Race Against Time: search is on for coronavirus treatments

The largest randomised clinical trial of potential coronavirus (COVID-19) treatments is underway as part of the race to find a treatment.

The world’s largest randomised clinical trial of potential coronavirus treatments is well underway in the UK as part of the race to find a treatment.

A number of promising treatments are being tested and, if the science supports it, will be given to NHS patients as quickly as possible.

Definitive results on whether the treatments are safe and effective are expected within months and, if positive, they could potentially benefit hundreds of thousands of people worldwide.

Almost 1,000 patients from 132 different hospitals have been already recruited in just 15 days and thousands more are expected to join the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial in the coming weeks, making it the largest randomised controlled trial of potential COVID-19 treatments in the world.

Health and Social Care Secretary Matt Hancock said: “The coronavirus outbreak is the biggest public health emergency in a generation and we are doing everything we can to fight it on all fronts through our evidence-based action plan.

“The UK is leading the way on research in the race to find treatments and we have now launched the largest trial in the world, pooling resources with our world-leading life science sector.

“As one of three major trials funded by the government, this marks a major milestone in our battle against coronavirus and offers renewed hope that together we can beat this.

“The public still has a crucial role to play by staying at home so we can protect the NHS and save lives.”

The trial is testing a number of medicines recommended by an expert panel advising the Chief Medical Officer for England. They include:

Lopinavir-Ritonavir, commonly used to treat HIV
Dexamethasone, a type of steroid use in a range of conditions to reduce inflammation
Hydroxychloroquine, a treatment for malaria

The trial is being conducted in over 130 NHS hospitals across the UK. Adult patients who have been admitted to hospital with COVID-19 are being invited to take part. The trial is specially designed so that as further medicines are identified, these can be added to the study within days.

Chief Medical Officer Professor Chris Whitty said: “The UK has world-leading life sciences and research sectors and, because of our joined up healthcare and health research system, we have been able to get hundreds of patients involved in this clinical trial in just 2 weeks.

“This marks a significant step in identifying treatments for coronavirus that could benefit patients and underpins our science-backed approach to fighting this virus.”

The trial is being coordinated by researchers at the University of Oxford, led by Peter Horby, Professor of Emerging Infectious Diseases and Global Health in the Nuffield Department of Medicine, and Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health.

To ensure that the healthcare system research resource is directed to benefit the national effort, the National Institute for Health Research (NIHR) has put in place a national process to prioritise COVID-19 research. The RECOVERY trial is one of those prioritised.

The study has received £2.1 million from UK Research and Innovation (UKRI) and the Department of Health and Social Care, through the NIHR. It is part of a wider £20 million rapid research response investment by the government to support looking at ways to tackle the coronavirus outbreak.

The move further bolsters the ‘research’ phase in the government’s science-led coronavirus action plan.

It follows decisive action by the UK’s medicines regulator to fast-track clinical trials for potential coronavirus treatments, meaning NHS patients could have faster access if medicines are proven to be effective.

The Medicines and Healthcare products Regulatory Agency (MHRA) has been working hard to put in place procedures to support manufacturers and researchers developing these treatments and approve clinical trial applications in days, rather than weeks.

Its experience as a world-renowned regulator means these rapid approvals are based on the latest scientific advice and do not compromise the government’s top priority of maintaining patient safety.

Peter Horby, Professor of Emerging Infectious Diseases and Global Health in the Nuffield Department of Medicine, University of Oxford, said: “The RECOVERY trial will provide much-needed evidence on the best care for patients with COVID-19.

“The more patients that are enrolled, the sooner we will know how best to treat this disease.

“We are very grateful to those patients who are participating and to the hospital and research staff who are helping us to find the best treatments.”

Stick to advice: STAY HOME THIS WEEKEND

With warm weather forecast this weekend people may feel tempted to head out more, but please stick to government guidance. You are saving lives by staying at home.

Transport Secretary Grant Shapps said: “Don’t travel unless it is essential and particularly avoid using public transport this weekend.

“I know that during the warm weather this weekend people may feel tempted to make the most of it and head out to nearby green spaces more than they have in recent weeks.

“But I want to urge everyone to continue to follow government guidance; that means not travelling too far to exercise or walk pets, staying 2 metres away from other people when outside, and only making journeys when absolutely essential.

“Please remember that anyone can get coronavirus and anyone can spread it – so stay home, protect the NHS, and save lives. As the Prime Minister has said, we will beat coronavirus, and we will beat it together. But to do that we need to stick with the guidance in place, and not break the regulations set to help tackle this outbreak.

