Every year, millions of people in the UK develop the flu.

For most people, this is an unpleasant experience but one that is soon recovered from.

For older people, whose health and immunity may be declining; and people whose health is affected by medical conditions, the risk is much higher as they cannot recover so easily from the virus.

What is new and so dangerous about the COVID-19 virus is that it has never been encountered before.

As such there is no vaccine and no medication that will cure or protect against the virus, though the same medications taken for the flu will help to reduce the symptoms.

The UK Government has advised that when someone has developed symptoms, they should take paracetamol rather than ibuprofen.

As a viral infection, antibiotics will not affect the virus. This new strain of the virus causes severe respiratory diseases, including pneumonia.

COVID-19 appears to spread in a number of ways.

The primary method is the respiratory route – contamination when someone carrying the virus coughs or sneezes.

It was long believed that standing more than 2 metres away from the person coughing or sneezing was a safe distance. As a result, the advice from UK Government is that everyone should practice ‘social distancing’ – remaining 2 metres (6ft) away from other people as far as possible.

Viruses also spread through tiny airborne particles, known as aerosols. These are released from the lungs rather than the nose or throat. These aerosols are invisible, cannot be felt, travel further than the droplets from sneezing or coughing, and can hover in the air for several hours.

This means that surfaces and hands can be contaminated, helping to transmit the virus. This is why hand washing and not touching your face are so important.

The overall risk rating for the UK as a whole has risen to ‘High’. Taking precautions is critically important to reduce the risk of spreading coronavirus.

These are:

• washing hands thoroughly with hot water and soap for at least 20 seconds (sing “Happy Birthday” twice), or with hand sanitizer where this is not possible;
• not touching your face when outside of the home and before washing your hands.
• using tissues when sneezing or coughing and throwing them away in a bin – Catch it; kill it; bin it;
• Self-isolating if you, someone in your home  or someone who you have been in recent contact with develop COVID-19 symptoms – see the section below.
• Self-isolating or shielding if you have been identified as vulnerable or extremely vulnerable by the NHS.

On 23^rd March, the UK Government updated their advice to employers and the public, and introduced lockdown measures, including:

• Only go outside for food, health reasons or work (where this absolutely cannot be done from home) Do not travel unless absolutely necessary.  If you are a keyworker travelling to work, try to, vary your travel times to avoid rush hour, when possible.
• Stay 2 metres (6ft) away from other people
• Wash your hands as soon as you get home

Other non-work related measures advised by the Government include:

• Do not leave the home if you or someone in your household has cold or flu symptoms (self-isolating)
• Do not leave the house if you have received a letter from the NHS stating that you are classed as extremely vulnerable (shielding)
• Stay at home and away from others (social distancing)
• Only leave the house to go to work is this cannot be done from home and is essential work, to go to the shops (as infrequent as possible) and for exercise once per day. Use telephone or online services to contact your GP or other essential services
• Order food and supplies online where possible.

These measures, along with handwashing and ‘Catch It, Bin It, Kill It’, are now the primary way to reduce the spread of COVID-19.

As mentioned above, it is well-established that people above the age of 70, along with those with underlying health conditions, are at higher risk of severe reaction to COVID-19 and should take extra precautions, particularly social distancing as well as shielding where notified by the NHS.

The Government have provided a detailed list of extremely vulnerable and vulnerable people. These are:

Extremely vulnerable

1. Solid organ transplant recipients.
2. People with specific cancers:
   • people with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
   • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
   • people having immunotherapy or other continuing antibody treatments for cancer
   • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
   • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD.
4. People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell).
5. People on immunosuppression therapies sufficient to significantly increase risk of infection.
6. Women who are pregnant with significant heart disease, congenital or acquired.

Vulnerable

• aged 70 or older (regardless of medical conditions)
• under 70 with an underlying health condition listed below (i.e. anyone instructed to get a flu jab as an adult each year on medical grounds):
  • chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
  • chronic heart disease, such as heart failure
  • chronic kidney disease
  • chronic liver disease, such as hepatitis
  • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
  • diabetes
  • problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
  • a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
  • being seriously overweight (a body mass index (BMI) of 40 or above)
• those who are pregnant

If you fall into any of the extremely vulnerable category, you must not leave your house for 12 weeks and must stay away from other members of your household if they are still going outside to work or shop.

If you fall under the vulnerable group and are still working, you should inform your employer of your health status immediately. They must perform a risk assessment to assess your likely exposure to COVID-19 and any mitigating control measures that can be enacted, then implement these as soon as possible. They may need to consult occupational health professionals to do this.

This may require you to work from home, stagger working time – arrival and departure - where possible, or change job roles to a non-customer facing role whilst the COVID-19 virus is at large in the population.

