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Coronavirus (Covid-19)

Updated: Jun 1, 2020

Coronavirus (Covid-19)

Main symptoms

The main symptoms of coronavirus are:

• High temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature), but if you have this facilty >37.8

• New, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

• Loss or change to your sense of smell or taste – this means you've noticed you cannot smell or taste anything, or things smell or taste different to normal

Most people with coronavirus have at least one of these symptoms.

Restarting NHS Bowel Cancer Screening Programme (NHSBCSP) colonoscopies at St Marks Screening Centre

The Bowel Cancer Screening Centre (BCSC) at St Mark’s is now a dedicated ‘COVID-19 minimised’ unit to enable urgent elective outpatient work to be performed in a safe, COVID negative environment.

Bowel Scope (Flexible Sigmoidoscopy) - This service remains suspended. All appointments have been cancelled and participants informed.


• There are no current plans to resume bowel scope invitations. This is because there is no ability currently to ensure adherence to distancing of patients and allow for the extra procedure time due to altered admission/discharge pathways, PPE requirements and enhanced room cleaning needed between procedures in this cohort of participants. The BCSC anticipates a national decision on bowel scope screening. It is recognised that those offered an appointment should have their invite honoured but this may be via alternative screening methods.


Referred for colonoscopy after criteria fulfilled from bowel scope – We are reviewing these cases with our screening consultants and inviting patients for their intended tests based on clinical recommendations.


FIT Screening – We have been given approval to recommence the services within the bowel cancer screening centre for colonoscopy.

We are currently in the process of contacting and inviting all those participants with an abnormal/ positive FIT result.

We are offering virtual video consultations. If video consultation is not available/appropriate, then the participant will be called to clinic (face to face).

All those attending for face to face outpatient clinic appointments:

  • The participant will be greeted by a member of staff wearing appropriate PPE (surgical face mask). The participant will be asked to apply alcohol gel to their hands and wear a surgical face mask. Each participant will have their temperature and symptoms checked on arrival.

  • We advise that at this time we cannot have family members/friends attend the appointment with patients (exceptional need discussed case by case). If carers/ relatives are required for additional patient need then they will need to follow the same testing & processes as the patient.

  • Patients are advised to avoid public transport and use private vehicles

Colonoscopy

  • Those who had colonoscopy postponed due to COVID-19 will be contacted by a member of the screening team. We understand that patients will have anxiety and questions related to rebooking their screening colonoscopy which can be addressed and discussed accordingly with one of our specialist screening practitioners or one of our screening consultants.

  • The Health Promotion Team is developing online materials to support and allow patients to understand the processes put into place and what to expect on arrival.

  • Patients and their households will be requested to ensure that they reduce unnecessary contact with others in line with current “lock down” criteria 7 days prior to their procedure.

  • All patients will be screened for symptoms and tested (swabbed) for COVID-19, approx. 3 days prior to their lower GI procedure.

  • We advise that at this time we cannot have family members/friends attend the appointment with patients (exceptional need discussed case by case). If carers/ relatives are required for additional patient need then they will be need to follow the same testing & processes as the patient.

  • Patients are advised to avoid public transport and use private vehicles

  • Patients are called at 7 and 14 days post discharge to check they are well and did not develop COVID-19 symptoms or complications post-procedure.

Radiology

  • CTVC will be undertaken at CMH as an interim measure to minimise exposure to COVID-19 and ensure patients and staff are as safe as possible in terms of risk.

  • All CTVC diagnostic tests will continue to be reported and authorised by St Mark’s Radiologists/Consultant Radiographer as per current BCS practices.

Interpreters

  • All interpreters will only be booked for telephone interpreting currently.

  • Only in exceptional cases (i.e: if patient is hard of hearing, needs BSL etc), can we book a face to face interpreter.

  • Interpreters can be invited and attend the Attend Anywhere video consultation.

  • Attempts will be made to match the language of the patient and a staff member where possible

  • A non-verbal communication sheet is also available in the endoscopy procedure room

Surveillance

· All patients due for surveillance have been postponed. All patients have been contacted by phone &/or letter.

· We are reviewing these cases with our screening consultants and inviting patients for their intended tests based on clinical recommendations.

Deferred polypectomy/ Site checks:

· Any patients needing a site check/ polypectomy are being reviewed by the screening consultant and we are inviting patients for their intended tests based on clinical recommendations.

Call & re-call

  • We are currently liaising with NHSE and the London HUB on resuming FIT invitations.

Staff testing:

  • ALL staff take responsibility for signs & symptoms of COVID-19 and are fully aware not to come to work if they are displaying any new symptoms. Each morning on arrival to work each staff member undertakes temperature/ symptoms screening.

I hope this clarifies the position of St. Mark’s Bowel Cancer Screening Centre currently.

If there is anything which is unclear and needs clarification please do email the team via lnwh-tr.bcsccontact@nhs.net or 0208 869 3543

For further information please visit:

Groups are at risk of COVID-19

Coronavirus (COVID-19) can make anyone seriously ill. But for some people, the risk is higher.

There are 2 levels of higher risk:

  • high risk (clinically extremely vulnerable)

  • moderate risk (clinically vulnerable)

People at high risk (clinically extremely vulnerable)

People at high risk from coronavirus include people who:

  • have had an organ transplant

  • are having chemotherapy or antibody treatment for cancer, including immunotherapy

  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer

  • are having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)

  • have blood or bone marrow cancer (such as leukemia, lymphoma or myeloma)

  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine

  • have been told by a doctor they you have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)

  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)

  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)

  • have a serious heart condition and are pregnant

If you're at high risk from coronavirus, you should have received a letter from the NHS.

People at moderate risk (clinically vulnerable)

People at moderate risk from coronavirus include people who:

  • are 70 or older

  • are pregnant

  • have a lung condition that's not severe (such as asthma, COPD, emphysema or bronchitis)

  • have heart disease (such as heart failure)

  • have diabetes

  • have chronic kidney disease

  • have liver disease (such as hepatitis)

  • have a condition affecting the brain or nerves (such as Parkinson's disease, motor neurone disease, multiple sclerosis or cerebral palsy)

  • have a condition that means they have a high risk of getting infections

  • are taking medicine that can affect the immune system (such as low doses of steroids)

  • are very obese (a BMI of 40 or above)

What to do if you're at moderate risk

If you're at moderate risk from coronavirus, it's very important you follow the advice on social distancing.

This means you should stay at home as much as possible. But you can go out to work (if you cannot work from home) and for things like getting food or exercising.

Unlike people at high risk, you will not get a letter from the NHS advising you to stay at home at all times.

(Correct as 29/05/2020)

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