“And for those people in the transport sector continuing to work day in and day out to ensure frontline workers can get to work, I want to reiterate my heartfelt thanks at the efforts and dedication you’re showing in helping with this nationwide effort.”

Deliveries begin for high risk groups

People in Scotland at highest risk of severe illness from coronavirus (COVID-19) will begin to receive home deliveries of essential groceries today.

Letters from the Chief Medical Officer have been issuing this week to those who are at greatest risk of COVID-19, to provide bespoke guidance on shielding from infection and information about the support available, which includes access to home deliveries through a text message service.

People who have received the letter this week and signed up to the service have been texted with the option of starting their weekly deliveries of essential food items including soup, pasta, rice, fruit, vegetables, tea, coffee and biscuits, as well as toiletries such as shower gel and toilet roll, on Friday.

Other measures being put in place include:

Specialist medicines such as chemotherapy drugs delivered through local health boards
Local Resilience Partnerships working with Community Pharmacy to scale up deliveries of pharmacy medicines
Work with supermarkets to ensure priority delivery slots for people at high clinical risk

Deputy First Minister John Swinney said: “These new services are available to those at the highest risk of severe illness from COVID-19 who do not have support structures around them to help.

“This includes people with specific forms of cancer, severe respiratory conditions, certain rare diseases, recipients of organ transplants, those on immunosuppression therapies and pregnant women with congenital heart disease.

“Many people will have support from friends and family but I would encourage everyone who receives a letter and requires support to sign up to the service immediately – this will ensure you have adequate supplies of food and essential items during these challenging times.

“It is vitally important that people at highest clinical risk are shielded as much as possible, and our advice alongside this text service will help protect people from the detrimental effects of the virus, including disruption to health and social care and key services.

“Our local services must prioritise those most in need and – by doing so – we will protect them, reduce the burden on the NHS and save lives. By continuing to work together, we can all play our part in keeping everyone safe.”

Those in the high risk group who do not have access to mobile phones will be able to register for deliveries through their local authority.

Contact details are on the NHS Inform website and can also be accessed through the main switchboard number for local councils.

The grocery delivery service will be led by Brakes and Bidfood with the first deliveries expected on 3 April.

The six categories of risk – as agreed by the UK’s Chief Medical Officers – are:

1. Solid organ transplant recipients

2. People with specific cancers:
a. People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
b. People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
c. People having immunotherapy or other continuing antibody treatments for cancer
d. People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
e. People who have had bone marrow or stem cell transplants in the last six 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. People who are pregnant with significant congenital heart disease

Initial estimates of the numbers involved were 150,000-200,000, however, a large number of people have been found to qualify in more than one category, and examination of patient records has identified patients who do not fall into the categories and do not need to apply such stringent measures to protect themselves.

NET sends further £5million to front line charities

The National Emergencies Trust has announced a further £5m of funding will be distributed to front line charities today helping those most impacted by the coronavirus outbreak. This is possible thanks to the generosity of the UK public, major charitable trusts and corporate donations.

So far, around half of the £16m total pledged to the Coronavirus Appeal has been given out (£7.5m in total), following an initial allocation of almost £2.5m a week after the appeal launched. Further distributions will be made in the coming days, to continue to support the most vulnerable in society.

The money will be distributed through UK Community Foundations to 46 local community foundations across the country.

Major businesses and charitable trusts across the UK, as well as the British public, have generously donated to the appeal, including corporate donors such as BT, Tesco, HSBC, M&S and National Grid.

The appeal is responding to the needs of local communities across the UK and allocating money to community foundations based on local factors such as levels of deprivation and demographics in each region.

Local Distribution

A snapshot of some of the local groups already benefitting from the appeal include:

Horncastle Food Bank

Horncastle Food Bank in Lincolnshire which has seen a 300% increase in demand for food and hygiene parcels. The group has also stepped in to help combat child poverty, by providing food for those children no longer receiving free school meals and are now also distributing hot meals for vulnerable people currently in isolation.

ASD Helping Hands

ASD Helping Hands helps those caring for children and young adults with autism, supporting over 1,300 families in Norfolk. Since the outbreak, the organisation has launched a web and phone-based advice and listening service to continue to support the mental wellbeing of families during this stressful time.

