COVID-19 Daily Update

Last Updated 03/08/2020 at 14:00

This document is updated on an ad-hoc basis.  What has changed since the last update?

  • Travelling from a risk area, section updated
  • Secondary healthcare section refreshed

For general healthcare information, please visit www.patient-wise.de/news.

What is isolation, and what is social distancing?

Who Should Be Doing It?

Who Should Be Doing It?
Any person who has any of the following symptoms:

  • a fever
  • a new continuous cough
  • a loss or change to your sense of taste or smell

OR
Is waiting for a coronavirus test result

OR
Has tested positive for coronavirus

OR
Lives with someone who has symptoms, is waiting for a test result or has tested positive.

OR
You receive notification from the medical centre or Germany public health informing that you have been in contact with a person who has tested positive for coronavirus.

How Long For?
Until further guidance is released by Host-Nation and UK governments and public health bodies.

How Long For?
Single person household with symptoms: At least 7 days and until you have been symptom free for 72 hours (with the exception of a cough or loss of sense of smell/taste) or have received a negative test result.

Please note: UK guidance is currently to isolate for 10 days; German guidance is 7 days. If you are isolating for any reason, contact the medical centre for further advice.

A member of a household has symptoms:
All members of the household usually need to self-isolate for 14 days from when the person in your home started having symptoms, or until a test confirms them negative and no other household member has symptoms. You may end your isolation if a test is confirms your household member is negative and you remain symptomless.

After a positive test result:
All people who test positive for coronavirus will need to self- isolate for 7 days and be symptom free for 72 hours with the exception of a cough or loss f sense of smell/taste as this can persist for several weeks. The medical centre team will advise you if further testing is required example if you are a key worker.

You are advised that you are a contact of a confirmed COVID-19 case:
14 days for the individual contact, there is no requirement for other household members to self-isolate if they have not had contact.

What Does It Mean?

  • Stay at home as much as possible
  • Stay 1.5 meters apart from people outside of your household
  • Wear a mask when shopping, buying fuel and using public transport
  • Members of no more than 2 households may meet up and this must be outdoors. Gatherings in houses is still prohibited.
  • Crossing internal EU boarders is only permitted for those with valid grounds and in possession of the appropriate documentation.

What Does It Mean?

  • Don't leave home unless it is for an urgent medical reason
  • Ask a friend or colleague to pick up food and medicine and drop it at your door
  • Children must also stay in the home
  • Nobody from outside your household can enter your home unless it is for an urgent medical reason
  • Tell the medical centre that you are isolating, we will stay in touch and give advice

Travelling in from a risk area:  Germany and Belgium have guidelines on persons travelling in from risk areas.  There may be a requirement to have a COVID test and to stay in quarantine for a period of time.  Non-essential travel to some locations may be prohibited.

For the most up-to-date guidance on risk areas, please visit:

The Robert Koch Institute (Germany) https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Risikogebiete_neu.html [also available in English]

Federal Public Service Foreign Affairs (Belgium) https://diplomatie.belgium.be/en [also available in English]

If you are travelling to or from a risk area, please contact your medical centre at the earliest opportunity to discuss.

Primary Healthcare (Medical Centres)

Corona-Warn-App

The German Government has recently released its COVID-19 tracing app called Corona-Warn-App. The app helps trace infection chains of SARS-CoV-2 (which can cause COVID-19) in Germany. The app is based on technologies with a decentralized approach and notifies users if they have been exposed to SARS-CoV-2. Transparency is key to both protect the app's end-users and to encourage adoption. The app has been designed to meet strict German privacy laws and is designed in line with Europe’s data protection law (GDPR), your name is not used by the app.  All SP, UKBCs, entitled contractors and their dependents are strongly encouraged to download the Corona-Warn-App as this app is designed to protect them and their families as they interact and pass numerous people going about their daily business here in Germany.  The Corona-Warn-App is available for download via the German App Store and Google Play Store and also operates in the English language. The app is currently Germany specific and those using a UK smart phone will currently not be able to download the app or will have issues downloading and using the app using the various workarounds found on the www for changing your country location.  The app must not be downloaded onto MOD official devices. Further information is available at: Corona-Warn-App Site https://www.coronawarn.app/en/ Corona-Warn-App FAQs https://www.coronawarn.app/en/faq/

Click to enlarge

TEST-ISOLATE-TRACE process for Germany entitled population:

You may have seen details in the UK Media about the new test and trace system going live in England.  Our process mirrors this system:

TEST

PCR swab testing is available for persons who present with symptoms of COVID-19, following both UK and German guidelines. Key workers have also been identified to facilitate testing of family members of a person with symptoms.