If you fall into the above categories and have concerns over the response from your employer, please contact your GMB Regional Organiser for further advice and support.

Self-isolation (also called self-quarantine) is a precautionary measure, where a person who may have the COVID-19 virus stays in a fixed location (usually at home, potentially in their bedroom) away from other people.

Updated guidance from the NHS was published on Thursday 12 March.

The position from government is now to self-isolate if you experience:  

A High temperature (37.8ºC or higher)

                OR  

A continuous cough  

On 16^th March, the Government announced new guidance where symptoms develop:

• if you live alone and you have symptoms of coronavirus illness (COVID-19), however mild, stay at home for 7 days from when your symptoms started.
• if you live with others and you or one of them have symptoms of coronavirus, then all household members must stay at home and not leave the house for 14 days. The 14-day period starts from the day when the first person in the house became ill
• it is likely that people living within a household will infect each other or be infected already. Staying at home for 14 days will greatly reduce the overall amount of infection the household could pass on to others in the community
• for anyone in the household who starts displaying symptoms, they need to stay at home for 7 days from when the symptoms appeared, regardless of what day they are on in the original 14-day isolation period. If you develop symptoms 13 days after self-isolating, you will need to stay at home for a further seven days (20 days in total)
• if you can, move any vulnerable individuals (such as the elderly and those with underlying health conditions) out of your home, to stay with friends or family for the duration of the home isolation period
• if you cannot move vulnerable people out of your home, stay away from them as much as possible
• if you have coronavirus symptoms:
  • do not go to a GP surgery, pharmacy or hospital
  • you do not need to contact 111 to tell them you’re staying at home
  • testing for coronavirus will not happen whilst you’re staying at home
• plan ahead and ask others for help to ensure that you can successfully stay at home and consider what can be done for vulnerable people in the household
• ask your employer, friends and family to help you to get the things you need to stay at home
• wash your hands regularly for 20 seconds, each time using soap and water, or use hand sanitizer
• if you feel you cannot cope with your symptoms at home, or your condition gets worse, or your symptoms do not get better after 7 days, then use the NHS 111 online coronavirus service. If you do not have internet access, call NHS 111. For a medical emergency dial 999

If you have to self-isolate, inform your employer immediately.

If you then develop symptoms, ensure that your employer knows this.

Where self-isolation means buying deliveries (takeaway food, online deliveries, etc.) it is important that wherever possible you avoid direct contact with the person making the delivery – arrange for deliveries to be left on doorsteps or outside the room.

Pay online or by leaving payment with family/friends, or even through the letterbox if needed.   

Make sure you inform the company you make the purchase from that you are self-isolating.  

This is a measure put in place by the Government to protect the most vulnerable people in society, as listed above in the extremely vulnerable category. If you have received a letter from the NHS saying that you come under this category asking you to follow face to face distancing measures, these are:

1. Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough.
2. Do not leave your house.
3. Do not attend any gatherings. This includes gatherings of friends and families in private spaces, for example, family homes, weddings and religious services.
4. Do not go out for shopping, leisure or travel and, when arranging food or medication deliveries, these should be left at the door to minimise contact.
5. Keep in touch using remote technology such as phone, internet, and social media.
6. Use telephone or online services to contact your GP or other essential services.

While the rest of your household are not required to adopt these protective shielding measures for themselves, we would expect them to do what they can to support you in shielding and to stringently follow guidance on social distancing.

1. Minimise as much as possible the time other family members spend in shared spaces such as kitchens, bathrooms and sitting areas, and keep shared spaces well ventilated.
2. Aim to keep 2 metres (3 steps) away from people you live with and encourage them to sleep in a different bed where possible. If you can, you should use a separate bathroom from the rest of the household. Make sure you use separate towels from the other people in your house, both for drying themselves after bathing or showering and for hand-hygiene purposes.
3. If you do share a toilet and bathroom with others, it is important that they are cleaned after use every time (for example, wiping surfaces you have come into contact with). Another tip is to consider drawing up a rota for bathing, with you using the facilities first.
4. If you share a kitchen with others, avoid using it while they are present. If you can, you should take your meals back to your room to eat. If you have one, use a dishwasher to clean and dry the family’s used crockery and cutlery. If this is not possible, wash them using your usual washing up liquid and warm water and dry them thoroughly. If you are using your own utensils, remember to use a separate tea towel for drying these.
5. It is not always going to be possible for some people to separate themselves from others at home. You should do your very best to follow this guidance and everyone in your household should regularly wash their hands, avoid touching their face, and clean frequently touched surfaces.

If the rest of your household stringently follow advice on social distancing and minimise the risk of spreading the virus within the home by following the advice above, there is no need for them to also shield alongside you.

