In the UK, new guidance has just been published to support kidney units to safely admit visiting dialysis patients, now Covid restrictions are easing. Kidney Care UK has contributed to this work, which is led by the Renal Association.
Units are asked to consider reopening to Dialysis Away From Base (DAFB) and let patients know whether they are open to it. Anyone wishing to travel should have a discussion with their clinical team as patients are vulnerable to COVID-19 infection and infections have occurred at dialysis units. This guidance only applies if shielding or local lockdown is not in place in base or destination units.
Fiona Loud, Policy Director at Kidney Care UK, said: “Being able to travel and have a change of scene despite the relentless rigours of treatment for kidney disease is an essential part of health and wellbeing for patients and their families. Now more than ever, after a year of lockdown and anxiety, it is absolutely vital for thousands of kidney patients in the UK to be able to meet up with friends and family not seen for months or get away and take a break.
“We appreciate that decisions on travel and opening up dialysis units to allow patients to dialyse away from home need to be made based on local safety considerations. However, with the vaccination programme in place and rates of Covid19 infection decreasing in the UK, we urge all units to support patients who want to travel. With the UK opening up and everyone else planning their trips and reunions, kidney patients need the same opportunities to do this."
The COVID-19 pandemic has seriously affected people with kidney disease and the risk of cross-infection had stopped dialysis away from base. As cases of Covid reduce the government is easing restrictions, based on its proposed roadmap out of lockdown restrictions. We hope that gradually units will be able to support patients who want to travel. Information on incidence of new COVID-19 infections in UK dialysis units can be found on the latest Renal Registry report
Here is what the new guidance says and what the units will be looking at before you travel:
- Assess risk based on the current incidence of COVID-19 in the base unit / locality and the designated unit/locality for DAFB.
- Ensure that there is a documented discussion between the clinical staff at the base unit and the DAFB centre for shared awareness of COVID-19 rates and confirmation of number of recent COVID-19 infections in the base unit or receiving service. Ensure that the patient is aware in advance of the local protocols that they will need to follow.
- Those wishing to have holiday dialysis should have received 2 doses of COVID-19 vaccine separated by at least 3 weeks before travelling. Travel should ideally be at least 2 weeks after the 2nd dose to build up an immune response. However, if a patient has refused vaccination or been unable to be vaccinated this should not exclude them being considered for DAFB.
- Patients should have a negative PCR COVID-19 swab 3-5 days before travel.
- On return to the base unit, patients should dialyse in isolation for 2 weeks, and have COVID-19 tests as per unit protocol. The base unit should consider its capacity to isolate patients on return from holiday whilst planning the timing of patients’ holidays.
- Patients should not travel if they are a close contact (within 2m distance for at least 15 minutes) of any individual with COVID-19 infection, including other patients on the dialysis unit, within the preceding 14 days. Or if they have been advised to self-isolate for any reason.
- Patients should not travel if they have symptoms of COVID-19 or are awaiting a COVID-19 PCR test result.
- Patients should not travel if they have planned surgery within 14 days after the proposed holiday return date as they will be asked to self-isolate for 14 days before the operation.
- Patients should follow the local guidance for high risk prevalence, in the DAFB locality. This guidance is likely to vary with time and between areas.
- Advise patients to take out travel insurance before making any bookings due to the risk of sudden cancellations. Check what is covered by travel insurance in the event of an infection with COVID-19 just before or during the holiday.
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