XPS 13 7390 constant fan noise and grinding

Hi 

The fan in my XPS 13 7390 has always been really loud all of the time.  Constantly on - it feels like I've got tinnitus. In the last few days, the fan has started making an occasional grinding noise. Now, whenever I pick up the device it makes a wurring sound followed by this grinding.

I've run diagnostics from Dell but all systems seemed okay.

I've tried quiet mode. No difference. 

The general noise is making this device almost unusable, with the added grinding sound it is not interfering with Teams calls as it's so noisy

Any ideas what could be going on? Thanks

 @DELL-Cares