Advice for over 70 and medically vulnerable individuals
The Government and health authorities have issued advice for people who are over 70 and those who are extremely medically vulnerable to continue to exercise personal judgement.
It is recommended that they stay at home as much as possible, limit engagement to a very small network for short periods of time, while remaining physically distanced.
When taking exercise outdoors, it is important to maintain 2 meters of distance from others and wash hands on returning home.
It is recommended to shop during designated hours only, while wearing a face covering, and to avoid public transport.
This includes people with severe respiratory conditions and transplant recipients, with a full list available at this link.
This list includes the following groups specific to cancer:
- People with cancer who are currently being treated with chemotherapy or medication. You may also be advised to cocoon for two weeks before starting your treatment or before coming in for surgery or a particular test.
- People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment. If you are unsure if your type of blood or lymph gland cancer weakens your immune system, check with your cancer team.
- People having immunotherapy or other continuing antibody treatments for cancer.
- You have lung cancer and are being treated with radiotherapy.
- 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.
If you are unsure if you should be following advice on cocooning you should discuss this with your GP or your medical team.
If you are in this group you should take the following steps:
- Strictly avoid contact with someone who is displaying symptoms of coronavirus. These symptoms include high temperature and/or new and continuous cough.
- You should continue to stay home as much as possible, limit social interactions to small groups, and always maintain strict social distancing when coming into contact with others.
- Avoid using public transport where possible, and try to confine your shopping to designated times for vulnerable people.
- Wear face coverings when in confined public spaces such as shops where social distancing may not be possible, and when in crowded outdoor spaces.
- Keep in regular contact with others using remote technology such as phone, internet, and social media.
- Use telephone or online services to contact your GP or other essential services.
- Ensure you keep phones/devices charged, and have credit on your phone so that you can stay connected.
- If other people are living with you they should adhere to social distancing guidelines and try keep 1m apart, and 2m where possible.
- Keep yourself mobile by getting up and moving as much as possible. If you have a garden or balcony, get out for fresh air.
Ireland is currently at Level 5 of the Government’s Plan for Living with Covid-19, with the following restrictions effective until 5 April:
- No social visits to other households or gardens, with the exception of a ‘support bubble’ for people at risk of isolation, including people living with shared custody arrangements and those living alone or with a partner with dementia. They can nominate one other household with whom they can mix. Close contacts of confirmed Covid-19 cases or anyone with symptoms of illness should continue to isolate as per public health guidelines
- Only leave home for essential work, shopping, exercise, care & medical appointments. People should work from home unless providing an essential service for which your presence is required on-site. No travel beyond a 5km radius from home, except for essential provisions, care and medical appointments.
Anyone who is over 70 and who also has one of the listed conditions should be especially careful to follow the guidelines around cocooning due to their higher risk.
We advise everyone to access medical assistance remotely, wherever possible. However, if you have a scheduled hospital or other medical appointment during this period, talk to your GP or specialist to ensure you continue to receive the care you need and determine which of these are absolutely essential.
It is possible that your hospital may need to cancel or postpone some clinics and appointments. You should contact your hospital or clinic to confirm appointments. For more information on this please visit our page on active cancer treatment and coronavirus.
It is good practice to have a list of alternative people who can help instead if your main carer becomes unwell.
If you receive regular health or social care from an organisation, either through your local authority or paid for by yourself, inform your care providers that you are cocooning and agree a plan for continuing your care.
If you develop symptoms of coronavirus
The most common symptoms of coronavirus are recent onset of:
- Fever (high temperature) and
- Shortness of breath or difficulty breathing
If you develop coronavirus symptoms, get medical advice by phoning your GP. In an emergency, call 112 or 999 if you are seriously ill. Do this as soon as you get symptoms. Do not visit the GP, pharmacy, urgent care centre or a hospital unless you are told to do so.
If you need to go to hospital as a result of catching coronavirus you should prepare a single hospital bag. This will include your next of kin or emergency contact, a list of the medications you take (including dose and frequency), any information on your planned care appointments and things you would need for an overnight stay (snacks, pyjamas, toothbrush, medication etc.). If you have an advanced care plan, please include that too.
Further guidance on cocooning
Limiting infection risk in the home
While people sharing the same space as you are not required to adopt these protective cocooning measures for themselves, they should do what they can to support you in cocooning and to strictly follow guidance on physical distancing.
Evidence shows that many cases of coronavirus infection display no symptoms yet the virus can still be passed on from those who are showing no signs of infection, especially through very close and prolonged contact.
The following steps will help keep people who are cocooning safe from infection, and should be followed as closely as possible by anyone coming into the same home:
- Everyone should always clean their hands regularly, especially after being outside the home, and cough/sneeze into your elbow.