Musical Memories

Social enterprise Musical Memories saw its 5th anniversary Big Sing concert for more than 150 older people in the community cancelled due to the outbreak. However, the social enterprise hasn’t been deterred and is now hosting live music online sessions every day for older people across rural Yorkshire to help fight loneliness and isolation. Funding will provide recording equipment to facilitate ever more creative and engaging remote concerts.

NET Coronavirus Appeal

The National Emergencies Trust’s Coronavirus Appeal was launched in partnership with the British Red Cross and with the support of the Duke of Cambridge.

Anyone can make a donation and further donations can be made by clicking the below button.

DONATE

This week celebrity supporters including Miranda Hart, Joe Lycett and Kate Thornton have shared video messages on their social media urging the public to get behind the appeal.

John Herriman, CEO of the National Emergencies Trust, said: “It is fantastic that good causes across the UK are already seeing the benefits of the public’s support and the overwhelming generosity of our corporate donors. It’s vital that we are able to offer support to these groups as soon as we can.

“Our work may have started but there is still much more to do. We’re asking the public to get behind the appeal and make contribution if possible, or to spread the word to help raise awareness.

“Everyone who donates can be confident their money is reaching those in need quickly and making an instant difference to the most vulnerable in our communities at this difficult time. We need to come together more than ever and I’m heartened the British public are rising to the challenge.”

Rosemary Macdonald, Interim CEO of UK Community Foundations, said: “Working closely with our network of 46 community foundations, we’re seeing unprecedented demand for support from those in need across our society.

“We’re working to make sure that donations reach communities quickly and in response to particular needs, so that we are properly supporting the most vulnerable as best we can.”

Further changes to waste collections ‘will help protect workers’ safety’

First it was glass, now it’s garden waste. Changes will be made to waste collections in Edinburgh to ensure the continued delivery of essential services and to protect the health of frontline workers and residents.

New arrangements will protect the health of frontline staff
Non-statutory garden waste collections will be suspended to allow for changes
Additional measures have been taken to safeguard public health

From 7 April we are suspending kerbside garden waste (brown bin) collections to help prioritise resources while enabling waste collection crews to observe social distancing guidelines during the ongoing coronavirus outbreak.

In order to give crew members the space to stay two metres apart, the number of operatives in refuse lorry cabs will be reduced, meaning we’ll need increased resources to carry out the collection of kerbside and communal general waste, food recycling and dry mixed recycling.

Council Leader Adam McVey said: “As a result of the current situation, non-statutory garden waste collections will be suspended until further notice, along with kerbside glass (blue box) collections, which were stopped earlier this month.

We’ll be in touch with households who have paid for this service about how we’ll compensate them for the reduction in service once we know the extent of the disruption.

“We’re working extremely hard to continue providing essential services to people living here, and our waste collection crews are doing a fantastic job. However, their health is of utmost importance so it’s important that we adapt service provision to protect their safety.

“This latest change will allow us to keep collecting most bins while giving teams the space to practise social distancing, limiting the potential spread of the coronavirus. I want to reassure the public that we’re doing everything we can to keep essential services running as close to normal as possible while looking out for the needs of the people who work for us.”

Depute Leader Cammy Day said: “Like local authorities across the country we face unprecedented challenges and at times like these it’s necessary to make changes for the good of the city, and our employees.

“We know this will be of some inconvenience to those planning to be gardening during this period, but I would discourage people from putting grass and cuttings in the brown bins in the meantime, as contents will begin to compost meaning they may become too heavy for us to collect once the service is up and running again. You can, however, find tips and advice for home composting on Changeworks’ website.”

To further support the essential collection of general waste, mixed recycling and food recycling, the council is procuring extra resources from a third-party provider, as well as reassigning staff from cleansing teams.

Anyone with symptoms of Coronavirus is encouraged to follow the guidance on how to dispose of waste correctly to help protect the safety of bin collection crews.

Additional measures taken to safeguard waste and cleansing workers’ health have been the increased provision of hand sanitiser supplies, in addition to hot water handwashing points in a number of vehicles, the washing down of lorries at the end of shifts and efforts to encourage social distancing in depots.

We will be contacting all those who have registered for garden waste collections to update on arrangements via letter or email, depending on how they signed up.

During this period, residents can continue recycling garden waste by using a compost bin if possible – tips and advice for home composting are available on Changeworks’ website.

If your brown bin is full please don’t put more garden waste in as the contents will start to compost and could become too heavy to empty when services start again.

Further information on changes to bin collections and other services can be found on the Council website.

