Covid-19 HSE Clinical Guidance and Evidence

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COVID-19 (coronavirus) Guidelines for people living with Lymphoedema and Lipoedema in Ireland (CD19-156 / 01.05.20)

• Purpose

• How might coronavirus affect people with Lymphoedema or Lipoedema?

• Important Points to Remember

Purpose

• The purpose of this leaflet is to offer general advice to people living with lymphoedema or lipoedema in Ireland regarding coronavirus or COVID-19. These suggestions are designed to offer helpful advice and are not intended to replace any advice given to you by your healthcare professional.
• We strongly recommend that you keep up to date with public health advice and directives in Ireland, and how coronavirus might affect you personally, by regularly visiting the Health Service Executive’s (HSE) coronavirus website at https://www2.hse.ie/coronavirus/
• This information leaflet has been adapted from advice provided by the Lymphatic Support Network – LSN (UK) and the Lymphatic Education and Research Network – LE&RN (USA) for an Irish audience. Links to the original publication are provided at the end of the leaflet.
   

How might coronavirus affect people with Lymphoedema or Lipoedema?

• According to expert advice given to the LSN, in nearly all cases lymphoedema or lipoedema alone does not make one more susceptible to the coronavirus. The only exception would be patients with the very rare form of primary lymphoedema with extensive lymphatic abnormalities involving the chest, i.e. lungs, and have generalised immune deficiency; we are assured those patients will know who they are.
   

Important Points to Remember

• The virus spreads mainly from person to person via sneezes and coughs, but it can be carried on the hands. As it's a new illness, we do not know how long the virus stays on surfaces or on fabrics. Spread is most likely from those who have symptoms.  The virus may survive for up to 2 days if someone who has it coughs or sneezes on a surface or fabric.
• The virus gets into your body through your nose, mouth or eyes when someone coughs or sneezes on you or when you have it on your hands and then touch your own face.
• It can take up to 14 days for the symptoms of coronavirus to appear from the time of exposure.
• Symptoms can be similar to the symptoms of cold and flu
• Common symptoms of coronavirus include
  • A fever (high temperature of 38 degrees Celsius or above)
  • A cough – any type of cough, not just dry
  • Shortness of breath or breathing difficulties

Tips for those wearing compression gloves/sleeves with hand attachment

• People living with lymphoedema or lipoedema should take the same precautions as others, however we note that this might be more of a challenge if you wear a compression glove as part of your treatment.

Remember to wash your hands frequently during the day

• Keep your hands well moisturised as frequent washing can make the skin dry and cracked (which may lead to cellulitis for those with upper limb lymphoedema).
• Advice given is that antibacterial hand gel will not damage garments if it is on your skin.
• Most garments will stay in peak condition for over 100 washes but putting them in a net washing bag can protect them further.
• Follow the manufacturer’s washing instructions on your garment but make sure that you wash your garments each day.
• Please remember that disposable plastic gloves may be used to stop your compression glove from becoming contaminated but will not protect you from the virus. The virus can live on the plastic glove and be transferred in the same way as it can on your hand, so the same rules apply—wash your hands frequently and change the glove often.
• You may choose to wear a disposable glove over your compression handpiece when you are out, but remember when you get home to;
  • Wash the uncovered hand,
  • Remove the disposable glove by placing your thumb on the inside of the disposable glove,
  • Roll the disposable glove off so that it ends up inside out and throw it in the bin.
  • Wash the uncovered hand again and use hand sanitiser on the fingers of the hand with the handpiece.
• Some people may find it a challenge to get a disposable glove to fit over their swollen hand. You may need to experiment with sizes.
• Carry a spare compression glove/garment with you in a sealed plastic bag to use if you are worried your glove may have been contaminated. Put the dirty one in the plastic bag and seal it up until it can be washed, remembering to throw the plastic bag away.

Remember

• IF YOU ARE CONCERNED ABOUT YOUR OWN HEALTH PLEASE TELEPHONE YOUR GP.
• IF YOU DEVELOP SYMPTOMS OF CORONAVIRUS, YOU WILL NEED TO SELF-ISOLATE AND PHONE YOUR GP.
• DO NOT ATTEND A GP SURGERY, PHARMACY OR HOSPITAL.

This information leaflet has been endorsed by the following organisations

• The Health Service Executive (HSE)                        
• The National Lymphoedema Framework Ireland (NLFI)            
• Chartered Physiotherapists in Oncology and Palliative Care (CPOPC)
• Irish Society of Chartered Physiotherapists (ISCP)
• MLD Ireland
• Lymphoedema Ireland