What went wrong — officially

• "The UK prepared for the wrong pandemic" — plans assumed flu, and a scalable test, trace and isolate system didn't exist (COVID Inquiry, 2024).
• Too little, too late: the Inquiry's 2025 report called February 2020 a "lost month" and found a lockdown a week earlier could have saved around 23,000 lives in England's first wave (modelled).
• Airborne spread was underplayed for months: early messages focused on handwashing and surfaces. WHO's guidance only fully described long-range airborne spread in late 2021.
• Protective equipment ran out: stockpiles were built for flu and lacked gowns; social care received a fraction of what it needed.
• Care homes were hit early and hard.

What households should take from it

• Act on the first credible warnings, not when your street is affected.
• Treat new respiratory infections as airborne from day one: ventilation and well-fitted FFP2/FFP3 respirators, not just hand gel and cloth masks.
• Have your own protective equipment and medical basics — don't rely on shops.
• Protect the most vulnerable early, especially anyone in or visiting care settings.
• Plan for months, not weeks, and for the harm isolation itself does.
• Vaccines can come remarkably fast — the first UK dose was given within a year. Surviving the first year is the goal.

Put it on and check the seal — every time

1. Clean hands. Hold the respirator by the edges; check it isn't damaged.
2. Cup it over nose and chin; pull the top strap over the crown of the head, the bottom one round the neck.
3. Press the metal nose clip with two hands to mould it to your nose — not a pinch.
4. Seal check: cover the front with both hands and breathe out sharply — no air should escape round the edges. Breathe in sharply — the mask should pull in slightly. If air leaks, readjust and check again.

What ruins the seal

• Beards and stubble — respirators need to be worn on clean-shaven skin to seal properly. A day's stubble is enough to let air leak.
• The wrong size: try two or three models before an emergency and keep the one that seals.
• Glasses pushing it out of place; hair under the edge; earloop-only styles.
• Talking a lot, wet or damaged masks.
• A seal check every time is essential but isn't a substitute for a professional fit test (offered by many workplaces and safety suppliers).

Reuse when supplies run short

• FFP respirators marked "NR" are designed for single use (one shift); "R" means reusable.
• In shortages, US crisis guidance allows limited reuse: no more than about 5 times per respirator, stored between uses in a clean paper bag, labelled with the user's name.
• Rotate several respirators so each rests a few days between uses.
• Throw it away if it is wet, dirty, damaged, contaminated with body fluids, or hard to breathe through.
• Never share respirators; don't wash or spray them with disinfectant.

🪟 Ventilate (free)

• Windows don't need to be open all the time: opening them fully for a few minutes at a time helps a lot.
• When anyone visits, open windows fully during the visit and for at least 10 minutes afterwards.
• The sick room: window slightly open, door kept closed, so air leaves the house rather than spreading inside it.
• Keep trickle vents open; run kitchen and bathroom extractor fans longer.
• Winter Open windows a little, or the top sash only, and heat rooms to at least 18°C for older people and anyone with long-term conditions.

🌀 Filter (when you can't ventilate)

• A HEPA air purifier removes particles from a room's air. It is not a substitute for ventilation and should never be a reason to close windows.
• Size it for the room: aim for 5 or more air changes per hour — the purifier's clean air delivery rate (CADR) should be at least 5 times the room's volume per hour.
• Avoid ionisers, "plasma" and ozone devices: the evidence is weak and some produce harmful by-products.
• Real performance is often below the manufacturer's claim — buy bigger than you think.

🧼 Handwashing — the basics that work

• Soap and water for at least 20 seconds, all surfaces, then dry with a clean towel. Good hand hygiene reduces respiratory infections by roughly 14% in studies — more for gut infections.
• Always use soap and water, not gel, after the toilet, after handling vomit or diarrhoea, and when norovirus or C. difficile is around: alcohol gels don't kill norovirus.
• Hand sanitiser needs at least 60% alcohol; rub until dry (about 20 seconds). It doesn't work on visibly dirty hands.
• Separate towels for the sick person.

