Article courtesy of The Times, 24th March 2020
Like most GP surgeries we have seen a dramatic increase in suspect cases of Covid-19 and we have lost a fifth of our team to quarantine. It is crunch time. So here is a bulletin from the frontline with an update on what you need to know to help yourself – and the NHS
Everything is changing fast. There is new guidance and protocols issued everyday so it is not surprising that people are confused, but please don’t call your GP surgery or NHS 111 without doing some homework first. Most of the answers to the hundreds of calls and emails we are receiving are clearly laid out in the latest guidance (see below). If you don’t have access to this, or still have a concern, then we are open and there for you, but please do your own research so that we can concentrate on more pressing tasks.
The new UK-wide shielding initiative designed to protect 1.5million of the most vulnerable is (as I write) the biggest recent change in tactics. In the next week if you are one of those affected you should receive a letter outlining what you need to do. In the meantime please do not call your GP or 111 to find out if you are likely to be included. Read the guidance on shielding (see below) and if in doubt follow the protocols while you are waiting for any letter to arrive.
Shielding is an extreme form of the cautious social distancing already advocated for groups deemed vulnerable, like the over-70’s and anyone eligible for an annual flu jab (healthy children aside). The 1.5million most at risk includes those with some types of cancer (not all), transplant patients, those with severe asthma and people taking immunosuppressant medication for conditions like arthritis and inflammatory bowel disease.
Immunosuppressants in particular are causing widespread confusion. Shielding doesn’t apply to them all. For example if you are taking oral steroids for bowel or joint problems, you do not need to shield unless you are on 20mg of prednisolone or more a day, or on a smaller dose alongside another immunosuppressant. There is similar confusion as to what constitutes severe asthma. Fortunately relevant patient groups, like Asthma UK have put up excellent summaries on their websites (see below). Please visit them if you are unsure.
All GP surgeries remain open (other than those closed by infection or quarantine) but we are trying to avoid seeing anyone face-to-face. Please do not turn up at your practice without an appointment. Every request to see a doctor or nurse will now be triaged to see if a video or telephone consultation will suffice. We will still see people if required but, as of this week, your GP or nurse is likely to conduct the consultation in full protective equipment (mask, gloves, apron etc).
Another change is the setting up of dedicated “red zones” where GPs and nurses will care for people with confirmed or suspected Covid-19 infection. These dedicated clinics are to look after infected people who are deteriorating or who develop other medical problems that require urgent attention – just because there is an epidemic doesn’t mean our patients stop having problems like blood clots, kidney stones, strokes and heart attacks. We have taken over a dental surgery which will be staffed by volunteers from local practices working on a rota. This will leave our normal surgeries as clean “green zones”.
I have been deeply impressed by how our community has responded to Covid-19 and it is vital that we all continue to support friends, family and neighbours. However some people have not been taking social distancing seriously enough, which is why a full lockdown is now in place. It is not about you – whether you are a fit and healthy 72-year old or a teenager who thinks they are invincible – it is about being a link in a chain of infection that could lead to hundreds, if not thousands, of extra cases. Some of whom will die. Please heed the stay at home advice.
In the meantime stay safe and keep washing those hands.
Helping us help you
Please read the the relevant advice before contacting 111 or your GP with any concerns, so we can use our resources where they’re needed most.
- Social distancing – what it means and why we should all follow the rules
- Guidance on the new shielding initiative for individuals and their families
- British Society of Gastroenterology advice for people with inflammatory bowel disease
- British Society for Rheumatology advice for people taking immunosuppressants
- Asthma UK guidance on shielding for adults and children with asthma
- Not sure if you have Covid 19?
- Stay at home advice if you do have symptoms
- Mental well being