Rationale COVID-19 ‘lockdown’ restrictions profoundly disrupted lives and often adversely affected health and wellbeing. Those who are clinically more vulnerable to COVID-19 due to living with long term conditions (LTCs) were at most risk of negative impacts on their health and wellbeing, including in relation to their LTC self-management strategies. This study explores how people managed their LTCs, health and wellbeing under social distancing restrictions and self-isolation during the first wave of the COVID-19 pandemic, and examines why some people managed better than others.

Methods Telephone interviews were conducted between 11th May and 13th July 2020 with people (n=44) aged 40 to 75 living in an urban and largely deprived area of North East England with one or more of eight LTCs, often including types 2 diabetes. Audio recorded interviews lasted between 20–120 minutes with an average of 50 minutes. Data were descriptively coded with the assistance of Nvivo 12 software and analysed using a social constructivist thematic analysis.

Results We found that while some deployed a range of capitals and/or etched out tactics to make life habitable, others experienced ‘zones of impossibility’ in which current health and wellbeing deteriorated and tangible futures retreated from view. Our analysis highlights inequalities amongst people with LTCs, and in particular regarding access to greenspace, exercise social and digital connection. Those people who were instructed to shield, had complex health issues, difficult life circumstances, or were living in the most disadvantaged situations were less able to deploy various forms of capital to cope with the lockdown, or to etch out tactics to mitigate negative effects. However, regardless of their circumstances, people expressed an attitude of ‘getting on with it’ and ‘just coping’ because they perceived others as in ‘the same boat’ or ‘worse off’ than themselves.

Conclusion Our findings demonstrate the impact of inequalities on the management of long term conditions during social isolation, and highlight the importance of outdoor mobility, exercise and social support for managing wellbeing and health.