New guidelines to protect frontline staff

New guidance on personal protective equipment (PPE) has been published for health and social care workers responding to coronavirus (COVID-19) in Scotland.

The guidance, which has been agreed by the four UK Chief Medical Officers and Chief Nursing Officers, follows an urgent review of the existing guidance against the latest evidence and WHO advice, on the safest way to protect health and social care staff.

The new guidance includes:

what type of PPE to use in secondary, primary and community care settings, and when to wear it

when clinicians need to wear a higher level of protective equipment, and in which settings

detailed advice around risk assessing use of PPE in a range of different clinical scenarios, including community settings, such as care homes and caring for individuals in their own homes

Health Secretary Jeane Freeman said: “Protecting staff working on the frontline is an absolute priority and I want to thank each and every one of them for their hard work and commitment in this incredibly challenging situation.

“I want our staff to feel as safe as possible and this updated guidance provides clarity so that health and social care staff caring for patients feel confident in which PPE they need to wear in different situations and settings.”

Scotland’s Chief Medical Officer Dr Catherine Calderwood said: “The updates to the guidance reflect the fact that COVID-19 is now widespread in the community, so health and social care workers are more likely to see patients with the virus, some of whom will not have symptoms yet.

“We have introduced new measures to improve the distribution of PPE, including a single point of contact for all health boards to manage local PPE supply and distribution, and an email address for NHS staff to contact if they do not have what they need. This is covid-19-health-PPE@gov.scot. It will be monitored continuously and allow us to act to resolve any specific supply issues more quickly.

“A helpline has also been set up for registered social care providers having problems accessing PPE, with extra staff to prepare orders for social care, additional delivery drivers, longer delivery hours and use of more external delivery companies to increase capacity. Work continues to source further PPE and ensure there is an appropriate supply for all our workforce.”

The Scottish Government also outlined details of the improved process to report COVID-19 deaths that began yesterday.

As part of this new system, 40 deaths, which would not yet have been reported under the old system – because next of kin had not been informed – have been included and allocated to the last three days as appropriate.

The data below shows the running total of the number of deaths reported, under the old and new systems, of those confirmed to have died from Coronavirus across the last few days. There are now 126 deaths confirmed using the new system:

Tuesday 31 March – 69 (previously 60)

Wednesday 1 April – 97 (76)

Thursday 2 April – 126 (86).

Stung into action: Hancock unveils testing plans

England will carry out 100,000 tests for coronavirus every day by the end of this month, Health Secretary Matt Hancock pledged yesterday.

Increased testing for the NHS will form part of a new 5-pillar plan, bringing together government, industry, academia, the NHS and many others, to dramatically increase the number of tests being carried out each day.

Mr Hancock’s announcement comes following increasing criticism of the government’s slow response to both testing for coronavirus and provision of vital personal protective equipment (PPE).

On Wednesday, trade unions urged the government to ensure essential workers get access to live-saving protective equipment in an open letter to ministers.

The letter, signed by the TUC, UNISON, RCM, GMB, Unite, BDA and CSP, said: “Our members care for the sick and the elderly, they look after our children and keep them safe, they make sure there is food on the supermarket shelves, they keep the lights on and the water running.

“We are weeks into fighting Covid-19. It is now clear that the lack of personal protective equipment for frontline workers has become a crisis within a crisis.”

The letter adds: “Workers are being exposed to unreasonable and unnecessary risk by the ongoing failure to provide key workers with adequate PPE.

“Every day we hear from our members that despite repeated assurances from government, people are being asked to work with inadequate or out of date protective equipment – and that is where PPE is being provided at all.”

The letter states starkly the risks faced by key workers. “They are risking their own health and safety for us. We must be clear what that means, those who are subject to prolonged and direct exposure to the virus – such as health and social care professionals – are risking their lives.”

Calling for urgent government action to increase PPE supply, the letter adds there must be “transparency on procurement, distribution, timescales and exactly how and when workers can expect to get the protection they need and deserve,” adding “we call on the government and employers to guarantee that no member of staff will be put under pressure to perform tasks without adequate protective equipment.”

The call was backed by Labour health spokesperson John Ashworth. “Labour calls on ministers to abandon attempts to gag staff and instead work closely with trade unions to ensure staff get the PPE that is so crucial to keeping them and patients safe,” he said.

The appeal – and, perhaps more importantly, criticism from loyal government supporting newspapers including the Daily Mail and the Telegraph – appears to have had an effect and the government has been stung into action.

