Can someone explain isolating before a procedure to me?

[OpheliasCrayon]

I have a procedure coming up, for which I am told I need a covid test and then to isolate for three days from this test. The test will be done in the hospital so they will be able to access the results for when I am admitted.

I have two young children and as it is half term childcare will call to me . My husband covers me a lot as I teach , so we have been juggling stuff with work / kids etc.

So I am looking after my children during this isolating.

I'm aware we can't see other people - but just to check - I can't meet anyone outside socially distanced / wearing a mask etc can I? It really is no one?

And since my kids can't be kept away from me - do we all have to isolate as a household really for those three days ?

Sorry I know this likely sounds dense but I want to check 1. Because it's half term so I don't want my children to miss out on stuff unnecessarily but

1. Because I never understand the rules anyway and obviously as I'm going into hospital I don't want to risk anyone else

Also - for one of the days my youngest still could be in nursery as they don't have half terms - in this scenario would it be better that she doesn't attend on that day as it is the first day of the isolation ? My husband could do drop off and pick up so I would be able to stay in the house the whole time, but then since I'm looking after her for the following few days .... Yeah I'm not sure - can she go or not?

I don't mind what the answers are I'll stick to it but I really am not sure!

@olympicsrock

I am a surgeon . As others have said this rule is to Prevent you passing covid onto vulnerable patients and staff in hospital and also they would not want to do your procedure if you had undiagnosed covid as ‘post op’ patients seem to get sick with covid. Your whole household need to isolate if you can’t isolate from them. It would be sensible to reduce your contacts right down for a week before the op. Understand that this may be difficult if You and DH work as teachers. But I would keep your little one off nursery at least from the day of the test onwards. In my view it would be reasonable to go for a walk in the countryside if you can keep well away from anyone else and touch nothing so no using public toilets/ contact with anyone/ using pay machines in car parks etc.

Thank you that's good to know we could go to the country and yes - no driving or paying etc it's where we live so it's just a very isolated family walk around the corner!

I did move the procedure from the Monday to the Friday so that I could isolate without missing work . So actually it will be a full week since I've been in school until I have it done - so I'm happy to isolate us for that time, especially if we can go for a very lonesome walk!

If I hadn't have moved it they would have been happy for me to miss the one day and come in literally 4 days after I'd been in school. So now it's 7 so that's better I feel.

My husband isn't a teacher, just me. He's worked solely at home since March.

Me and him also have cancelled a few social engagements so that that wasn't adding in any extra risk to the situation. As in I need to go to work and I can't help that, but neither of us are going out to a restaurant, because that is an unnecessary risk and unfair on potentially other patients if I got it after the test, but to be fair also me. I've been waiting almost a year for this so I don't want to add in any extra chance of it being postponed if I caught something.

I do understand that it's to do with other patients - honestly isolating has been a concept in our home well before covid - we had an immunosuppressed very prem baby so we have been well used to protecting her and obviously the other babies in the NICU

No worries - I'll so it all as I'm supposed to!

I had three procedures in three months.

I had to isolate for two weeks the first two ops with Covid test three days before op and the last op, isolate for three days and Covid test on day one of the three days.

I was told I had to stay at home, no going for a walk and included not even to walk a dog. Fortunately I don't have one. Anyone in the household also had to isolate the same and for the same amount of time. I could go into the garden but that was it.

I got the impression that possibly procedures had been cancelled at the last minute because people did not follow the instructions and continued to go outside their house and garden.

@cobblers123

I had three procedures in three months.

I had to isolate for two weeks the first two ops with Covid test three days before op and the last op, isolate for three days and Covid test on day one of the three days.

I was told I had to stay at home, no going for a walk and included not even to walk a dog. Fortunately I don't have one. Anyone in the household also had to isolate the same and for the same amount of time. I could go into the garden but that was it.

I got the impression that possibly procedures had been cancelled at the last minute because people did not follow the instructions and continued to go outside their house and garden.

I don't have a dog either! Not with this dodgy hip!!

It's fine. Honestly my hip is such a mess that after this half term I am more than happy to chill out at home with the kids and do very little if that's what is required of me.

I don't give a crap about covid and if I catch it - as I said one, I think I've had it and two, I'm just not bothered....but I do care about risking others so of course I'll do what we need.

The disney + channel was invented for a reason......

I work in this sort of setting, so may be able to shed some light.

Initially, we were assuming all patients were covid +ve. This meant lengthy and elaborate decontamination proceedures, which slashed the number of people we could treat.

To manage that, we moved to a model of ensuring that everyone was covid -ve. This allows us to use normal, pre-covid cross infection measures and treat more people, which is obviously a huge win for everyone on waiting lists.

Initially we required a 2 week self-isolation. That moved to 72 hours. I suspect (don't know, but suspect) that the change was because most people would isolate for 72 hours, but most would tell you they'd isolated for 2 weeks without having done so. A shorter isolation people comply with is better than a longer where they don't.

