all sensible about how we interact and what we do if we have symptoms. Top tips from this video include:

  • Remember to undertake regular hand hygiene
  • Limit touching:
    • Don’t share cups or other high risk items
    • Be aware of face touching and the need for tissues etc to minimise the temptation
    • Limit physical contact (if appropriate for the scenario – hard to do this with your kids)

Make sure you still have a plan

My vulnerable mum and brother have just caught COVID-19 for the first time. Something I definitely blame on the change in guidance BTW. They had been prepared in terms of a plan but even they have struggled because they weren’t as prepared as they had been as they had avoided it for the last 2 years. Like them a lot of us had plans early on but have let them lapse. Now with the switch from public health to personal responsibility it is important we prepare for what the means for us as individuals and dust off those plans.

If like me (and until recently my close family) you have managed the last 2 years without catching SARS CoV2 and it all feels a bit inevitable now what can you do?

  • Have a plan for getting food brought to you, either via a support network or via delivery
  • Have pre-planned what that food might look like. Easy food that can either be put in the oven without further prep or food that doesn’t require cooking. COVID-19 brain is real and you may struggle to make decisions whilst unwell
  • Ensure you have all the medications you might need (both for COVID-19 and otherwise) for 2 weeks. Think symptom relief paracetamol/lemsip etc
  • Plan for distraction, especially if you have children. If you have a short attention span and are bed/sofa confined how will you distract yourself. Personally im planning to re-watch the whole of the Golden Girls on Disney Plus. I’ve deliberately held off 😁
  • If you have to split your household into exposed and non exposed how could you do it – the answer may simpky be that you can’t but its worth some thought

Keep risk assessment in your mind

Most of what this post is about is linked to risk assessment and risk control. If you work in healthcare should you be having that lunch with your colleagues? If you are going to see your grand mother have you recently been to a night club? If you’re commuting in an area of ever increasing prevalence i.e. London should you be wearing a mask on the tube? If you haven’t found time to get that booster, now is your moment!

The decision to move to personal responsibility is just that, it’s about every one of us thinking about our own risk and choosing to take responsibility to protect both ourselves and others. We can’t be passengers in this, the govenment change doesn’t mean there is no longer risk, just that it is our risk to own and control. We can only do that by working together. So listen to the science rather than the politicians and make sure we continue to protect those who are most at risk. After all that is what a civilised society is supposed to do.

All opinions on this blog are my own

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