Coronavirus: Is is still safe to go out walking? – Dr Nick Summerton

We all need functioning hospitals – and intensive care units – to be able to care for the one in 20 people who will become very sick with the virus in addition to those of us who might, unfortunately, get another significant illness or have, say, a bad road traffic accident.

Department of Health (DH) guidance asks all of us to keep away from individuals with symptoms of coronavirus and to avoid going to GP surgeries.

Only essential travel should be undertaken and, if possible, we must all try to work from home. We have also been asked to stop coming together in groups at pubs, cinemas, restaurants, theatres, bars, clubs and to cancel any family gatherings. Schools are now shutting. On top of all this, it is recommended that people who are over 70, have an underlying health condition or are pregnant take even more stringent steps to keep them away from other people.

But, having spent the last couple of days speaking to patients in my practice, I have discovered that applying the guidance about social distancing can be extremely challenging.

It is difficult enough to persuade some fit young people that they must stop going to pubs and clubs when they have already been told that, for them, coronavirus will be a mild illness. Even more tricky is providing targeted – and enhanced – advice to specific individuals based on their age and existing illnesses.

People are more likely to get sick from coronavirus if they are aged over 70, are pregnant or have a health conditions affecting their heart, kidneys, lungs, liver, spleen or nervous system. Individuals with diabetes, cancers or a weakened immune system due to HIV or certain medicines also need to be careful. In short, if you get a flu jab each year from your own GP, then you will be at higher risk from coronavirus.

In shielding the elderly and the vulnerable a careful balance needs to be struck between a person’s individual risk – should they catch coronavirus – against the health benefits of continuing with some social activities and having some exercise.

I have been asked about an 89-year-old lady with chronic bronchitis and diabetes wanting to continue going to the hairdressers. Her age and her health problems meant that she was highly likely to become very sick should she get coronavirus. On the other hand, for many older ladies, I know that having their hair done is a very important social activity and, for some, might be the only time that they have a decent chat during the course of a whole week.

Several of the people who attend my local walking group are well over 70 and some have other illnesses too. But, for them, they get tremendous physical and mental health benefits from being outside, walking and talking. I have also witnessed the enormous boost people get – following a bereavement or an illness – from joining a countryside ramble. How will it affect their wellbeing if these individuals are now confined to their own home – alone – for three months?

Moreover, numerous individuals over the age of 70 are the backbone of communities – running charities, leading voluntary organisations and supporting others. Also many of us – young and old, families and individuals – will need help with shopping and collecting medicines if we need to self-isolate.

Those people who require enhanced protection need to work out a ‘personal distancing plan’ (PDP) with a close friend or relative. It is about balancing all the risks and all the benefits of staying at home or getting out. It is also about working out different ways to do things. Can others run errands for me? Can I learn to use Skype? What exercises can I do at home? Is it a chance to do a job I have been putting off for years? Can I improve my own health and lower my risks by stopping smoking or losing some weight?

To assist with developing PDPs, doctors – like myself –must offer some assistance by categorising our patients into low, medium or high coronavirus risk groups. We also need to make it much clearer that – although cough and a temperature are the most common symptoms of coronavirus – people at higher risk also need to keep away from those who have sore throats, headaches, muscle aches, shortness of breath or individuals who just feel unwell.

A healthy lifestyle is all about balance and this is particularly important now.

Dr Nick Summerton is a East Yorkshire GP and public health specialist.