[翻译] NHS给在英国所有人的关于"社交距离"以及保护老年人和弱势成年人的行为指南
译者注:
1. 该指南发布于2020年3月16日
2. NHS: National Health Service 英国国民医疗服务体系
3. 英文原文在底部
背景及适用范围
该指南适用于每个人。指南建议所有人采取"社交距离"措施以减少人际交往，从而减少新型冠状病毒的传播。该指南适用于自我居家隔离，无论你是否有来自朋友，家人或护理人员的支持。如果你居住在住家护理的环境里，请阅读这份指南。
我们建议对于新型冠状病毒(COVID-19)所致的严重疾病具有增加性风险的人群要特别严格地遵循"社交距离"措施。
这些人群包括:
- 70岁或以上的人群 (无论健康状况如何)
- 70岁以下，但有以下潜在健康状况的人群(任何由于健康原因每年被要求注射流感疫苗的成年人)
- 慢性(长期)呼吸道疾病，比如哮喘，慢性阻塞性肺疾病(COPD)，肺气肿，或支气管炎
- 慢性心脏病，比如心力衰竭
- 慢性肾炎
- 慢性肝部疾病，比如肝炎
- 慢性神经性疾病，比如帕金森病，运动神经元病，多发性硬化，学习障碍，或脑性瘫痪
- 糖尿病
- 脾脏问题，例如，镰状细胞疾病，或者移除了一侧的脾脏
- 由HIV，艾滋病，服用类固醇药物或者化疗导致的免疫缺陷
- 严重超重(身高体重指数BMI在40或以上)
- 孕妇
注意: 有些临床状况会大大增加人们患COVID-19所致严重疾病的风险。如果你也属于这类人群，下周在英格兰的NHS会直接联系你并建议你采取一些更加严格的措施来保障你及他人的安全。现在，你必须严格而完整地遵循下面列出的"社交距离"措施。
这个群体包含由复杂的身体状况导致面临额外风险的人，例如:
- 曾接受器官移植并且仍在接受免疫抑制药物治疗的人群。
- 患有癌症并正在接受主动化疗或放射疗法的人群。
- 患有血液类癌症或骨髓类癌症，比如白血病，并处于任何治疗阶段的人群。
- 胸腔部位有严重状况的人群，比如囊性纤维化或严重的哮喘(需要住院或服用类固醇药物)。
- 身体系统患有重大疾病的人群，比如严重的肾病 (需要透析)。
什么是"社交距离"?
"社交距离"措施是指一系列可以用来减少人际交往的举措。这些举措有助于减少新型冠状病毒(COVID-19)的传播。
这些举措包括:
- 避免同表现出新型冠状病毒(COVID-19)症状的人接触。症状包括发热，和/或新出现并且持续的咳嗽。
- 避免在非必要的情况下使用公共交通工具。如有可能，调整你的通勤时间来避开高峰期。
- 尽可能在家工作。你的雇主应当支持你的这一行为。请参阅雇主指南获取更多信息。
- 避免大型集会，以及较小室内的集会。比如酒吧，电影院，餐厅，剧院，俱乐部等。
- 避免与朋友和家人聚会。通过远程通讯技术来与他们保持联络，比如电话，网络，社交媒体。
- 使用电话或在线服务来联系你的社区医生或其他的基础服务。
每个人都应该在实际允许的情况下尽力遵循这些原则。
我们强烈建议你尽可能多地采取这些措施，并且尽可能严格限制自己与朋友和家人的面对面交流。特别是如果你，
- 年龄在70岁以上
- 有潜在的健康状况
- 怀孕
洗手和呼吸道卫生
通过遵循一些普遍原则，你可以帮助阻止呼吸道病毒的传播。这些原则包括:
- 勤洗手。当你回家或开始工作，擤鼻涕，打喷嚏，咳嗽，进食或处理食物时，使用肥皂和水洗手至少20秒，或使用免洗洗手液。
- 避免在没洗手时用手触碰你的眼睛，鼻子，和嘴。
- 避免与有症状的人近距离接触。
- 咳嗽或打喷嚏的时候使用纸巾掩住口鼻，然后把纸巾扔到垃圾桶并洗手。
- 对家里经常接触的物体和家具表面进行清洁和消毒。
如果你出现了新型冠状病毒(COVID-19)的相关症状你应该怎么做?
同样的原则适用于普通人群以及对于新型冠状病毒(COVID-19)所致的严重疾病有增加性风险的人群。如果你出现了新冠肺炎的症状(高烧，新出现且持续的咳嗽)，应当在家自我隔离7天。你可以在这里阅读在家隔离的完整指南。
若减少社会接触，我该如何获得食物和药品上的帮助?