🧹 Clean, then disinfect

• Cleaning (detergent and water) removes dirt and most germs. Disinfecting kills what's left. Disinfectants don't work well on dirty surfaces — clean first.
• Daily in an outbreak: door handles, light switches, taps, toilet flush and seat, phones, remotes, banisters, kitchen worktops.
• In the sick room and its bathroom: clean, then disinfect at least daily.
• Ventilate while using bleach. Never mix bleach with other cleaners (especially acids or ammonia) — it releases toxic chlorine gas.

🚪 The "clean entry" routine

1. Set up a "dirty zone" just inside the door: hooks for coats, a box for shoes, hand sanitiser, a bin, a bag for outer clothes.
2. Coming in: shoes off, coat and bag on the hook, mask removed by the straps into the bin (or a paper bag if reusing).
3. Wash hands for 20 seconds before touching anything else in the house.
4. In a severe outbreak: put outer clothes straight into the wash and shower.
5. Wipe phone, keys and glasses.

📦 Deliveries & shopping

• Ask for contact-free delivery to the doorstep; collect after the driver has left.
• For airborne diseases, the risk from packaging is low — handwashing after unpacking is usually enough.
• For diseases that survive on surfaces, leave non-perishables in a porch or garage for 72 hours, or wipe them, and wash fresh produce under running water.
• Don't share delivery slots or items with other households without care.

🛒 The one who goes out

• Pick one healthy, lower-risk adult to do all essential trips.
• Go at quiet times, with a list, a respirator, sanitiser and contactless payment or exact cash.
• Combine errands; make each trip count.
• That person is the household's main exposure: they should keep their distance from the most vulnerable person at home.

🛡️ Shielding someone vulnerable

• Give the most vulnerable person (very old, immunosuppressed, on chemotherapy, with serious lung or heart disease) their own room and, ideally, bathroom.
• If sharing a bathroom, they use it first; others clean touched surfaces after use.
• Everyone else in the house acts as if they could be carrying the infection: keep apart, ventilate, mask when close.
• Arrange food and medicine deliveries for them; ask neighbours and volunteers to help.

Choose the room

• A single room with a door that closes and a window that opens.
• Closest to a toilet; ideally a bathroom used by the sick person only.
• Away from the most vulnerable people in the house.
• Remove clutter, rugs and soft toys that are hard to clean.
• Bed raised or propped so the person can sit up (easier breathing, easier care).

Stock the room

• Large jug of water and a cup, oral rehydration sachets
• Thermometer, pulse oximeter, the daily check chart and a pen
• Bucket or bowl for vomit, tissues, a lidded bin lined with a bag
• Hand sanitiser at the door; masks, gloves and aprons for the carer
• A bell or phone to call for help; a torch; extra pillows and blankets
• Bedpan or commode if the toilet is too far

💧 Fluids first

• Fever, fast breathing, vomiting and diarrhoea all drain fluid. Dehydration makes every illness worse.
• Aim for pale straw-coloured urine. Dark urine, or passing very little, means drink more.
• Offer small amounts often — a few sips every 10–15 minutes is easier than a full glass.
• Water, diluted juice, weak squash, soup, ice lollies, jelly; oral rehydration solution if vomiting or with diarrhoea.

🛌 Rest, warmth & comfort

• Rest in bed or a chair, propped up if breathing is difficult.
• Light clothing and bedding during a fever — don't wrap up tightly or try to "sweat it out", and don't sponge with cold water.
• Change position every 2 hours if they can't move much; check heels, hips and the base of the spine for red marks (pressure sores).
• Keep the room calm and ventilated; dim light helps headaches.

🍲 Food

• Appetite often disappears — that's fine for a few days if they drink.
• Offer small, easy meals: soup, toast or crackers, rice, porridge, bananas, yoghurt, eggs.
• As they recover, build up protein and calories again.

🪥 Hygiene & dignity

• Mouth care: sips of water, brush teeth or wipe the mouth, lip balm — a dry mouth is miserable.
• Help with washing; change sweaty bedding and clothes.
• Help to the toilet or commode; watch for falls when they first stand.
• Talk to them, explain what you're doing, keep them company — fear makes everything worse.

