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GPs go forth

First coronavirus patients detected via opportunistic GP testing

Exclusive Opportunistic testing in GP practices has already identified two cases of the new coronavirus (Covid-19), Pulse has learned.

Public Health England confirmed to Pulse that the new programme of 'random' testing within GP settings detected two cases, both within Surrey.

It comes after the first death from Covid-19 in the UK was confirmed yesterday, an elderly patient in Berkshire with underlying health problems.

The Government has also updated its advice, stating that people who have visited any part of Italy - and not just the northern regions - should self-isolate if they have any symptoms, even mild.

Coronavirus has also been listed as a 'notifiable' disease, meaning GPs are required to report all cases of COVID-19 to Public Health England.

Since last week, patients presenting to 100 participating GP practices with severe respiratory infections, but who do not display Covid-19 symptoms, are being tested on an opportunistic basis.

When it launched the surveillance system, PHE said there was 'no evidence' that the virus was 'circulating in the community' in England. However, since then five patients who had not travelled from coronavirus-affected countries, or had known contact with patients who had, have been diagnosed.

The PHE surveillance system has since been rolled out to all hospital trusts in England.

Earlier this week, the Government announced a UK-wide action plan to deal with the outbreak, which it said could affect 80% of the population in a worst-case scenario.

The Government said its strategy was to 'contain, delay, research and mitigate' a coronavirus outbreak - but yesterday chief medical officer Professor Chris Whitty said it has already moved into the 'delay' phase.

This will see a focus on trying to delay the peak of the virus until warmer months, when NHS services are expected to be less busy.

Addressing MPs on the House of Commons health and social care committee yesterday, Professor Whitty said more community transmission is now highly likely.

He said: ‘There are several, not large cases, but several cases where we cannot see where this has come from, in terms of a clear transmission.'

Dr Richard Cook, a GP in Brighton, said: ‘It will be interesting to see whether a positive result from PHE's surveillance in primary care will change the Covid-19 advice to GPs.

'In particular, whether more widespread testing will be recommended over time, or how to manage patients with symptoms but not deemed, at this stage, to be in a high risk group.’

Professor Chris Witty, chief medical officer for England, offered condolences to the family and friends of the patient who died from coronavirus.

He said: 'The patient, who was being treated at the Royal Berkshire Hospital, was an older patient who had underlying health conditions. We believe they contracted the virus in the UK and contact tracing is already underway.'

Planned measures for the NHS to tackle the epidemic includes the GMC re-registering retired doctors; cancellations of routine care; and NHS staff being allowed to forcibly detain patients suspected of having the virus. 

NHS England has already declared the outbreak a 'stage 4' emergency, meaning it can take control of local NHS resources, such as for example emergency bed planning.

Across the UK, at least 20 GP practices have been forced to clean for deep cleaning after potential exposure, while a small number of practices have now moved to a telephone-first model of consultation to avoid walk-in cases.

 

Readers' comments (11)

  • Contain phase was a bit of disaster.
    Not sure why non essential travel was not dealt with several weeks ago. That is essentially how it got around the globe so quickly.

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  • If we are now in the community spread phase, how exactly are we supposed to notify it when we haven't been issued with swabs or instructions for taking them? All this work is still going to 111 which according to Radio 4 this morning is struggling to keep up with demand.

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  • Ultimately this will suit the exchequer..... fewer people over 80s needing pensions and healthcare paid for...... if the death rate in the over 80s really is 14-16% then we will soon see our ITUs and HDUs blocked..... we can see hoe its spreading globally despite all the measures... the asymptomatic carriers can't be identified and likely its too late now anyway........

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  • Why not take this opportunity to ask patients to make greater use of e-Consult (there may be other supported products in use) as first line contact with surgeries and only telephone if no access to e-Consult. No reason not to use the current situation to alter patient behaviour which could continue after the Covid-19 problem settles?

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  • Hancock should lead at his idea of IT consulting. Shut the surgeries.

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  • Sorry being my usual thick self but these are opportunistic and not a known risk, so once they are retrospectively diagnosed whats the cunning plan as they wont have been put in isolation pods when the attended and none of the medical staff who attended them will have had any sort PPE on? Bet the other patients in the waiting room at same time are pleased!

    One assumes PHE will be even busier, that's till we run low on testing kits like USA?

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  • THIS IS NOT SURPRISING. GIVEN THE MAP OF CASES AND THE NUMBER OF COMMUTERS TO LONDON WHO LIVE IN SURREY, THIS AREA SHOULD NOW HAVE ENHANCED TESTING....

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  • I feel a little reassured by this finding - if the virus is actually more prevalent than previously thought, yet only one person in the UK has died of it, then logic dictates that the virus is less virulent then previously thought.

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  • depends - 15% death rate in over 85years according to italys figures, if your general population is healthy then the rate will be lower, more poverty then higher rates. as its mainly affecting the south so far then death rates will be lower as the population is healthier, we have to wait to see what happens when it hits the poorer areas and travels north. most poor people do not get the luxury of a holiday abroad in winter as its too expensive.

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  • Dear All,
    Why only opportunistic. Surely, as Dylan implies, they should be testing everyone to in these 100 surgeries to establish the true prevalence. Testing opportunistically won't tell us the absolute prevalence. Then perhaps we might scale down this pandemic of panic?
    Regards
    PauL C

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