Where possible, employers should be allowing staff to work from home, as directed by the Government. However, there are many sectors that GMB members work in where workers are required to still work, such as the NHS, ambulance drivers, school workers, airport workers, some cleaners, delivery drivers and supermarket workers to name a few.

These workers may require more specific precautions to be implemented, either because the risk of infection is higher, or because they regularly come into contact with those who are most vulnerable – older people, or people in poor health – or those most likely to spread the virus - children. In such cases, a specific risk assessment for contamination risk should be performed.

This is a COSHH assessment, required under the Control of Substances Hazardous to Health Regulations 2002.

The primary control measure will be removal from the source of exposure where possible – home working where this is feasible. For most workplaces, allowing workers to follow self-isolation procedures should ensure that only workers who are not an exposure risk attend work.

There will obviously be certain job roles that run the risk of close contact with suspected or confirmed COVID-19 carriers. Where this is the case, personal protective equipment (PPE), particularly the provision of face masks, must be implemented.

Where members are dealing with people who are confirmed to be infected (i.e. to provide care), then the previous advice from Public Health England still applies, and the following PPE is appropriate:

• Long-sleeved fluid repellent disposable tunic/coverall/gown;
• Long, tight-fitting gloves;
• FFP3 respirator, fit-tested; if available – see below
• Eye protection – either single-use goggles or full-face visors.

This must all be provided on an individual basis and not for shared use. Contaminated PPE must be cleaned or replaced and not continually used when compromised.

For most job roles, a face mask is not needed, and wearing one could increase the risk of exposure to the virus due to the wearer touching their face more often than usual.

The surgical masks that are often pictured in the media have very little value as a protective measure.

They primarily reduce the amount to which any virus is expelled by a person, rather than preventing exposure from another person.

The most effective widely available face mask is the FFP3 (filtering facepiece respirator level 3), which is the same standard used where the presence of asbestos is suspected.

This will not eliminate exposure to the virus, but reduces the exposure level by up to six times compared to a surgical mask.

There have been many advertisements, particularly on social media, for N95 masks. This is an American standard that is only equivalent to UK FFP2.

The N95 mask is only tested against dry contaminants, whilst FFP3 is tested against wet aerosols. As such the N95 mask is less effective, and FFP3 should be supplied where face masks are required.

The N95 mask is however preferable to surgical masks or no mask at all. This is acceptable if the FFP3 is not available to be provided.

Any mask supplied must have a CE certification mark, which indicates conformity with EU health, safety and environmental protection standards. This should be found either on the mask itself, on the packaging.

All masks must be personal issue only – they must not be shared between workers.

To be effective the mask must fit properly, with a tight seal around the nose and mouth. Most suppliers sell fit-testing kits.

Fitting is critical as gaps around the bridge of the nose and under the chin allow air to leak in, defeating the filtration.

Guidance on face fitting is available from the HSE. The British Safety Industry Federation (BSIF) can provide detailed guidance where large scale fitting is required.

The standard test involves wearing the mask, placing a plastic hood around the head and spraying saccharine solution inside it. If the sweet flavour can be tasted then the mask is not fitting tightly enough.

Apart from ensuring that risk assessments and COSHH assessments are kept up to date, the most important action is to keep all workers updated on actions being taken to reduce risks of exposure in the workplace.

This would include ensuring that all contact numbers and emergency contact details are up to date.

Management training may be needed on the symptoms of COVID-19, and more importantly the actions to be taken where cases are suspected.

This will primarily be ensuring that any worker who suspects that they are infected does not attend the workplace, and self-isolates.

GMB Safety Representatives must be kept informed of all control measures being implemented and there should be mechanisms in place that allow safety representatives to raise concerns with senior managers, health and safety managers and infection control leads on behalf of staff.

The guidance from ACAS for employers and employees is clear on this point:

The workplace's usual sick leave and pay entitlements apply if someone has coronavirus.

Employees should let their employer know as soon as possible if they're not able to go to work.

The employer might need to make allowances if their workplace sickness policy requires evidence from the employee. For example, the employee might not be able to get a sick note (‘fit note’) if they’ve been told to self-isolate.

ACAS guidance on this is also clear.

If an employee is not sick but their employer tells them not to come to work, they should get their usual pay.

Employees are entitled to time off work to help someone who depends on them (a 'dependant') in an unexpected event or emergency. This would apply to situations to do with coronavirus. 

For example:

• if they have children they need to look after or arrange childcare for because their school has closed
• to help their child or another dependant if they're sick, or need to go into isolation or hospital

There's no statutory right to pay for this time off, but some employers can and should offer pay. GMB is making this demand on employers to do the right thing.

For Further Information: https://www.acas.org.uk/coronavirus