Taking a temperature

• A high temperature is 38°C or more.
• Under 5s: digital thermometer in the armpit (an infrared ear thermometer is fine from 4 weeks). Don't use mouth readings in young children, forehead strips or glass thermometers.
• Older children and adults: digital thermometer under the tongue until it beeps.
• Write it down with the time. A parent's feeling that a child is hot should be taken seriously.

Comfort without medicine

• Plenty of fluids — little and often.
• Light clothing and bedding; a comfortably cool room.
• Don't sponge with cold or tepid water, and don't over-wrap or under-dress a child.
• Check on a feverish child during the night.

How to take a reading

1. Rest, sitting, for at least 5 minutes first.
2. Remove nail varnish or false nails; warm the hand if it's cold.
3. Put it on the index or middle finger; rest the hand on the chest at heart level and keep still.
4. Leave it on for at least a minute, longer if the number keeps changing.
5. Record the highest number once it has stayed the same for 5 seconds. Don't confuse it with the pulse (heart rate) number.
6. Take a baseline when well, then at least 3 times a day when ill.

What the numbers mean (adults)

Children: 95% or less is a warning sign; below 91% means serious illness.

Adult CPR

1. Unresponsive? Call 999 immediately, phone on speaker.
2. Not breathing normally? Slow, gasping or noisy breathing counts as not normal.
3. Push hard and fast in the centre of the chest (lower half of the breastbone): 5–6 cm deep, 100–120 a minute, letting the chest come back up fully.
4. If trained and willing: 30 compressions to 2 rescue breaths. Otherwise, continuous compressions — the 999 call handler will guide you.
5. Send someone for a defibrillator (AED) — anyone can use one; it talks you through it.
6. During COVID-19 the Resuscitation Council advised: don't put your face close to theirs to check breathing; lay a cloth or towel over their mouth and nose and do compression-only CPR until the AED or ambulance arrives. Use the same approach in a dangerous respiratory outbreak.

Child and baby CPR

1. Shout for help; call 999 (if alone, start CPR first, then call on speaker).
2. Give 5 rescue breaths — breaths matter more in children. Then 30 compressions to 2 breaths (15:2 if trained in children's CPR).
3. Press down at least one third of the depth of the chest: two fingers or two thumbs for a baby, one or two hands for a child.
4. 100–120 compressions a minute. Keep going until help arrives.
5. In a pandemic, the risk of infection from a child is small compared with the risk of not acting — give breaths.

Choking — adult or child over 1

• Encourage them to cough.
• If the cough isn't working: up to 5 sharp back blows between the shoulder blades.
• Then up to 5 abdominal thrusts (hands clasped above the belly button, pull sharply in and up).
• Repeat; call 999 if it's not cleared. If they become unconscious, start CPR.

Choking — baby under 1

• Lay the baby face down along your forearm, head lower than the body, supporting the head.
• Up to 5 back blows.
• Turn face up; up to 5 chest thrusts with two fingers in the centre of the chest.
• Repeat; no blind finger sweeps. Call 999 if not cleared; CPR with 5 breaths if they become unresponsive.

Signs of dehydration

• Adults and children: thirst; dark, strong-smelling urine; peeing less; dizziness; tiredness; dry mouth, lips and eyes; sunken eyes.
• Babies: sunken soft spot on the head; few or no tears; fewer wet nappies; drowsy or irritable.
• Emergency (999): confusion, very drowsy, fast breathing, cold blotchy hands and feet; a child under 5 with no wee for 12 hours.

What to give

• Oral rehydration sachets (Dioralyte, Electrolade and others) from a pharmacy, made up exactly as the packet says with safe water. Stock 20+.
• Small sips often — a teaspoon every 1–2 minutes for small children. If they vomit, wait 10 minutes and start again more slowly.
• Keep breastfeeding or formula feeding.
• Avoid fizzy drinks, fruit juice and sweet tea — too much sugar can make diarrhoea worse.
• Restart normal food as soon as they want it.

Other care

• Don't give anti-diarrhoea medicine (loperamide) to children under 12, or to anyone with blood in their stool or a high fever.
• Strict handwashing with soap — gel doesn't kill norovirus.
• Stay off work or school until 48 hours after the last episode.
• Wash soiled bedding separately at 60°C.