ISOLATE

All persons who show symptoms are advised to isolate for 7 days and family members for 14 days initially. If the test is negative the symptomatic person will need to remain isolated until recovered from symptoms and advised to do so by the medical centre.

TRACE

All confirmed cases are notified to German Public Health authority. Cases will be interviewed to identify their contacts. For the entitled population this will be carried out by the Nurse Advisor Health Protection from the medical centre. Contacts who are registered with the German health sector will be notified to Germany Public Health who will manage the contact and trace process. All contacts will be advised to isolate for 14 days and instructed on what to do if they develop symptoms. High risk contacts will be offered testing. If you are contacted by the German Public Health authority and advised to isolate, please call the medical centre at the earliest opportunity to let us know, we can then provide support.

Sennelager Medical Centre

The Medical Centre is open from 0800 till 1700 Mon-Thur, and 0800 -1330 on Fridays.  The majority of appointments are being conducted by telephone.  Do not attend the medical centre without calling for an appointment first. Tell the receptionist if you are concerned that you have been exposed to someone with COVID-19 or if you have a fever, persistent cough, or loss/change to your sense of taste or smell.  Please wear a mask or fabric face covering when visiting the medical centre.

SHAPE Medical Centre

The medical centre closes at 1600hrs and we are asking patients to call 0032 (0)476710699 between 1600-1700 for urgent medical advice, and then Hospital Helpline after 1700.  Most appointments are being conducted by telephone.  Do not attend the medical centre without calling for an appointment first. Tell the receptionist if you are concerned that you have been exposed to someone with COVID-19 or if you have a fever, persistent cough, or loss/change to your sense of taste or smell. Please wear a mask or fabric face covering.

Attending appointments at the medical centre

Please attend appointments at the medical centre alone, i.e. do not bring partners or relatives into the building with you.  For children, 1 parent or guardian may attend with the child.

Immunisations:

Routine immunisations (vaccinations) for children and for occupational (work-related) reasons are continuing, and remain an important part of protecting your health.  If you or your child require routine or occupational vaccinations, please call the medical centre in the first instance to discuss.  This applies to both military and civilian staff.

Out-of-hours:

If you need advice on how to access medical care out of hours, the Hospital Hotline can help.  This line is not staffed by clinicians, but they can signpost you to the nearest appropriate medical care.  In a medical emergency, call 112 and request an ambulance. Please note the operator will ask you to confirm the reason you require an ambulance, so they organise the correct type of transport for you.  For non-urgent medical queries, call your medical centre during opening hours.

Whose Guidelines Are We Following?

There are differences between different governmental and public health department guidelines.  Each country has a different pattern of the epidemic and therefore there are differences in the programmes countries have put in place. We are mirroring and balancing as far as possible both host-nation and UK guidelines.  This page on patient-wise will be updated daily with information that is relevant to the BA(G) and EJSU populations.  Regardless of location, ALL PATIENTS MUST TAKE THE FOLLOWING ACTION:

  • Check your contact details are up to date at your medical centre
  • Ensure you have basic self-care items in your medicine cabinet, including a thermometer and paracetamol
  • If you are on regular medication ensure you have a good supply of this at home
  • Follow advice given by your CoC
Chronic illnesses

We would like to assure our patients with chronic illnesses that your scheduled reviews will continue to take place. Although face-to-face consultations are restricted we will continue to provide treatment advice and monitoring utilising alternative consultation methods in line with UK practice and guidelines.

Clinically Vulnerable Patients

Certain factors can make patients more vulnerable to COVID-19, either because of susceptibility to the virus, or because they are more likely to experience a more severe illness and/or complications.

