Heath Clinic FAQs
This is a very uncertain time for everyone so we have compiled these FAQs.
Please check to see if your question is answered below before calling the Heath Clinic reception.
What is Coronavirus?
Coronaviruses are a large family of viruses that can infect mammals and birds. There are seven strains that can infect humans and they typically causing mild illness. 1 in 6 cases of the common cold are caused by coronaviruses.
COVID-19 is the name of the disease caused by the current coronavirus (SARS-CoV-2 strain) outbreak. Most people infected with the COVID-19 virus will experience mild to moderate respiratory (chest) illness and recover, without requiring special treatment. 1 in 5 people develop a more serious illness. This tends to be older people, and those with an underlying medical problem like cardiovascular disease, diabetes, chronic respiratory disease (asthma or COPD) or cancer.
The commonest symptoms of COVID-19 are a high temperature (feeling hot to touch on your chest or back, or a fever over 37.8C), and a new, continuous cough. That means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours.
The COVID-19 virus spreads through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. It infects people through their ears, eyes, nose and mouth. So, it’s important to cover your nose and mouth when coughing or sneezing, and wash your hands thoroughly and frequently.
At the moment, there are no specific vaccines or treatments for COVID-19. Lots of research is being done. There have been headlines about using the HIV drug lopinavir/ritonavir (also known as Kaletra, uncommonly used for treatment in the UK) to treat coronavirus but no good evidence yet that it will work. The drugs used for PrEP are not active against coronavirus.
What is the difference between ‘self-isolating’, ‘social distancing’ and ‘shielding’?
The latest guidance is that all of us should stay at home. This was part of the government announcement on the 23 March and will be reviewed in three weeks’ time. This is ‘social distancing’:
- Only go outside for food, health reasons or work (where this absolutely cannot be done from home).
- Stay 2 metres (6ft) away from other people.
- Wash your hands regularly, including as soon as you get home.
‘Self-isolating’ means staying at home if you think you, or a household contact, may have COVID-19.
- If you live alone and you have symptoms of COVID-19 (a new cough or fever), however mild, stay at home for 7 days from when your symptoms started.
- If someone else in your home has symptoms of COVID-19, they must stay at home for 7 days, but all other household members who remain well must also stay at home and not leave the house for 14 days (this is to allow for the time it can take for them to get infected and then recover).
‘Shielding’ means staying home at all times, and avoiding any face-to-face contact for a period of at least 12 weeks from the week of 23rd March 2020.
Anyone with a CD4 count less than 50 would fall into this category. If that is you, then you and your docotor will already be aware, otherwise don't worry.
Am I at higher risk (in a vulnerable category) because of my HIV and do I need to self-isolate?
So far, there is no evidence to determine whether people with HIV are at greater risk of COVID-19 acquisition than HIV-negative people. Therefore, people with HIV alone are not considered ‘extremely vulnerable’ and do not need to undertake ‘shielding’ unless they have one of the conditions listed in this guidance: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19.
BHIVA advises patients with a CD4 cell count less than 50 (CD4 <50), or people who have had an opportunistic illness within the last 6 months, should follow the ‘shielding’ advice for the extremely vulnerable.
BHIVA advises that people not on antiretroviral therapy (ART) or with a CD4 count <200 should follow social distancing stringently.
But I don’t know what my CD4 count is!
Our staff are currently collating a list of all patients whose last CD4 count was <200 and we will be contacting these patients to advise them.
What should I do if I think I have COVID-19?
Do NOT attend the clinic.
If you have a fever and/or a new, persistent cough, stay at home if you are well enough to do so, and do NOT call 111 or your GP. You do NOT need to let the clinic know. You need to remain at home for 7 days, and other members of your household (partners, children, family etc.) need to self-isolate for 14 days.
You can access information and advice from NHS 111 here. Testing for coronavirus is not currently recommended as it is not needed if you're staying at home.
If you feel you cannot cope with your symptoms at home, your condition gets worse, or your symptoms do not get better after 7 days, then call the NHS 111 Coronavirus Service.
Do I have to do anything special to keep well, because of my HIV?
You should continue taking your antiretroviral therapy, at the same dose. Do NOT increase the number of tablets you take – this will not help you if you get COVID-19, neither will it protect you from getting it. Your treatment will keep your virus undetectable which in turn supports your immune system to function at its best.
If you get COVID-19, the fitter you are, the better the outcome. Stopping smoking or vaping will definitely help. Take exercise where you can (one form of exercise a day, for example a run, walk or cycle), and if you do have to self-isolate, you can find exercise suggestions online here.