Get help (111 or GP) if

• Signs of dehydration despite ORS, or can't keep any fluid down
• Blood in the stool or vomit; severe tummy pain
• Diarrhoea lasting more than 7 days, or vomiting more than 2 days
• A baby under 1 (especially under 6 months), more than 5 stools or 2 vomits in 24 hours
• Older, pregnant or immunosuppressed people, or anyone with kidney disease or diabetes

Babies under 3 months — always get help

• A temperature of 38°C or more in a baby under 3 months is treated as high risk — call 111 urgently or 999 if they look unwell. (A fever soon after vaccinations can be expected — check the leaflet.)
• No paracetamol under 2 months; no ibuprofen under 3 months, unless a clinician advises.
• Watch for poor feeding, fewer wet nappies, floppiness, a weak or high-pitched cry, breathing pauses or grunting.
• Keep breastfeeding: breast milk gives some protection and is the best fluid.

Young children

• Children get dehydrated faster than adults — offer fluids often.
• Use the children's danger signs and check them during the night too.
• Judge how ill a child is by how they look and behave, not just the temperature — a child who is playing and drinking with a temperature of 39°C may be less ill than a quiet, floppy child at 37.8°C.
• Don't put masks on children under 3. For older children, ventilation and handwashing matter more.
• Keep children's vaccinations up to date — measles, whooping cough and flu are dangerous on top of a pandemic.

Fever and medicines

• Get any temperature of 38°C or more checked in pregnancy — contact your GP (under 12 weeks), midwife or maternity unit.
• Paracetamol is the first choice for pain and fever in pregnancy — at the lowest dose that works, for the shortest time. Untreated fever can itself harm the baby. There is no good evidence that paracetamol causes autism (MHRA, 2025).
• Avoid ibuprofen and other anti-inflammatories unless a doctor advises.
• Pregnant women are a priority group for flu antivirals and vaccines — ask early.

Spotting illness early

• Older people often have no fever — or a temperature that's slightly low (36°C or below) or just 1.5°C above their normal.
• Pneumonia may show only as confusion, drowsiness, falls, tummy discomfort or not eating — with no cough.
• Sudden confusion or a sudden change in behaviour needs urgent medical help.
• Know each person's normal: their usual temperature, oxygen level, breathing and how alert they are.
• Blood sugar control often goes haywire in people with diabetes when they're ill — check more often.

Shielding at home (as in COVID-19)

• During COVID-19, people at highest risk (organ transplant recipients, people on chemotherapy or strong immunosuppressants, severe lung disease, some rare conditions) were advised to stay at home and avoid face-to-face contact for at least 12 weeks.
• Within the home: keep 2 metres apart, sleep separately, eat in their own room, use a separate bathroom if possible (or use it first, then others clean it), separate towels, ventilate shared areas.
• Essential carers continue — with respirators, hand hygiene and no visits when unwell.
• See Isolating a household.

People with weakened immunity

• May not respond fully to vaccines — the people around them getting vaccinated matters more.
• Should contact their specialist team at the first sign of infection — they may be eligible for early antiviral or antibody treatments.
• Keep a written care plan and contact numbers from their specialist team.

Care homes and home care

• Care homes were among the worst-hit settings in 2020. Ask the home about its outbreak plan, visiting arrangements and how you'll be kept informed.
• If a relative has home carers, agree a back-up plan if carers fall ill.
• Keep in touch daily — isolation and loneliness are dangerous in their own right.

When antibiotics are needed

• Bacterial pneumonia after flu or another virus (see Breathing) — getting worse after starting to recover, fever returning, chest pain on breathing, coughing blood.
• Sepsis, infected wounds, urine infections, some ear and throat infections, plague and anthrax after exposure.
• These need a clinician's assessment — phone 111 or a GP, describe the symptoms and readings from your check chart.