Patients classified as clinically extremely vulnerable have been contacted by the medical centres this week.

Ayrshire Barracks:

Dr Gerold – Community Paediatrician in Moenchengladbach continues to provide routine children’s immunisations and U-examinations. Please note, these appointments are only available in the morning. An appointment must be booked prior to attending the practice and if you need any assistance with this, please contact the Hospital Hotline on 0800 588 9936 or 0049 521 305 3960 (from UK mobile or outside Germany)  If you require to attend the Praxis for any other reason, afternoon appointments will be available, but again you must book prior to attending. You should not attend the practice without an appointment and only the patient and one (1) accompanying parent should attend any appointment. Please note that that the Paediatric Host Nation GP for the Ayrshire PAR, Dr Gerold, is closed until 24.07.20.  Cover during her absence is detailed on www.patient-wise.de

Looking after your mental health

Disruption to normal daily life, worrying about loved ones, and social isolation can be tough on your mental health.

How are you feeling?

Highly anxious or depressed on most days.  Overwhelming feelings are affecting your relationships with others. STOP - get a GP appointment to discuss treatment options and prevent further deterioration.

Anxious or low in mood on some days, having a mixture of good and bad days.  On days when you are feeling overwhelmed you may get relief from online CBT such as www.moodgym.au using meditation apps such as HeadSpace.  Let the people close to you know how you feel and take regular exercise.  If symptoms don't ease, book in with one of our GPs.

RECOGNISE - escalating feelings, seek self-help methods

 You generally feel ok but may have low level anxiety.  These feelings are normal, however it is important to check in on your thoughts and feelings to prevent escalation.  You may find self-care measures such as breathing techniques, meditation, yoga and general diet and exercise helpful.

ACKNOWLEDGE - your feelings and practice techniques to maintain your emotional health

 The following support is available via your medical centre:

  • Our GPs are trained to diagnose and treat many mental health issues and should be your first port-of-call
  • Our mental health staff offer online consultations.

You can be referred to these services by your GP.

Safeguarding

We continue to work alongside allied services in safeguarding vulnerable children and adults who may be at continued or increased risk during this difficult period. If you have any concerns about yourself or a vulnerable individual, please contact:

  • British Forces Social Work Service on +44 808 1683111 or email crt.bfsws@coreassets.com where a duty social worker is available 24hrs a day.
  • The Duty GP at Sennelager Medical Centre; +49 5254 982 2414; from 08.00 to 1700, Monday to Thursday, 0800 - 1330 Friday.

Boarding school children

School closures across Europe have meant that boarding school students have had to return to their parents/guardians across BA(G), SHAPE and EJSU. If your child has returned from boarding school to any of these locations, please contact your medical centre to ensure that your child is correctly registered with us for their ongoing healthcare provision. If your child has any ongoing medical conditions that require treatment or monitoring, this information will need to be requested from their registered GP practice.

Secondary Healthcare (Hospitals)

A face mask has to be worn - covering mouth and nose at all times - whilst you are in the hospital / outpatient departments.

A&E Attendance

  • If you require emergency care, please be aware that no-one is permitted to accompany you to the A&E department.  One (1) parent / guardian will still be allowed to attend with a child up to the age of 18
  • All hospitals used by the PAR have set up a triage service (initial assessment) and patients will be directed to:
    • the respective emergency department
    • ask patients to return to their home if immediate hospital treatment is not considered necessary
    • to see their GP if treatment on an outpatient basis is possible.
  • If you attend A&E and are admitted to hospital, your relatives will not be permitted to bring in any items for you (no visitors until post 3rd day of admission).  Therefore, we recommend you take a hospital bag with you with items like wash kit, pyjamas and phone chargers.
  • If you feel you need to attend hospital out-of-hours, the Hospital Hotline can give advice on how to access care. This line is not staffed by clinicians, but they can signpost you the nearest appropriate medical care.