The rules will differ slightly from Trust to Trust depending on their risk assessment and the risks of the proceedure but, broadly:

1. The patient themselves rigorously self-isolates.
2. If the patient is a child, so does the parent who will be bringing them.
3. The rest of the household can either rigorously self isolate, or move out (for example to a hotel) and carry on with life in whatever passes for normal these days.

Hopefully that helps, but please ask if not.

@Motorina

I work in this sort of setting, so may be able to shed some light.

Initially, we were assuming all patients were covid +ve. This meant lengthy and elaborate decontamination proceedures, which slashed the number of people we could treat.

To manage that, we moved to a model of ensuring that everyone was covid -ve. This allows us to use normal, pre-covid cross infection measures and treat more people, which is obviously a huge win for everyone on waiting lists.

Initially we required a 2 week self-isolation. That moved to 72 hours. I suspect (don't know, but suspect) that the change was because most people would isolate for 72 hours, but most would tell you they'd isolated for 2 weeks without having done so. A shorter isolation people comply with is better than a longer where they don't.

The rules will differ slightly from Trust to Trust depending on their risk assessment and the risks of the proceedure but, broadly:

1. The patient themselves rigorously self-isolates.
2. If the patient is a child, so does the parent who will be bringing them.
3. The rest of the household can either rigorously self isolate, or move out (for example to a hotel) and carry on with life in whatever passes for normal these days.

Hopefully that helps, but please ask if not.

Lovely thank you that helps.

So the 72 hours seems ok and also as I said when someone said I should miss work - actually I won't have been at work for 7 days rather than the given 3 anyhow.

As per my previous point though - obviously you can't eliminate all risk but I mean - what's the situation with if I tested negative but then say got it asymptomatic or something a few days later.? Are you just accepting that you can try the absolute best you can with everything you've put in place but you have to accept that that scenario may happen?

I have a procedure coming up in November. I have been told to shield for 3 days before and strictly follow social distancing for two weeks before. But, my DS can still go to school (I have checked this), so I'll have to do school run during those two weeks. My procedure is on a Monday, so the shielding is from the Friday, and we are able to cover pick up that day, which luckily does make things easier logistically.

I'm seeking clarity from my local trust on what the difference is between shielding and strictly distancing. My understanding is we are distancing now anyway, so it is a case of carry on until the shielding starts, or are there extra measures to put in?

As per my previous point though - obviously you can't eliminate all risk but I mean - what's the situation with if I tested negative but then say got it asymptomatic or something a few days later.? Are you just accepting that you can try the absolute best you can with everything you've put in place but you have to accept that that scenario may happen?

Pretty much, yes. The only way to eliminate risk is to close theatres to anything non-lifethreatening. Which clearly has other major downsides! Or we could put all patients and all staff in a cell for two weeks pre-op, and feed them through a tube, which would make them 100% covid-safe, but is also not without issue.

So it's a balancing act between enough restrictions to keep the risks as low as possible, whilst still allowing procedures to go ahead. And between the ideal isolation period and what people will actually do - better a 72 hour isolation that most people follow, than a 2 week that most don't. That balancing act may shift as we go into winter and case numbers in the community go up, because a big factor in keeping people safe until recently is that it was pretty unlikely any individual patient would actually have Covid.

Try not to worry too much, though. Really, our procedures are very thorough and very safe. Is it risk free? No. But nor is the drive to the hospital, and it's unlikely you're losing sleep over that.

Yes, we are all well aware someone could still be covid positive. We have no way of knowing whether anyone has complied with the isolation instructions, plus we know there can be a long incubation period. However it does reduce the risk and as already mentioned, it is recognised that compliance is better if you advise 72 hours than 2 weeks. Hopefully you will follow the instructions to take extra care for the 2 weeks before the procedure. I know you say you don't care about cv for yourself, but you need to understand the link between cv and thromboembolism, especially given you are less mobile due to your hip. You have a much higher risk of surgical complications if you unknowingly have CV. So please do think of yourself in all of this too (I know you are kindly thinking of others). Good luck

@Motorina

As per my previous point though - obviously you can't eliminate all risk but I mean - what's the situation with if I tested negative but then say got it asymptomatic or something a few days later.? Are you just accepting that you can try the absolute best you can with everything you've put in place but you have to accept that that scenario may happen?

Pretty much, yes. The only way to eliminate risk is to close theatres to anything non-lifethreatening. Which clearly has other major downsides! Or we could put all patients and all staff in a cell for two weeks pre-op, and feed them through a tube, which would make them 100% covid-safe, but is also not without issue.

So it's a balancing act between enough restrictions to keep the risks as low as possible, whilst still allowing procedures to go ahead. And between the ideal isolation period and what people will actually do - better a 72 hour isolation that most people follow, than a 2 week that most don't. That balancing act may shift as we go into winter and case numbers in the community go up, because a big factor in keeping people safe until recently is that it was pretty unlikely any individual patient would actually have Covid.

Try not to worry too much, though. Really, our procedures are very thorough and very safe. Is it risk free? No. But nor is the drive to the hospital, and it's unlikely you're losing sleep over that.

