by BSPGHAN | Apr 7, 2020 | IBD, News
Dear Members,
I do hope that this message finds you and your families and friends in continuing good health. It is an unsettling update today on the situation as it unfolds, as it is anticipated that there will be a rapid climb of Covid-19 to hit our hospitals and community services this week and next.
The focus has to be on pulling together as an NHS team to incident manage life threatening situations. When we emerge from this, there will be an important recovery phase to plan for.
Today, BSPGHAN has helped to kick start the process and contributed towards a Gap Analysis to feed back via the RCPCH to NHS E. This will help planners understand the need for time dependent diagnostic procedures and appointments for patients who are referred with commonest or high risk PGHAN conditions.
I am indebted to the BSPGHAN IBD Working Group and the Birmingham Children’s Hospital Nutrition nurses who have prepared the following guidance for members and the two items that you can use for information for parents/carers (attached):
1.BSPGHAN IBD Working Group statement for Health Care Professionals COVID_IBDWG_HCP
Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD.
2.BSPGHAN IBD Working Group
PARENT/CARER INFORMATION LEAFLET COVID_IBDWG_Parents_Carers
Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD.
3. Parent/ Carer Information Letter for families of children on home parenteral nutrition (authored by Birmingham Women’s and Children’s Hospital Nutritional Care Team nurses) Birmingham Letter for HPN patients
I would like to draw your attention to advice on practice and service provision for patients with IBD. Please mitigate risks of infection to theatre teams and preserve the PPE supply by limiting all but non emergency endoscopy for now.
Importantly, the parent carer guidance, 2. and 3. provides; –
a] paediatric-specific advice on shielding, helping professionals and families interpret what ” shielding” looks like for ‘At Risk’ children with IBD who are on immunosuppression and for those on Home PN, and
b] advice to avoid “late presentation” of febrile episodes in patients with IBD and on home PN.
I am mindful that I would not ordinarily send out a letter intended for families unless it had been ratified by Council, but in these exceptional circumstances, there is a need for rapid guidance, especially if there is confusion on ‘shielding’ advice. Please can I ask members to check the home PN letter and amend the content as you see fit for local use before you share it with your families.
The next few weeks may be tough for our teams. Please look after each other and make sure that you stay protected and remain safe.
Thank you to Jochen and the IBD working Group and a personal thanks to Elaine, Louise and Gemma and all our amazing IBD, Gastroenterology and Nutrition nurses who are working tirelessly to keep our families well informed, safe and well.
Best wishes
Sue, President of BSPGHAN
April 7th 2020.
by BSPGHAN | Apr 2, 2020 | Hepatology, IBD, News
Please see the following updates
- Guidance for health professionals with IBD or liver disease
https://www.bsg.org.uk/covid-19-advice/bsg-basl-rcp-guidance-for-healthcare-workers-with-moderate-risk-inflammatory-bowel-disease-and-liver-disease/
- Cvid19 UK IBD registry tool for adult patients
The tool aims to help identify and reach moderate and high-risk IBD patients.
The IBD registry tool is currently restricted to those are are aged 18 years or older but they are working on extending its use to under 18s
https://www.bsg.org.uk/covid-19-advice/covid-19-uk-ibd-tool-for-patients-is-now-live/
- COVID-19 – RCPCH trainee progression in the UK through 2020
https://www.rcpch.ac.uk/resources/covid-19-rcpch-trainee-progression-uk-through-2020
- EMA press releases related to COVID-19:
Please check EMA’s dedicated webpage on COVID-19 for the latest updates.
Thank you all again for your continued collaborative effort to support professionals and patients.
Best wishes
Sue Protheroe
e-mail President@bspghan.org.uk
President 2/4/20
by BSPGHAN | Mar 31, 2020 | News
Dear members
Please share this updated letter C0106 HPN COVID patient information_UPDATED_27 March with families of children on home parenteral nutrition. It outlines plans that home care providers are putting in place and changes that families may expect.
Please be aware of the latest advice.
“Keeping yourself safe”
“The government is regularly updating its guidance on at-risk groups. In light of the latest information your hospital teams now consider that patients on HPN are a high risk group, as you/your child have significant organ impairment (GI) and a central venous access device in place. This advice is endorsed by the British Society of Gastroenterology. It advises you to follow the guidance on ‘shielding’ stringently, as outlined by the government, and you are strongly advised to stay at home and avoid any face-to-face contact for at least 12 weeks in the first instance.
This can be challenging but the consensus is it is the best way to keep yourself/your child safe”.
Kind regards
Sue Protheroe
BSPGHAN President 31/03/20
e-mail President@bspghan.org.uk
by BSPGHAN | Mar 30, 2020 | News
This is a challenging time but amid the concern, there are uplifting stories of how people are looking out for each other and communities pulling together. The children’s rainbows of hope in windows and the national clap for carers to celebrate the work of the NHS and care workers on Thursday were much appreciated.
Information is useful—but too much information can be unhelpful. I have limited news updates to new information from consensus sources. We don’t generally benefit from watching the news over and over. Try to focus instead on the things you need to get done. Value the rest of the time to relax with your family or friends and reach out to those who may not have such good support networks as you may have.
The bulletins below have some reassuring observations for our patients.
I hope that these help guide your practice while working differently.
1 )Statement “Gastrointestinal endoscopy in children and COVID 19 pandemic” – ESPGHAN Endoscopy Special Interest Group
http://www.espghan.org/societal-papers/covid-19-informational-statements/
“..elective procedures – especially those such as upper gastrointestinal (GI) endoscopy which is an ‘aerosol-generating procedure’ (AGP) – should be put on hold at present. Equally ileocolonoscopy, given that we know now that COVID-19 can be excreted in stools. Local and physician judgment should occur when determining which patients require urgent endoscopic diagnostic testing, but these should be kept to a minimum. Obviously, life-saving endoscopy such as GI bleeding and button battery ingestion are mandatory and should not be deferred. In the event of endoscopy being required a full personal exposure protection package should be worn by those in the immediate vicinity of the endoscopy including an FPP3 mask or equivalent”
3) Letter from Lorenzo d’Antiga, Italy “Coronaviruses and immunosuppressed patients” https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/lt.25756
Preliminary experience so far show that children under 12 years of age do not develop coronavirus pneumonia regardless of their immune status although they get infected and can spread the infection. Immune suppressed patients are not at risk for severe pulmonary disease compared with the general population.
2) Article “COVID-19 and paediatric inflammatory bowel diseases: global experience and provisional guidance (March 2020) from the Paediatric IBD Porto group of ESPGHAN”. see PDF attached https://bspghan.org.uk/jpgn-s-20-00391
Preliminary data for PIBD patients during COVID-19 outbreak are reassuring.
IBD per-se does not currently seem to be a risk factor for acquiring SARS-CoV-2, nor for a more severe infection. Standard IBD treatments including biologics should continue at present
4) Surveys – please report cases of COVID-19
- a) “PedIBD and Covid-19” ESPGHAN Porto IBD Group https://research.szmc.org.il/redcap/surveys/?s=FP38CNWRLE
- b) “EoE/EGID and COVID-19 ”
http://www.espghan.org/societal-papers/covid-19-informational-statements/
https://redcap.clalit.co.il/redcap/surveys/?s=PHLW7EC8WD
Best wishes
Sue Protheroe
President 30 March 2020
