Once again, a huge thank you for everything you have done and are doing. Lincolnshire, and Libertas, have coped exceptionally well so far. It is hard to believe that we are now 5 whole weeks into lockdown.

Libertas teams have been exceptionally resilient, and shown great fortitude. This is recognised amongst a whole range of people, from or clients and customers through to our leaders in the Local Authority and beyond. Many of you are now dealing with, and helping people through, active COVID infections and the professionalism and strength shown by each and every one of you has been tremendous. As always, a few notes to keep you up to speed:

Testing has been made available this week through Lincolnshire County Council (LCC) for key workers or co-habitees (family) who are in the first 4 days of symptoms. That has been taken over by a central system, which has quickly broken. LCC continue to provide the service, and if you feel you need or want a test please talk to your Manager. We are expecting more widespread availability, including home swabbing kits, very soon.

No email would be complete without this. You should now be fully conversant with guidelines on PPE for each duty or visit. If you have any doubts at all, talk to your Team Leader or Manager. In addition to recommended PPE, we have tried our very best to provide some extra additional precautionary items. These include disposable visitor coats, mob caps, oversleeves, general-issue face masks, general-issue eye protection/visors (where not specified for COVID cases) and general-issue hand rub. These are not requirements of the job, but additional items. Sadly while we will do our best, we cannot guarantee supply of any of these items.

Hand rub is produced by Bottomley Distillery under a Critical Situation Permit from the HSE. In order to get it out as quickly as possible we have allowed people to take unlabelled containers. Labels are in production; in the meantime the key information is: WHO-recommended formulation

Use: Apply a palmful of alcohol-based hand rub and cover all surfaces of the hands. Rub until dry.
For external use only. Avoid contact with eyes. Keep out of reach of children.
Composition: Isopropanol, glycerol and hydrogen peroxide
Flammable: Keep away from flame and sources of heat
Formulating company: Bottomley Distillery
Date of production: March 2020

Extremely Vulnerable High Risk Groups – EV-HRGs
People who are Extremely Vulnerable have been asked by the NHS to undertake shielding. Shielding is a more intense form of social distancing, and is very restrictive. Amongst the precautions for extremely vulnerable people, is the additional requirement for us to use a face-mask (FRSM) that has not been used elsewhere.

Over the next few days our systems will be updated to reflect this. We will provide zip lock bags for stowage of FRSM for use with EV-HRG service users. The stowage should be clearly marked with your name, and remain in the Service Users property.

• Use a new, unused FRSM on your first visit to a EV-HRG customer
• After the visit, if the mask is clean and undamaged, place it in the ziplock stowage bag.
• Ensure the stowage bag is clearly marked with your name
• You can reuse the FRSM at your next visit with that Service User.
• If the bag or mask is damaged, dirty or otherwise unsuitable – use a new FRSM
• You can replace the FRSM for a new one whenever you want

The aim of this procedure is to look after supply of FRSMs; as you will know from national news PPE continues to be a challenge throughout health and social care. With that said, don’t use a mask that you feel is unsuitable. Use a new one.

General Coronavirus Situation
The current situation in the UK is difficult to describe with any accuracy. CV figures vary, from what appeared to be a plateau or decline, to further rises towards the end of last week. The good news is that the current Social Distancing measures seem to be working; the
transmission rate R0 – the number of people an infected person will go on to infect – has dropped below 1, which means that fewer and fewer people become infected.

Remember though, that almost all the statistical analysis, and almost everything you see on TV and in the media, is heavily biased towards London and the South East, simply because of the much larger population, and population density. Lincolnshire has lagged behind the curve, because we are more remote, more rural, and more spread out. This also means that it is likely that we will also lag behind the UK figures, possibly by as much as two weeks, when talking about peak demand, plateau and decline of numbers.

The NHS has coped exceptionally well – thanks in more than part to YOU. In preparation, the NHS freed up 33,000 beds by delaying less urgent and routine care, and diverting resources – the equivalent to an additional 50 hospitals. The incredible NHS Nightingale hospitals, of which there are 7, are largely unused, and one (Sunderland) may never open it’s doors. The UK has so far, avoided the incredibly distressing scenes seen around Europe, with Hospital and heath facilities simply overwhelmed with demand. Whatever political arguments follow, the simple fact that we may never need to fully use this additional capacity is testament to the capability of the NHS, the effectiveness of everyone’s efforts to stay indoors, and YOUR contribution in helping to keep people safe and well at home.

Nearly 5 weeks after the first restrictions were placed on the general public, people throughout our organization are starting to feel fatigue. Fatigue is not the same as sleepiness; it is a normal and natural after-effect of stress, and does not generally go away after a nap. Anxiety is a form of stress, and both stress and anxiety levels have been really high over the last few weeks, as people come to terms with increased worry, huge changes to social and working environments, and often working and thinking much more than normal to get through the first stages of the changes. Now that some routine is re-established (whatever odd routine that may be), fatigue is starting to kick in.

There is no cure, no pill. It is for most people, a normal and natural after-effect and will go away by itself. Rest and relaxation help, as does eating well, drinking more water and less alcohol and coffee. Talking can often help too, so try to make time for friends, family and

As we enter week 6, I can only repeat what we have said before. Thank you – from our Service Users, the agencies and health care services that wouldn’t be able to cope without you, and by extension, the whole population of Lincolnshire who currently enjoy free, unhindered and unrestricted access to health care for all conditions, simple and urgent; help that may not have existed today without your contribution.

Thank you, from all of us.

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