向你的家人，朋友，邻居寻求支持或使用在线服务。如果这些都无法实现，那么公共部门，企业，慈善机构，以及公众都会做好准备来帮助那些被建议待在家里的人。与其他人交流以及向他们求助是非常重要的，他们可以帮助你安排食物，药品以及其他必要服务和物资的快递，也会照料你的身体和心理健康。
如果你通过医疗和社会护理组织来获得支持，例如，你通过地方政府或者医疗保健系统获得医疗护理，这些都会照常进行。你的医疗或社会护理提供商将会被要求采取额外的预防措施来确保你的安全。对于正式护理人员的建议可以在家庭护理指南中找到。
如果有医院或社区医生的预约应该怎么做?
我们建议每个人都尽可能远程就医。然而，如果你在这个时期内有安排好的与医院的预约或其他医疗相关的预约，和你的社区医生或临床医生讨论来确保你能继续获得所需的护理，并考虑是否可以推迟预约。
对于包括护理人员在内的访客有什么建议?
你应当联系那些会经常来拜访你的朋友和家人，告诉他们你现在正在减少社会接触，并请他们不要在这段时间来拜访你，除非他们是来为你提供一些基础护理。基础护理包括帮助你洗衣服，穿衣服，和准备餐食等。
如果你通过某个组织来获得医疗或社会护理，无论是来自当地政府还是自费，通知你的提供者，告诉他们你正在减少社会接触，并且与他们商讨一套可以继续为你提供护理的方案。
如果你的朋友或家人为你提供基础护理，与他们沟通，告诉他们一些额外的预防措施来确保你的安全。这份家庭护理指南也许会对你有帮助。
和你的护理者讨论在他们身体不适的情况下你该怎么办也是一个好主意。如果你需要护理但是不知道该联系谁，或者如果你没有可以帮助你的家人或朋友，你可以联系地方委员会，他们会帮助你。
对于和健康风险较大者一起生活的人有什么建议吗?
如果你和一个健康风险较大的人住在一起，请参阅家庭指南
如何保持心理健康?
可以理解，你也许会觉得"社交距离"让你有点无聊甚至沮丧。也许你的心情和感受都会受到影响，你可能会觉得心情低落，担忧，或者失眠，你也可能会很想念和其他人一起外出活动。
在这样的时刻，你会很容易陷入一些不健康的行为模式，而这些行为模式会让你感觉更糟糕。这种时候，一些简单的行为就能够帮助你保持身心健康，比如:
- 在 NHS 的网站上搜索可以在家运动的方式
- 做一些你喜欢的事。包括阅读，烹饪，以及其他的一些户内爱好，或者听广播，看电视节目。
- 尽可能保持饮食健康，营养均衡，喝足量的水，规律运动，并且尽量不要吸烟，酗酒，或滥用药物。
- 保持通风，如果可能的话晒晒阳光，或者在花园里走走。
你也可以出门散步，如果你能与其他人保持至少2米的距离。
下面还有更多的信息来帮助你在这段时期内保持心理健康。
在这段时期内如何同家人朋友保持联络?
充分利用好你的朋友，家人和其他的社会关系可能带给你的支持。尽力和身边的人通过电话，信件，或者网络保持联系。让他们了解你想如何与他们保持联系，并让它成为你日常惯例的一部分。这对你保持心理健康也很重要，和他们聊聊你的感受可能会很有帮助。
记住，和那些你信赖的人分享你的担忧是没有任何问题的，并且当你这么做的时候，你也在支持着他们。或者你也可以使用 NHS 的推荐热线
给非正式护理人员的建议
如果你正在护理一位健康状况风险较高的人，你可以运用下列举措来保护他们，降低他们当下面临的风险。
一定要遵循关于卫生的建议，比如:
- 到家的时候要洗手，而且要经常洗手，洗手时使用肥皂和水洗手至少20秒或使用免洗洗手液
- 打喷嚏或咳嗽的时候用纸巾或袖子(不能用手)掩住口鼻
- 用过的纸巾立刻扔进垃圾桶然后马上洗手
- 如果你觉得身体不适就取消来访，重新安排他们的护理。
- 为他们提供信息，告诉他们在身体不适的时候可以联系谁，如何使用NHS 111新型冠状病毒在线服务，并把NHS 111的电话号码留在显眼的位置。
- 找到不同的渠道来获得支持和帮助。 Carers UK 提供了一些关于创建应急计划的建议。
- 在这段时间里照顾好自己的身心健康。
建议总结
*如果你的家人或和你共同居住的人开始持续性咳嗽或发烧
**如果你独自居住并开始持续性咳嗽或发烧
***例如电影院，剧院，酒吧，餐厅，俱乐部
****例如通过电话或网络
1 比如任何需要每年注射流感疫苗的人
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Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults
Background and scope of guidance
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:
- Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
- Avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible
- Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information
- Avoid large gatherings, and gatherings in smaller public spaces such as pubs, cinemas, restaurants, theatres, bars, clubs
- Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
- 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
* if one member of your family or household has a new continuous cough or high temperature
** if you live alone and you have a new continuous cough or high temperature
*** for example cinema, theatre, pubs, bars, restaurants, clubs
**** for example via telephone or internet 1 such as anyone instructed to get a flu jab each year
