Individuals from the Black, Asian and Minority Ethnic (BAME) communities have been more adversely affected by COVID-19. Those of Bangladeshi, Black and Asian ethnic origin are up to twice as likely to be affected with higher death rates than the White population. Those from the BAME community will score higher in the ethnicity section and dependent on the score and risk profile should have a structured review with their employer. We acknowledge not all ethnicities have been explicitly mentioned in the score card, for example the Filipino community. Individuals can discuss with their employer where they feel they ‘best fit’ in relation to ethnicity scoring. This is to ensure interventions to minimise the risk of COVID-19 infection are considered and where difficult to social distance then risks are mitigated by exercising higher levels of precaution in the work environment. In the community and home, precaution should be exercised including avoiding attendance in congregations where precautions including social distancing and face masks are not exercised and adherence to government guidance on actions to mitigate risk of transmission and congregations are not being followed.
Being obese or excessively overweight increases the risk of severe illness and death from COVID-19. The risk of complications increases significantly as the BMI increases although a more accurate marker for obesity would be the waist circumference. Being overweight does not increase the risk of contracting COVID-19 but once infected the obese individual is at a greater chance of becoming ill, being admitted into hospital and having a worse outcome. Reducing your weight will reduce the risk of complications if infected with COVID-19 and advice and guidance on weight management can be obtained from the practice nurse at your GP surgery or on the NHS website. Ask about any locally commissioned services by the NHS to support weight loss through local exercise programmes and diet support. Check nhs.uk on tips and guidance on weight loss.
The Royal College of Obstetricians and Gynaecologist (RCOG) have provided clear guidance on COVID-19 and pregnancy (www.rcog.org.uk – Coronavirus (COVID-19) infection and pregnancy). The guidance does highlight the potential implications of being severely affected by COVID-19, particularly affecting women as the pregnancy progresses. Specific guidance on how and where pregnant women can safely work should be advised on an individual basis, following employer-led workplace and individual risk assessment. Pregnant women should stringently adhere to the national guidance around social distancing, hand washing and face masks/coverings.
Certain medical conditions have an increased adverse effect on the complications from COVID-19 infection. Recent studies have shown that people with diabetes and hypertension have a significantly increased risk compared to other medical conditions. All individuals with a condition listed in the toolkit should ensure:
- Their medical condition is well controlled and stable
- They have at least an annual medical review with their GP Practice to ensure there are no new developments with their illness and the medication and any associated tests are undertaken
- Any exacerbation of your illness is addressed as soon as possible by seeking support from your GP to manage the exacerbation.
- Compliance with national guidance around social distancing, wearing masks, hand washing and where necessary quarantine and shielding to protect yourself from exposure to the COVID-19 infection.
Vitamin D is important for bone and muscle growth. There is also a view that vitamin D has a role in the body’s immune response. Sunlight exposure is the main source of vitamin D but in most this is inadequate and requires supplementation through diet or supplements. Vitamin D supplements are not specifically licensed for preventing or treating any infection including COVID-19, it is the view of the co-authors that low levels of the vitamin can lead to an adverse effect on the ability to recover following a COVID-19 infection.
Recent guidance from NICE has been published in June 2020 (www.nice.org.uk – COVID-19 rapid evidence summary: vitamin D for COVID-19 Evidence summary [ES28]). Although the key message from NICE is recognised by the co-authors (that there is no evidence to support the taking of vitamin D supplements to specifically prevent or treat COVID-19), it is the view of the group that there is benefit in taking vitamin D to support healthy body development. The NICE guidance does recognise the need to follow UK Government advice on daily vitamin D supplementation to maintain bone and muscle health during the COVID-19 pandemic (www.nhs.uk – Vitamin D) with the NHS website providing guidance on good sources of vitamin D.
Working in a public environment leads to increased engagement with wider parts of society. Whether you work in a shop environment, a GP surgery or in an office setting the risk of infection will increase the more engagement that occurs with other people. It is essential that national Government guidance on social distancing, hand washing and wearing of masks is adhered to both for the safety of yourself and the safety of other members of the community. At present wearing of masks ( https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own ), in line with national guidance should be adhered to and avoid social hugging, kissing and hand shaking to minimise risk of transmission.
In the current climate if your risk profile highlights a moderate to high risk then avoid travel abroad for social reasons to minimise risk of infection whilst abroad requiring medical intervention.
COVID-19 pandemic has affected all parts of society whether this is through personal infection, family or friends being affected, social isolation for a significant length of time or the way in which the virus has spread across the world causing devastation across communities. Those with existing mental health problems have been more vulnerable and required additional support. Whether you have a pre-existing mental health problem or not, or whether this is related to a home, community or work-related matter, if you feel your mental health is being negatively affected then please seek the appropriate support you require as soon as possible. Have a look at www.nhs.uk for national guidance or contact your GP surgery to seek local support services that are available.