COVID-19 NICE Guidance - patients with Cystic Fibrosis

The purpose of this guideline is to maximise the safety of patients with cystic fibrosis and make the best use of NHS resources, while protecting staff from infection.

1. Communicating with patients and minimising risk

• Communicate with patients, their families and carers, and support their mental health and wellbeing to help alleviate any anxiety and fear that they may have about COVID-19. Sign post to charities such as the Cystic Fibrosis Trust
• Be aware that some patients, families or carers may need specialists psychological or social work support in the context of COVID-19
• Minimise face-to-face contact to reduce the risk of infection
• Inform patients, their families and carers that they should contact their cystic fibroses team if they think the patient may have COVID-19, to ensure that their symptoms are appropriately assessed
• Be aware that symptoms of COVID-19 and pulmonary disease exacerbations may be difficult to differentiate at initial presentation
• If a patient has symptoms of COVID-19 on presentation or admission, follow UK government guidance.
• All healthcare workers should follow UK government guidance on infection prevention and control
• Ensure that relevant members of the CF team are involved in decisions about the care of patients with suspected COVID-19 including escalation of treatment
• Patients with symptoms of COVID-19 should carry out airway clearance in a well-ventilated room, separate from other household members if possible, unless the patient needs assistance
• Explain to patients, their families and carers that when a nebulise is used to administer any antibiotic, the aerosol comes from the fluid in the nebuliser chamber and will not carry virus particles from the patient. Inform families and carers to use appropriate hand hygiene when helping patients with their nebuliser mask.

2. Treatment and care planning

• Inform patients, their families and carers to continue with all their usual self-care arrangements
• Inform patients, their families and carers to wash their hands and clean equipment such as face masks and mouth pieces used for nebulised therapies or face masks used for non-invasive ventilation, by regularly using washing-up liquid or following the manufacturers cleaning instructions
• Prescribe usual quantities of medicines to meet the patients clinical needs – normally 30 days’ supply
• Inform patients, their families and carers to follow the advice they have previously been given about what to do if they have an exacerbation, including taking rescue medications and contacting their CG team
• Monitor patients with CF closely, because they may be at greater risk of rapid deterioration if they contract COVID-19