Flu antivirals

• Oseltamivir (Tamiflu) and zanamivir are prescription-only medicines. In the UK they're offered when flu is circulating to people at higher risk — over 65s, pregnant women, babies, people with long-term conditions or weakened immunity — and only help if started within 48 hours of symptoms.
• In a flu pandemic, the government stockpiles antivirals and may set up a national flu service and collection points. Find out how it works as soon as it's announced, so you can act within the 48 hours.

📏 Monitoring

• Digital thermometer (under-arm digital for children under 5; ear or digital for older children and adults)
• Fingertip pulse oximeter + spare batteries
• Blood pressure monitor (if anyone has heart or kidney problems)
• Blood glucose meter and strips (if anyone has diabetes)
• Watch or phone with a seconds display (for counting breaths and pulse)

💊 Medicines (over the counter)

• Paracetamol tablets and children's liquid paracetamol
• Ibuprofen tablets and children's liquid ibuprofen (if suitable)
• Oral rehydration sachets (20+)
• Antihistamine tablets and liquid; hydrocortisone 1% cream
• Loperamide (not for children under 12), indigestion remedy
• Saline nasal spray, throat lozenges, honey (not for babies under 1)
• Oral syringes for measuring children's doses

🩹 First aid

• Sterile dressings, gauze, plasters, wound closure strips, micropore tape
• Crepe and triangular bandages; safety pins; tweezers; scissors
• Saline pods or clean water for wound cleaning; antiseptic wipes
• Burns dressings / cling film; instant cold packs
• Large trauma dressing; tourniquet (and training to use it)
• CPR face shield

🧤 Infection control

• Nitrile gloves, aprons, FFP2/FFP3 respirators, eye protection
• Hand sanitiser and liquid soap
• Plain unscented bleach and measuring jug
• Bin bags, clinical waste-style bags, paper towels
• Vomit bowls, commode or bedpan, waterproof sheet

Prepare before you need help

• For each person: a one-page summary — name, date of birth, NHS number, conditions, medicines, allergies, GP, next of kin.
• Keep the daily check chart up to date — it's exactly what a clinician will ask for.
• Know where your nearest A&E, urgent treatment centre and pharmacy are, and how you'd get there without an ambulance.
• Agree who would go to hospital with a sick child or a confused older relative.

Getting help when phones fail

• Go in person to the nearest hospital, GP surgery, pharmacy, fire or police station.
• Send two healthy people with a written note: patient details, symptoms, timings, readings, medicines.
• Listen to local radio for emergency medical points, testing centres and treatment centres.
• Neighbours with nursing, medical or first-aid training can be invaluable — know who they are now.

How a release might show itself

• An announced incident: a suspicious package, powder, spray or device, with emergency services on scene.
• Or no obvious event — just an unusual pattern of illness spotted by doctors days later: clusters of severe illness in previously healthy people, a disease not normally seen in the area, illness in an unusual age group, many people falling ill after the same event, or people and animals falling ill together.
• Many agents of concern (for example anthrax) are not passed from person to person — the danger is the original exposure. A few (such as plague in its lung form) can spread between people, which is why officials may ask exposed people to stay apart.

What the authorities will do

• Emergency services cordon the area, assess the hazard and may carry out mass decontamination of people on site.
• People who may have been exposed will be told not to leave and travel to hospital themselves — it can spread contamination; medical help comes to them.
• Public health teams trace and contact anyone exposed.
• The UK holds stocks of medical countermeasures; exposed people may be given preventive treatment or vaccines at local distribution centres.

Oral rehydration saves lives

For viral haemorrhagic fevers and cholera alike, much of the death toll comes from fluid loss. Specialist treatment includes intravenous fluids and, for Ebola, antibody medicines; at home, steady oral rehydration (see Dehydration) is the most important thing a carer can do while waiting for help.

Ticks and mosquitoes

• Lyme disease (ticks): about 1,000–1,500 lab-confirmed cases a year in the UK, many more diagnosed by the rash. A spreading "bullseye" rash 3–30 days after a bite needs a GP visit.
• Remove ticks promptly with a tick tool or fine tweezers, gripping close to the skin and pulling steadily.
• Invasive mosquitoes that can carry tropical diseases have been detected in England, but there is no established local spread. Report sightings to UKHSA's Mosquito Watch.