It is normal be worried – everyone is – and taking care of your mental health is also important, with useful advice in this article
Is there any medicine I can take to protect myself from Coronavirus?
To date, there is no specific medicine recommended to prevent or treat the new coronavirus.
Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, do not provide protection against the new coronavirus. Neither does the seasonal ‘flu (influenza) vaccine. The COVID-19 virus is so new and different that it needs its own vaccine. Researchers are working on this. Although these vaccines are not effective against the COVID-19 virus, routine vaccination against pneumonia and influenza remain highly recommended for people living with HIV, to protect your health.
How will the COVID-19 pandemic affect my HIV care?
We are limiting face to face contact in line with NHS England guidance to try to reduce the chance of you catching or passing on COVID-19 to other patients and staff.
During the pandemic we anticipate that staffing levels will drop as staff fall sick, isolate, care for children and move to help out in other areas of the NHS. We understand that you are taking life-saving medication and that we need to ensure you have them throughout the pandemic. This is our utmost priority. We have made careful plans to ensure that there will ALWAYS be clinic staff who can deal with emergency advice and prescriptions. However, to do this we need to cancel ALL routine clinic appointments and blood tests for stable patients until further notice. There will be some people who will need advice over the phone or in person. We will let you know if you need to keep your appointment or wait for a telephone call.
How will the clinic ensure I have enough medications now that my appointment is cancelled?
Our consultants and clinical nurse specialists are now going through the appointments that are booked in for the next few months. Staff are contacting patients to determine if their appointment can be deferred, and to organise a new prescription. Where safe, we will be prescribing enough medications to last you until September 2020. Home deliveries may take up to 3-4 weeks to process, due to increased demand and reduced services. Therefore, where patients have a supply of less than one month of medications at home, we will prescribe an additional 2-months of medication to collect from the hospital pharmacy to ensure nobody runs out whilst waiting for their home delivery.
How will I know when to collect my medications?
Our pharmacy will contact you regarding your medications.
If you get your medications delivered via Alcura homecare to your house, Boots Pharmacy or another location, you can contact Alcura directly by:
- sending an email to email@example.com
- or call them on: 01604 433510
Monday to Friday - 8am until 6.30pm
Saturday - 9am to 1pm
If you collect you medicines from the hospital pharmacy, the pharmacists will contact you to advise on when to collect your medications.
What about my blood tests, when will these be done?
We will not be doing any routine bloods for people who are stable. Your doctor will be looking through your record and previous blood results and deciding whether your HIV is stable and if you need to have bloods. You do not need to call and check with us whether a blood test is needed. If we think you do need a blood test, we will let you know. If you plan to attend for a blood test but have not been contacted by the clinic in advance, please call to check whether or not you should attend.
Is it safe to continue to take my medicine without having my blood test first?
Yes, you should continue to take your medication. Our doctors and nurses are reviewing all patients’ medical records and previous blood results and if we have any concern, we will be contacting you.
I am pregnant. What will happen to my care?
The doctor looking after you will decide on an individual basis how often you need to be reviewed. Follow-up appointments may be reduced, based on an assessment of your HIV treatment and results so far. The British HIV Association (BHIVA) released guidance on 25th March 2020. As a minimum, you will need bloods when your pregnancy is confirmed, and at 36 weeks of pregnancy. You will also have either a virtual (telephone) or in-person review in each trimester (each 3 months). The 36 week review should be face-to-face where possible to confirm your birth plan. We will work very closely with your midwife to ensure you continue to get good care.
Can I attend the clinic?
We have suspended walk-in HIV services for the time being and you will not be able to walk in. We will only see patients who have been requested to come in after telephone discussion with a doctor or nurse and we cannot see patients who have symptoms that may be related to COVID-19. If you do attend, you may be asked to leave. If you turn up for an appointment which has been cancelled, we will not be able to see you.
Can I contact the clinic?
We are asking you NOT to phone the clinic to ask about your appointment or your prescription unless you are running out in the next two weeks. Staff are extremely busy and we need to put all our energy into ensuring that we maintain your drug supply and see those patients who do need to be seen.
If you have a non-urgent query, you can email us at firstname.lastname@example.org and one of our staff will respond as soon as possible. Please do not email with any urgent queries.
Everything is changing so fast, where can I find the most up-to-date information?
How will I know when normal service has resumed?
We will contact patients and offer appointments!
The information in this FAQ factsheet is adapted from: British HIV Association (BHIVA), European AIDS Clinical Society (EACS), Terrence Higgins Trust (THT), UK Government.