Hospital Cafeterias remain CLOSED

OUTPATIENTS

  • Important: Some providers require a negative Corona virus test before you attend for an Outpatient appointment. If this is required, the test will be organised by the hospital. The Patient Support Team (PSO) will contact you and provide the necessary information and organise an appointment for this test 48 hours prior to your Appointment.
  • Once the test is completed, you MUST self-isolate until your Outpatient appointment
  • If you have a persistent dry cough, fever, signs of a cold or loss/change to sense of taste or smell in the 14 days before your outpatient appointment, you MUST contact the department to arrange another appointment. If you have any linguistic difficulties doing this, please contact the Hospital Hotline on 0800 588 9936 or from a UK mobile or from outside Germany call 0049 521 305 3960.
  • Providers may also need to know if you have had - or have been in contact with anyone who has had - a confirmed coronal infection.
  • Some hospitals have introduced a questionnaire which you will be required to complete either before or at your Outpatient appointment. The PSO will advise when they contact you about your appointment.
  • If you have any queries or concerns about your outpatient appointment, please contact the Hospital Hotline for advice.

OBSTETRIC OUTPATIENTS

Clinics continue, but women must attend alone without partner and other children.

If you have any concerns or questions, please contact the Hospital Hotline on 0800 588 9936 or from a UK mobile or from outside Germany call 0049 521 305 3960.

The VISITOR policy in Hospitals in Germany, and EJSU / ISODET locations are outlined below, but please be aware the situation can change at any time.

INPATIENTS

Adult Visiting Policy

  • These precautionary measures still apply:
  • Children under 10 years of age are not allowed to visit in hospital
  • Visits are allowed under strict guidelines.
  • The daily visiting hours remain between 15:00 and 19:00 hrs for a maximum of one hour.
  • Visiting adult patients is permitted from the 3rd day of treatment, and from then a daily visit during the hours shown above
  • Patients are required to provide details of their visitor(s) at the time of admission. The data will be stored on the hospital’s IT-system and they will also be checked at each visit.
  • Visitors will be given a visitor’s permit from the hospital registration points after a short screening – please return the permit at the entrance when you leave the hospital.
  • Visiting is limited to one visitor per day.
  • No more than 1 visitor is allowed at a time in a patient room. This means that if in a shared room, there may be waiting times. You and the patient can help organising the visits by coordinating visits with the patient’s roommate to avoid unnecessary waiting times.

Obstetric admissions Visiting policy

  • If admitted to hospital, Fathers may visit the expectant mother once a day from the day of admission onwards.

Children and Adolescents Visiting Policy

  • For children and adolescents, two additional visitors per day in addition to the accompanying person are permitted from the 1st day.
  • On the children's intensive care unit and the neonatal wards, visits are restricted to parents only.
Other points:
  • Unnecessary trips are to be avoided – visitors, should go directly to the ward and register at the nurses’ station – for registration and de-registration.
  • The individual clinical departments reserve the right to put special regulations in place depending on the condition of their patients
  • Please follow the instructions of the hospital staff. They can limit/restrict visits any time.
  • Please disinfect your hands when entering and leaving the hospital and patient rooms.
  • Please abstain from physical contact and keep a safe distance (min. 1.5 metres) to the patient and all other persons.
  • Further exemptions are given for visits for critically ill patients.

If you have any queries relating to this, please contact the Hospital Hotline on 0800 588 9936 or from a UK mobile or from outside Germany call 0049 521 305 3960

This information was updated at 1400 (CET) on 04/08/2020.  Whilst every effort is made to keep it up to date, COVID-19 is a rapidly developing situation and guidance is frequently changing.  If you are in any doubt about whether to self-isolate, call your medical centre for advice.  In a medical emergency, always call an ambulance and let them know if you are worried about COVID-19 exposure.  Do not attend any UK or German Healthcare facility without first speaking to a clinician and telling them that you are concerned about COVID-19.

Contact Numbers

  • Ambulance: 112
  • Hospital Hotline: 0800 5889936 or +49 521 305 3960 (from UK mobile or outside Germany)
  • SHAPE Medical Centre: +32 (0)65445824
  • SHAPE Dispensary: +32 (0)65445999
  • Sennelager Medical Centre: +49 (0)5254 982 2414
  • Sennelager Dispensary: +49 (0)5254 982 4985

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