Honestly I couldn't care less about risk to myself. But I have a lot of illnesses and I spend a lot of time in hospitals, and what with my job I do care about other patients. Mostly because we all likely take immunosuppressants and stuff so any appointments or procedures I attend are likely to be with other vulnerable people.

Oh alright I'll give a bit of a crap about myself as well then!

My son had an audiology appointment a few weeks ago, he had a covid test four days before the appointment.

The letter said he may need to isolate after the test, but there wasn’t any more detail. I contacted the hospital and on the first two calls no one knew what the procedure to follow was, on the third they said he needed to isolate (but could attend school as normal and go out as long as he was 2m from people outside of the household). Got to the appointment, they asked if the whole household had been completely isolating since the test (no obviously as we followed the advice from your team), appointment went ahead. The consultant did say that very few of her patients had been given the correct information.

Was told 3 days of isolation for whole family- no specifics were given. Health visitor said "oh make sure you still go for a walk for your mental health ".

@Motorina

I work in this sort of setting, so may be able to shed some light.

Initially, we were assuming all patients were covid +ve. This meant lengthy and elaborate decontamination proceedures, which slashed the number of people we could treat.

To manage that, we moved to a model of ensuring that everyone was covid -ve. This allows us to use normal, pre-covid cross infection measures and treat more people, which is obviously a huge win for everyone on waiting lists.

Initially we required a 2 week self-isolation. That moved to 72 hours. I suspect (don't know, but suspect) that the change was because most people would isolate for 72 hours, but most would tell you they'd isolated for 2 weeks without having done so. A shorter isolation people comply with is better than a longer where they don't.

The rules will differ slightly from Trust to Trust depending on their risk assessment and the risks of the proceedure but, broadly:

1. The patient themselves rigorously self-isolates.
2. If the patient is a child, so does the parent who will be bringing them.
3. The rest of the household can either rigorously self isolate, or move out (for example to a hotel) and carry on with life in whatever passes for normal these days.

Hopefully that helps, but please ask if not.

This is interesting. DH got a letter a month ago about an operation (no set date, he was supposed to contact them to arrange). It mentioned a 2 week isolation and I pointed out to him that that would include DC and I as well (especially as we don't have a spare bedroom or bathroom). He had a strop and said he wasn't having it done then! He might consider 3 days acceptable, but he couldn't just pop along to the hospital for a COVID test 3 days prior to surgery as he is having it done in London and we are hours away from London. 3 days would also be a lot easier to cope with having all of us at home together and a lot easier to arrange with work than having to take 2 weeks off from a job that can't be done at home.

Thanks all for your help!

I have an op on Monday (privately) and I had a test on Friday morning. I’m isolating but I haven’t been told that my Dh and kids need to. The paperwork just said I needed to. DS is at football training now with DH.

@PinkPiranha11

I have an op on Monday (privately) and I had a test on Friday morning. I’m isolating but I haven’t been told that my Dh and kids need to. The paperwork just said I needed to. DS is at football training now with DH.

My paperwork said I need to isolate. Didn't mention anyone else. But I assume that since I need to look after my kids and I can't isolate from them that we all need to. .. Your DS and DH could have theoretically picked something up today and bring it home to you. Although, I would imagine that even if that was the unlikely case, you wouldn't yet be infectious by Monday. But Ive taken it to mean in order for me to isolate successfully we all need to.

I had surgery over the summer. Had to isolate for two weeks before and two weeks after.

So I did exactly that, as did the whole household.

We only left the house three times those four weeks: to take me to the hospital for a Covid swab, to take me to hospital for surgery, to pick me up from hospital the following day. That was it. It was pretty horrendous but I didn’t want to risk getting it and having my op further delayed (cancer surgery, so…), plus I also didn’t want to get it and have it affect my recovery. Looking at it that way made it somewhat easier to stick to staying in rather than thinking of how I didn’t want to risk infecting other patients or staff or inadvertently delay anyone else’s treatment.

I’m having surgery next month. Got my pre op next week. Not sure if they’re still saying two weeks isolation or if they’ve moved to this swab 3 days before system. However I’m going to isolate for two weeks regardless. Last thing I want is a positive swab and the op be cancelled. I’ve been waiting over a year!

Well I'll stick to the three days I've been told. I can't take time off work I absolutely have to be there next week, and nor have the hospital asked me to so I have no need.
I've emailed DD2s nursery and told them she won't be in on the Tuesday.

I have a private operation happening on the 24th, at my original consultation in August I was told it would be two weeks of the whole household isolating. But this has since changed to isolation after my covid swab this coming Wednesday.

Luckily we have a loft which is an almost self contained flat, so DH and DC will continue as normal, and I'll just be upstairs locked away and will drive myself to the hospital, with DH following in a taxi to take the car home. I'm on a strict liquid diet pre-op so don't need to worry about using the kitchen or anything.

Similar to you we think we came down with it in March but with no tests available unless admitted and haven't had an antibody test there's no way or knowing.

Yeah I think the hospitals are moving to 3 days as they only need to do the minimum to ensure you don’t bring Covid in. No skin off their nose if you have a positive swab and can’t have the op. I’m going to do everything I can to ensure I get the op, can’t risk waiting another year!