- Be alert to anyone showing any of the symptoms of coronavirus infection – eg temperature, headache, loss of taste/smell. Coronavirus symptoms can appear similar to other colds and common illnesses like hay fever so medical advice should be sought if anyone in the household begins to show any signs of illness.
- You should stay away from other people in your home as best you can, and where common areas are shared try to ensure that the room has a good flow of air.
- If you have to go into the same room with other people at home you should try to keep at least 1 metre (3 ft) and where possible 2 metres away from them.
- If you can, you should use a toilet and bathroom that no one else in the house uses.
- If you cannot have your own toilet and bathroom, the toilet and bathroom you use needs to be kept clean (see advice below).
- Another tip is to consider drawing up a rota for bathing, with you using the facilities first.
- Make sure you use separate towels from the other people in your house, both for drying after bathing or showering and for hand-hygiene purposes. Using towels with different colours or patterns can help.
- 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. Do not share cutlery and utensils.
- When using your own cutlery and utensils, remember to use a separate tea towel for drying these.
- Clean all regularly-touched surfaces such as counters, table-tops, doorknobs, bathroom fixtures, toilets and toilet handles, phones, keyboards, tablets, and bedside tables every day. Standard household cleaning products work just fine, and even common soap and water is very effective.
It will of course be difficult for some people to separate themselves from others at home. You should do your very best to follow this guidance and everyone you share a space with should regularly wash their hands, avoid touching their face, and clean frequently touched surfaces such as door handles and table tops.
Supports for people cocooning
In the first place, family, friends and neighbours can support you once you stick to cocooning guidelines and they stick to physical distancing guidelines.
Where possible use online services. If these options are not available to you, the Government is putting in place assistance through the local authorities, working with the voluntary sector services, to ensure you can have access to food, essential household supplies and medicines. Each local authority will publish contact details.
ALONE is providing a telephone support line, seven days a week from 8am – 8pm, for all older people and their families to contact if they would like any advice, reassurance or additional support: 0818 222 024. This support line is also open to extremely medically vulnerable people.
The support line offers similar advice to that being provided by the HSE through its website and helpline. If you receive support from health and social care organisations, for example, if you have care provided for you through the local authority or health care system, this will continue as normal.
The Irish Cancer Society is providing remote counselling sessions for people who are affected by cancer and who cannot access face to face services as result of the coronavirus pandemic. To access this service, please call our Freephone Support Line on 1800 200 700.
If you are experiencing stress due to the current situation, this article from clinical psychologist Dr Paul D’Alton about how cancer patients can look after their mental and physical wellbeing might be helpful, as well as advice from the National Cancer Control Programme on coping with worry which you can access by clicking here.
While it might be more difficult to see them, stay in touch with friends and family who are a vital support at this time. Take people you know and trust up on offers of help with anything you may need from outside, always reminding anyone you are in contact with of the precautions they should take to avoid passing on infections.
Finally, try to keep physically active. You can take short trips outside to get exercise and fresh air so long as strict social distancing is practiced at all times.
Advice for carers
Visits from people who provide essential support to you such as healthcare, personal support with your daily needs or social care should continue, but any carers or care workers who develop symptoms of coronavirus must stay away until 14 days after the symptoms first appeared and they have been without a fever for 5 days.
These staff will have been well briefed on the steps they need to take to protect the people they care for from getting infections.
For family members and other people caring for anyone who is over 70 or extremely medically vulnerable, the following steps can help to keep everyone safe from infection:
- Wash your hands on arrival and often, especially before and after being in contact with the person you are caring for. Use soap and water for at least 20 seconds or use hand sanitiser.
- Avoid touching your face and cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze.
- Put used tissues in the bin immediately and wash your hands afterwards.
- Do not visit or provide care if you are unwell and make alternative care arrangements.
- Provide information to the person being cared for on who they should call if they feel unwell, write out the phone number of their GP and GP out-of-hours service and leave these prominently displayed.
- If it is an emergency, call the emergency services at 112 or 999 and remember to tell them that the person may have or has been diagnosed with coronavirus.
- Find out about different sources of support that are available.
- Look after your own well-being and physical health during this time.
Click here for the full guidelines on cocooning from the HSE.
General information from the HSE on cancer and coronavirus is available here.
Go to our cancer and coronavirus webpage at www.Cancer.ie/Coronavirus for more information on hospital services, coronavirus illness and employment benefits and more.
The Irish Cancer Society continues to be available to provide support and information on this matter or any other queries related to cancer through its Freephone Irish Cancer Society Support Line on 1800 200 700.
For more information
1800 200 700