Question

What are physical distancing, social distancing and self-isolation (shielding) for HIV and COVID-19?

24 March 2020. Related: All topics, COVID-19.

Answer

Thanks – the information about the new coronavirus (CoV-2) and COVID-19 is changing every day.

The official name for the virus is now SARS-CoV-2. It is pronounced CO-VEE-TOO). COVID-19 is the disease caused by CoV-2.

New terms to describe how to reduce risk of CoV-2 include distancing and shielding (see below). These new terms are explained below.

Physical (social) distancing

Reducing contact with people was first referred to as social distancing. But this really means face-to-face (physical) contact. More recent information now refers to physical distancing.

This is to reduce the times you are in social or work situations with other people. When outside, it involves keeping about six feet distance between each other. This limits the chance of breathing infectious droplets from someone who doesn’t know they are infectious. The highest risk comes from coughing or sneezing without using a handkerchief or your sleeve.

Since 23 March 2020, physical distancing is recommend for everyone in the UK. It means staying home as much as possible. It is okay to go out for essential food or medicines etc (ideally only once a day). It is okay to exercise outside (but not in groups). Or to travel to work if you cannot work from home. However, people who are most at risk from CoV-2 should be staying home.

Some HIV positive people need to be very strict with physical distancing.

If you have a CD4 count between 50 and 200 cells/mm³.
If you are not taking HIV treatment (ART).
If you have a detectable viral load. [This caution increases for highest viral load].

Social (virtual) contact

Social (virtual) contact is very different.

Make sure you stay in contact with your friends and family virtually. This can be by phone, social messaging and Facetime etc. Keeping up this virtual contact is really important.

This will help you stay socially connected without risk of coronavirus.

It will support you and your friends during this difficult time.
It will help if you or your friends develop symptoms.

Self-isolation – also called ‘shielding’

Some people need to be even more careful than just staying home. This involves changing the way to live to make sure you have the highest protection against catching CoV-2.

In the UK this is referred to as shielding and it is for people who have health conditions that make them extremely vulnerable to CoV-2. This includes HIV positive people with a CD4 count lower than 50 cells/mm³. (Other conditions include those with severe breathing difficulties or suppressed immunity (ie with certain cancers or transplant recipients).

Shielding includes not having physical face-to-face contact with other people for 12 weeks. This will involve some contact (at a safe distance) with people who are supporting you. For example, to bring you food or medicines, or to help with other home care. People with COVID-19 symptoms should not be involved in this care and support.

Anyone helping you should be protecting both you and themselves by strictly following advice on physical distancing. This also applies to people who currently live with you.

If you need to follow advice about shielding, it is even more important to keep in touch in other ways. Virtual contact with your family and friends will help. This can include telephone, social messaging and Facetime etc.

Information about shielding and people who are extremely vulnerable from Public Health England.