Covid-19: Derry doctors are ‘working harder than ever’

We all appreciate these are very different and difficult times. We have all had to change and adapt to the new normals, writes Dr Paul Molloy.

As I’ve said on previous occasions, GP surgeries are open and working just as hard as ever. Hospital Emergency Departments are dealing with increased capacities.

All health facilities are no different to any other public place. We must maintain safe social distancing and encourage people to wear masks.

We appreciate people would like to be able to book appointments the way they used to. Doctors’ waiting rooms are and have always been a means of illness transmission. That seems like a common sense suggestion considering they are usually full of sick people. We have to stagger appointments and make sure those in the waiting room are socially distanced. This means we can’t do normal surgeries.

COVID-19 presents usually with a respiratory illness in adults but in kids evidence is coming to light that diarrhoea illnesses and other presentations can occur. While kids are lower risk for transmission and severe illness, there is still a risk and we can’t say, ‘we don’t have to be as careful if a child is coming,’ so the same rules apply for all.

We are making arrangements at present to start seeing kids in the COVID centres as we expect the usual increase in coughs and colds with them going back to school.

Anyone who call tell who has COVID just by looking at them, I’d be grateful to hear from them.

As I said, we are doing full surgeries. Probably half to two-thirds of these can be dealt with either by phone, referral to another member of our practice team or by video consult or the use of photos. The remainder will still need a face to face appointment. As long as you don’t have a cold or flu symptoms, that is fine. However, if you do, we then arrange for an appointment at the COVID centre.

The COVID centres are manned by GPs. So, on any given day, a doctor, or possibly two from your practice, will have to work there. The other doctors just have to work harder.

So, we are manning both our practices and the COVID centres which dilutes our numbers.

We also have to comply with the rules regarding contacts. In my own practice, we have already lost a doctor on four occasions to isolation after they were in contact with a positive case or had a family member that was ill, usually a child.

Thankfully, recent speedier testing has allowed them to get back to work quicker.

At any one time, a practice could have half or more of their staff isolating or needing tested.

Whatever your opinion regarding COVID-19 - and that is entirely up to you - there are still people testing positive.

The vast majority of people will just have a flu-like illness but the high risk groups are at risk.

People with chronic disease are fragile and have very little reserves to fight a further illness.

The statistics will tell us that most people who die will have had another issue. That might be obesity, smoking, COPD, heart disease, cancer and other things.

If this makes you stop smoking or do more exercise, well, that can only be a good thing as it lessens your risk from COVID and, in the longer term, reduces your risk of nearly every other illness also.

Imagine someone who has COPD or heart disease is on a roller coaster and they are at the top of the first high point just before the initial plunge of speed downwards - that’s what it would be like for them if they got COVID; probably not enough to kill a healthy person but sufficient to put you over the edge if you are already ill.

It just so happens that we are talking about COVID but that final illness could as easily be flu, gastroenteritis or something equally simple that a normal heathy person could easily fight off.

The statistics that suggest that most of the deaths are in people who are already ill are to be expected.

If you are fit and healthy, you will probably take reassurance from this; but you may also have a family member or friend who isn’t as fit as you. You probably don’t want to spread any illness to them.

I follow the advice I am given by experts. If I’m told to wear a mask, wash my hands and socially distance, I’ll do it.

It’ll not only stop the spread of COVID but many other illnesses, too. So, I might as well do it, if I’m asked. I don’t really see it as much of a sacrifice personally.

Unfortunately, hospitals and ED departments must also comply with infectious disease guidelines regarding social distancing etc., I have seen many reasons mentioned for the crowding and waits in ED. Unfortunately, the need for safety just slows everything down, including the ability to transfer people to hospital beds and out of A&E.

This puts pressure on those arriving as there is no where to see them. The hospital staff and managers are all very dedicated and working very hard to rectify this.

COVID is a very real illness, probably more so if you have had it or know someone who has had it. Like flu, it’ll probably be around for a while and we just have to manage as best we can.

* Dr Paul Molloy is a GP at Clarendon Medical in Derry.