Reducing long-term risk at home

• Keep vaccinations up to date for everyone (including adults' boosters and hepatitis B if at risk).
• Don't share razors, toothbrushes, needles or anything that can carry blood.
• Use gloves to deal with blood and dispose of sharps in a rigid container.
• Ventilate shared rooms and get a long cough checked.

😷 Protection

• FFP2 or FFP3 respirators: at least 20–30 per adult (more for a carer)
• Nitrile gloves (box of 100–200), disposable aprons
• Eye protection: safety glasses or a face shield for the carer
• Liquid soap and alcohol hand sanitiser (60%+ alcohol)
• Plain unscented bleach and a measuring jug; disinfectant wipes; spray bottles
• Heavy-duty bin bags; paper towels
• CO₂ monitor (to check ventilation); a HEPA air purifier or the parts for a DIY box-fan filter

🩺 Medical (see Medical kit)

• Digital thermometer and a pulse oximeter (plus spare batteries)
• Paracetamol and ibuprofen (adult and children's), in date
• Oral rehydration sachets: 20+ (diarrhoea and fever both dehydrate)
• A month of all regular prescriptions
• Throat lozenges, honey, saline nasal spray, tissues
• Antihistamines, anti-diarrhoeal (adults), indigestion remedies

🥫 Food & household

• 2–4 weeks of food you already eat, including easy foods for the sick: soups, crackers, rice, bananas, jelly, ice lollies, honey, tea
• Baby formula and nappies for 4–6 weeks; pet food and medicines
• Toilet roll, washing powder, washing-up liquid, sanitary products
• Bottled water or containers, in case water treatment staffing fails
• Freezer full: cooked meals in portions for days when the carer is exhausted

📞 Information & morale

• Printed copy of this guide, contact list, medicines list for each person
• Battery/wind-up radio; phone chargers; a working home internet connection
• Books, games, puzzles, craft materials, school books for children
• Exercise kit for indoors; seeds and compost for a windowsill or garden
• A written plan: who cares for whom if adults fall ill at the same time

Daily habits that protect

• Routine: fixed times for getting up, meals, work or school, exercise and bed.
• Daylight and movement: time outdoors (garden, doorstep, a quiet walk) every day if it's safe; indoor exercise if not.
• Connection: daily calls or video with family and friends; check on people who live alone.
• Limit the news: one or two check-ins a day from reliable sources, not constant scrolling.
• Purpose: a project, learning something, helping a neighbour, growing food.
• Sleep: regular times, a dark room, screens off an hour before bed.

Children and teenagers

• Explain what's happening honestly, at their level; let them ask questions.
• Keep school routines: a timetable, a work space, breaks.
• Give them jobs and some control: planning meals, choosing activities.
• Let them stay in touch with friends.
• Watch for changes: withdrawal, sleep problems, anger, bedwetting, not eating — and talk.

💼 Work

• Ask your employer now about working from home, sick pay and what happens if you have to care for someone.
• Key workers (health, care, food, utilities, transport): plan childcare and a way to keep your household safe when you come home (see the clean entry routine).
• Don't go to work ill. "Presenteeism" spreads outbreaks.

🎒 School

• Schools may close or switch to remote learning; keep books, paper and a device ready.
• Know who can collect your children and keep the school's list up to date.
• Children of key workers and vulnerable children may still be able to attend — ask early.

💷 Money

• Build a buffer of 1–3 months' essential costs if you can.
• Check Statutory Sick Pay and benefit eligibility; government support schemes may be announced in a major outbreak.
• Keep some cash, but expect shops to prefer contactless.
• Beware scams: fake tests, cures, "vaccine appointments", fines or charity appeals — the NHS will never ask for bank details for a vaccine or test.

🏛️ Your rights and the law

• In a major outbreak the government can use emergency powers (as with the Coronavirus Act 2020) to require isolation, close premises and restrict gatherings. Follow them.
• Rules change quickly and vary between England, Scotland, Wales and Northern Ireland — check the official site for where you live.