Professor John Newton the Director of Health Improvement for Public Health England, has been appointed to help deliver the new plans and bring together industry, universities, NHS and government behind the ambitious testing targets.

He will coordinate a national effort with global manufacturers encouraged to expand their manufacturing capacity here in England; our strongest, home grown businesses in life sciences and other industries are encouraged to turn their resources to creating and rolling out mass testing at scale, and the government will support anyone with a scalable scientific idea or innovation to start a business.

New testing capabilities for the NHS and their families will support staff who are isolating at home to return safely to work if the test is negative, and keep themselves and others safe if the test is positive.

Significant progress to increase testing has already taken place across the country to protect the vulnerable, support our NHS, and ultimately save lives. New testing centres have been established at the main hotspots of the disease, and the UK has already conducted more than 152,000 tests. The 5-pillar plan sets targets to expand the England’s capability further.

The new 5-pillar plan outlines the ambitions to:

Scale up swab testing in PHE labs and NHS hospitals for those with a medical need and the most critical workers to 25,000 a day by mid to late April;
Deliver increased commercial swab testing for critical key workers in the NHS, before then expanding to key workers in other sectors;
Develop blood testing to help know if people have the right antibodies and so have high levels of immunity to coronavirus;
Conduct surveillance testing to learn more about the spread of the disease and help develop new tests and treatments; and
Create a new National Effort for testing, to build a mass-testing capacity at a completely new scale.

Once widespread testing is available, we will prioritise repeated testing of critical key workers, to keep them safe and make sure that they do not spread the virus.

Over time, plans announced today will also see increasing focus on testing to see if people have already had the virus, to identify if they have the antibodies that will give them immunity against catching it again. This science is new and developing, but the aim is for a successful test that can be rolled out at scale, that could allow critical workers – and then the wider population – to return to work and their daily lives.

The Health Secretary also announced that over £13 BILLION of debt will be written off as part of a major financial reset for NHS providers – and community pharmacies will also receive a £300 million boost.

Seems the government has found that magic money tree after all!

New technology to aid COVID-19 air transfers

The Scottish Ambulance Service is utlilising the latest medical technology to aid in the safe transfer of COVID-19 patients using air ambulance.

The ‘epishuttle’ technology allows patients to be placed in a sealed adult sized incubator for transfer by air ambulance, providing protection for both patients and staff in complex cases.

To date, eight of these shuttles have been purchased, two of which have been received and are being tested for a go-live date on 3 April. A further two will be received on 17 April and another four by Mid-May.

The investment, of more than £500,000, will allow the Service to ensure patients receive the highest possible standards of care whilst increasing capacity for complex transfers involving COVID-19 patients, such as those from remote and Island communities.

The Scottish Ambulance Service is working in partnership with Transport Scotland, Loganair and the RAF to increase the range of transport options available for COVID-19 transfers.

Pauline Howie, Chief Executive of the Scottish Ambulance Service, said: “This is an unprecendented situation and our staff across the country are doing a fantastic job in caring for patients across Scotland.

“The fight against COVID-19 has required the NHS to think differently and to move at pace. By adapting our approach and using this latest available technology, we are taking swift action in the best interests of patients and our hardworking staff – whilst increasing our capacity.

“The introduction of epishuttles will increase the range of options available to us as a Service as we deal with COVID-19 cases, particularly for rural and island communities.

“I’d also like to thank our colleagues at Transport Scotland, Loganair and the RAF who have been offered fantastic assistance to us through aircraft and staff. It has been a real team effort and means we have the full range of resources available to us to enable us to react to any situation as we continue to help communities across Scotland in the months ahead.”

Health Secretary Jeane Freeman said: “We’ve been working closely with the Scottish Ambulance Service to significantly increase capacity for airlifting patients off the islands and to ensure that any patients from our island communities with COVID-19 can be transported to receive the appropriate healthcare when they need it.

“The first batch of Epishuttles will be available from this Friday, with plans well underway to increase the number of these single patient isolation pods in the coming weeks. Epishuttles are designed to protect patients and crew from potential infection and safely transport patients on fixed wing aircraft.

“In the meantime, SAS is working with the RAF who are currently providing cover for transfers off the islands, using three puma helicopters based at Kinloss which can transfer some patients without Epishuttles.

“Our NHS is on an emergency footing and all health boards have been undertaking extensive work across Scotland to maximise the capacity available to manage expected rise in demand due to COVID-19. We can all play our part and ease pressure on services by staying at home, except for key workers, essential shopping, reasonable exercise or caring for the vulnerable.”

