What is Social Distancing?

This guidance is for everyone. It advises on social distancing measures we should all be taking to reduce social interaction between people in order to reduce the transmission of coronavirus (COVID-19).

It is intended for use in situations where people are living in their own homes, with or without additional support from friends, family and carers. If you live in a residential care setting guidance is available.

We are advising those who are at increased risk of severe illness from coronavirus (COVID-19) to be particularly stringent in following social distancing measures.

This group includes those who are:

• aged 70 or older (regardless of medical conditions)
• under 70 with an underlying health condition listed below (ie 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

Note: there are some clinical conditions which put people at even higher risk of severe illness from COVID-19. If you are in this category, next week the NHS in England will directly contact you with advice the more stringent measures you should take in order to keep yourself and others safe. For now, you should rigorously follow the social distancing advice in full, outlined below.

People falling into this group are those who may be at particular risk due to complex health problems such as:

• people who have received an organ transplant and remain on ongoing immunosuppression medication
• people with cancer who are undergoing active chemotherapy or radiotherapy
• people with cancers of the blood or bone marrow such as leukaemia who are at any stage of treatment
• people with severe chest conditions such as cystic fibrosis or severe asthma (requiring hospital admissions or courses of steroid tablets)
• people with severe diseases of body systems, such as severe kidney disease (dialysis)

What is social distancing?

Social distancing measures are steps you can take to reduce the social interaction between people. This will help reduce the transmission of coronavirus (COVID-19).

They are:

1. Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
2. Avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible
3. Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information
4. Avoid large gatherings, and gatherings in smaller public spaces such as pubs, cinemas, restaurants, theatres, bars, clubs
5. Avoid gatherings with friends and family. 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

Everyone should be trying to follow these measures as much as is pragmatic.

We strongly advise you to follow the above measures as much as you can and to significantly limit your face-to-face interaction with friends and family if possible, particularly if you:

• are over 70
• have an underlying health condition
• are pregnant

This advice is likely to be in place for some weeks.

Handwashing and respiratory hygiene

There are general principles you can follow to help prevent the spread of respiratory viruses, including:

• washing your hands more often – with soap and water for at least 20 seconds or use a hand sanitiser when you get home or into work, when you blow your nose, sneeze or cough, eat or handle food
• avoid touching your eyes, nose, and mouth with unwashed hands
• avoid close contact with people who have symptoms
• cover your cough or sneeze with a tissue, then throw the tissue in a bin and wash your hands
• clean and disinfect frequently touched objects and surfaces in the home

What should you do if you develop symptoms of coronavirus (COVID-19)

The same guidance applies to the general population and those at increased risk of severe illness form coronavirus (COVID-19). If you develop symptoms of COVID-19 (high temperature and/or new and continuous cough), self-isolate at home for 7 days. You can find the full guidance at stay at home.

How can I get assistance with foods and medicines if I am reducing my social contacts?

Ask family, friends and neighbours to support you and use online services. If this is not possible, then the public sector, business, charities, and the general public are gearing up to help those advised to stay at home. It is important to speak to others and ask them to help you to make arrangements for the delivery of food, medicines and essential services and supplies, and look after your physical and mental health and wellbeing.

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. Your health or social care provider will be asked to take additional precautions to make sure that you are protected. The advice for formal carers is included in the Home care provision.

What should you do if you have hospital and GP appointments during this period?

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 clinician to ensure you continue to receive the care you need and consider whether appointments can be postponed.

What is the advice for visitors including those who are providing care for you?

You should contact your regular social visitors such as friends and family to let them know that you are reducing social contacts and that they should not visit you during this time unless they are providing essential care for you. Essential care includes things like help with washing, dressing, or preparing meals.

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 reducing social contacts and agree on a plan for continuing your care.

If you receive essential care from friends or family members, speak to your carers about extra precautions they can take to keep you safe. You may find this guidance on Home care provision useful.

It is also a good idea to speak to your carers about what happens if one of them becomes unwell. If you need help with care but you’re not sure who to contact, or if you do not have family or friends who can help you, you can contact your local council who should be able to help you.

What is the advice if I live with a vulnerable person?

If you live in a house with a vulnerable person refer to our household guidance.

How do you look after your mental wellbeing?

Understandably, you may find that social distancing can be boring or frustrating. You may find your mood and feelings are affected and you may feel low, worried or have problems sleeping and you might miss being outside with other people.

At times like these, it can be easy to fall into unhealthy patterns of behaviour which in turn can make you feel worse. There are simple things you can do that may help, to stay mentally and physically active during this time such as:

• look for ideas of exercises you can do at home on the NHS website
• spend time doing things you enjoy – this might include reading, cooking, other indoor hobbies or listening to the radio or watching TV programmes
• try to eat healthy, well-balanced meals, drink enough water, exercise regularly, and try to avoid smoking, alcohol and drugs
• keep your windows open to let in fresh air, get some natural sunlight if you can, or get outside into the garden

You can also go for a walk outdoors if you stay more than 2 metres from others.

Further information on looking after your mental health during this time is available.

What steps can you take to stay connected with family and friends during this time?

Draw on support you might have through your friends, family and other networks during this time. Try to stay in touch with those around you over the phone, by post, or online. Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing and you may find it helpful to talk to them about how you are feeling.

Remember it is OK to share your concerns with others you trust and in doing so you may end up providing support to them too. Or you can use a NHS recommended helpline.

Advice for informal carers

If you are caring for someone who is vulnerable, there are some simple steps that you can take to protect them and to reduce their risk at the current time.

Ensure you follow advice on good hygiene such as:

• wash your hands on arrival and often, using soap and water for at least 20 seconds or use hand sanitiser
• 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 if you are unwell and make alternative arrangements for their care
• provide information on who they should call if they feel unwell, how to use NHS 111 online coronavirus service and leave the number for NHS 111 prominently displayed
• find out about different sources of support that could be used and access further advice on creating a contingency plan is available from Carers UK
• look after your own well-being and physical health during this time. Further information on this is available here

Summary of advice