Working during COVID-19: GP Perspective

Written by: Dr Craig Munro from Cape Hill Medical Centre

It was in January that I started to obsess

over the news, as word spread about a novel human coronavirus causing some serious illness and a lot of fear in China. When the subject came up at a practice meeting in late January, it seemed natural to volunteer as COVID lead. After all, it would give me

an official reason to read more news, and maybe a little more admin time. I’d worked through SARS, MERS and swine flu, all of which came to nought in the UK, so this would be no different. Right

Wrong.

As the number of UK cases rose from 0 to 2 to 8 to more, it became clear that this was going to be much bigger. Immediately, the official guidance felt like it wasn't enough. Put up a poster on your door. Ask people if they’ve been to China. As a diverse practice with patients who speak more than 50 languages and travel as widely as this would suggest, it was surely only a matter of time before we were inundated. Rumour spread of practices who had closed their doors and gone telephone-first. Someone knew someone whose practice had set up a quarantined area for seeing people with fevers. Should we do the same? On one hand, quick action might prevent the spread of COVID, on the other, what would be the consequences for people with long-term conditions or with symptoms of possible cancers? There was no official guidance telling us to lockdown, and the government and Public Health England would surely tell us to do so if we needed to? Right?

Wrong.

Over the next few weeks, the guidance came out thick and fast - just not from the government. Websites like Primary Care Pathways compiled lists of guidelines, some from reputable sources like the BMA or RCGP, others from individual practices or CCGs; information that looked sensible but lacked scientific rigour. Some of it was useful, much of it wasn’t, but it all had to be read, assimilated, and a decision made about putting it into practice. My “one-page summary” of the latest guidance for clinicians quickly grew to over 50 pages and 12,000 words.

When the NHS England standard operating procedures for general practice finally appeared, we had already done most of what was suggested. Had we waited for this to appear before acting, I cannot imagine how many more COVID cases we would have had in our patient population, how many more staff we would have sent home, sick or to self-isolate.

Now we move into a new phase, with the recovery of services like cervical screening and long-term condition management, planning for this year’s biggest ever flu immunisation campaign, and dealing with a new surge of COVID cases that is just beginning in our practice area. We hope that this time the guidance will come before we need it. Right?