The rights and health of refugees, migrants and stateless must be protected

A joint press release from The Office of the High Commissioner, United Nations Human Rights; International Organisation for Migration; World Health Organisation:

In the face of the COVID-19 crisis, we are all vulnerable. The virus has shown that it does not discriminate – but many refugees, those forcibly displaced, the stateless and migrants are at heightened risk.

Three-quarters of the world’s refugees and many migrants are hosted in developing regions where health systems are already overwhelmed and under-capacitated. Many live in overcrowded camps, settlements, makeshift shelters or reception centers, where they lack adequate access to health services, clean water and sanitation.

The situation for refugees and migrants held in formal and informal places of detention, in cramped and unsanitary conditions, is particularly worrying.

Considering the lethal consequences a COVID-19 outbreak would have, they should be released without delay. Migrant children and their families and those detained without a sufficient legal basis should be immediately released.

This disease can be controlled only if there is an inclusive approach which protects every individual’s rights to life and health. Migrants and refugees are disproportionately vulnerable to exclusion, stigma and discrimination, particulary when undocumented.

To avert a catastrophe, governments must do all they can to protect the rights and the health of everyone. Protecting the rights and the health of all people will in fact help control the spread of the virus.

It is vital that everyone, including all migrants and refugees, are ensured equal access to health services and are effectively included in national responses to COVID-19, including prevention, testing and treatment. Inclusion will help not only to protect the rights of refugees and migrants, but will also serve to protect public health and stem the global spread of COVID-19.

While many nations protect and host refugee and migrant populations, they are often not equipped to respond to crises such as Covid-19. To ensure refugees and migrants have adequate access to national health services, States may need additional financial support. This is where the world’s financial institutions can play a leading role in making funds available.

While countries are closing their borders and limiting cross-border movements, there are ways to manage border restrictions in a manner which respects international human rights and refugee protection standards, including the principle of non-refoulement, through quarantine and health checks.

More than ever, as COVID-19 poses a global threat to our collective humanity, our primary focus should be on the preservation of life, regardless of status. This crisis demands a coherent, effective international approach that leaves no-one behind.

At this crucial moment we all need to rally around a common objective, fighting this deadly virus. Many refugees, displaced, stateless people and migrants have skills and resources that can also be part of the solution.

We cannot allow fear or intolerance to undermine rights or compromise the effectiveness of responses to the global pandemic. We are all in this together. We can only defeat this virus when each and every one of us is protected.

New guidance to support mental wellbeing during the coronavirus outbreak

Advice on looking after your mental health during the coronavirus (COVID-19) outbreak is now available on NHS inform, Scotland’s trusted health information site.

As people across Scotland adjust to these unusual circumstances, NHS 24’s mental health practitioners anticipate many will experience anxiety and stress about what’s going on in the world. In particular, those living alone or who are self-isolating, may be struggling with limited social contact as a result of social distancing measures.

NHS 24 Medical Director, Dr Laura Ryan, said: “Everyone deals with this type of situation differently, and it may feel like there is a lot going on which is outside of your control.

“Remember it’s ok, not to feel ok. Understandably, you may need some additional mental health support at this challenging time. Don’t forget that we’re all in this together and that support is available from a wide range of organisations to help you get through this.”

The NHS inform website hosts the national information service for COVID-19 and now provides online information and practical advice on mental wellbeing – www.nhsinform.scot/coronavirus-mental-wellbeing

Guidance is centred on four main areas:

Staying informed – having the right information, as news from unreliable sources can make you feel more upset and anxious.

Creating a healthy home routine – helping everyone in your home to keep a sense of calm and order.

Staying connected – keeping in touch with friends and family online or by phone, to help you feel less alone while staying home.

Finding support – just talking to someone can help, phonelines such as Breathing Space and Samaritans are there to offer support.

Breathing Space National Coordinator, Tony McLaren, said: “We are receiving lots of calls to the Breathing Space helpline from people feeling anxious about their health, or concerned about the health of others.

“It’s perfectly understandable to feel this way, and our advisors are here to listen and offer support. Having mental health information available on NHS inform is an additional resource which can be accessed to potentially help ease anxieties.”

You can hear more from Tony on how to manage your mental health- search for ‘Tony McLaren NHS 24’ on www.soundcloud.com.

Extra funding from the Scottish Government has been made available for NHS 24 to develop additional self-help guides, online resources and mental health services to cope with further demand.