Who gets vaccinated first

Doses go first to the people most likely to die. In COVID-19 the independent Joint Committee on Vaccination and Immunisation (JCVI) prioritised: care home residents and staff; people 80+ and frontline health and care workers; then by descending age and medical risk down to people in their 50s — groups covering about 99% of preventable deaths. The biggest single risk factor was age. Expect a similar approach, adjusted for whoever the new disease hits hardest.

Treatments

• Antiviral medicines may be offered to people at high risk, usually only if started early (often within a couple of days of symptoms). Know whether you're eligible and how to get them quickly.
• Hospital treatments improve fast in a pandemic as trials report — the UK's RECOVERY trial found the first life-saving COVID-19 treatment within months.
• Beware "cures" sold online. Only use treatments recommended by the NHS.

Protecting the household

• Try not to touch the body if the person had an infection. If you do (to say goodbye, or move them into a dignified position), wear gloves if you can and wash your hands with soap for 20 seconds afterwards.
• Open windows and move to another room while you wait.
• If the person needs to be moved, lay a cloth or mask over their mouth and nose first.
• For a suspected high-consequence infection (Ebola-type), do not touch, wash or prepare the body at all — the body remains highly infectious. Wait for specialist help. Many Ebola infections in West Africa were caught at funerals.
• Family rituals that involve close contact (washing, dressing) should only be done with protective equipment and advice from the funeral director.

What happens next

• A doctor, nurse or paramedic verifies the death.
• A doctor completes the medical certificate of cause of death, which is reviewed by a medical examiner (England and Wales); the family may be contacted.
• Register the death within 5 days of the medical examiner's confirmation (England and Wales), or within 8 days in Scotland.
• Contact a funeral director; they can collect the person from home.
• In a pandemic, rules on funerals and gatherings may change — the funeral director will know the current position.

After the illness

• Recovery from a serious infection can take weeks. Build activity up gradually; rest when tired.
• Eat well — protein, fruit and vegetables — to rebuild strength lost while ill.
• Keep watching for setbacks: fever returning, new breathlessness or chest pain can mean a second infection.
• Follow official advice on when you can stop isolating; protect vulnerable people for longer.

Long-term effects ("long COVID" and post-viral illness)

• Some people have symptoms for weeks or months: extreme tiredness, breathlessness, joint and muscle pain, "brain fog", headaches, sleep problems, changes to taste and smell, anxiety and low mood.
• Symptoms lasting over 12 weeks with no other explanation are called post-COVID syndrome (long COVID) — see your GP, who can refer you to specialist services.
• Pace yourself: be careful with exercise, and stop if it makes symptoms worse.
• Get urgent help for chest pain, or if your oxygen level is low or drops when you move about.

Getting the household back on track

• Replace and rotate everything you used: medicines, masks, food, ORS.
• Get vaccinated as soon as you're eligible.
• Catch up on postponed health care — screening, check-ups, dental care.
• Talk as a family about what worked and what didn't.

Looking after each other

• Many people feel exhausted, anxious or low after a pandemic, especially carers and the bereaved.
• Children may need time and support to settle back into school and friendships.
• If feelings don't improve, talk to a GP — NHS talking therapies can be accessed directly in England.

🛡️ Protect the household

• Act early: stock masks, medicines, food before the rush
• Ventilate: windows open a little, more when visitors come
• FFP2/FFP3 respirators, seal-checked, in shared indoor air
• Fewer contacts; outdoors not indoors; one shopper
• Wash hands with soap (gel doesn't kill norovirus)
• Shield the most vulnerable; clean entry routine
• Isolate the sick at once: one room, one carer

📊 Key numbers

🩺 Caring for the sick

• Fluids little and often — pale urine is the goal
• ORS for vomiting/diarrhoea; small sips
• Paracetamol or ibuprofen for comfort, by the label; write every dose down
• Check temp, breathing, oxygen, drinking, urine, alertness every 4–6 hours
• Sit up to breathe; don't lie flat on the back
• Know the danger signs; act at once

☣️ Deliberate release

• Remove yourself — away, upwind
• Remove outer clothing — not over your head
• Remove the substance — blot skin, then wash
• Stay for the emergency services; don't go home or to a GP
• Not at the scene: go in, stay in, tune in