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The waiting game

RCGP warns of 'confusion' around coronavirus advice to GPs

The RCGP has said there is ‘confusion’ around the advice being given to GPs on triaging potential coronavirus cases.

In a statement to the BBC, RCGP chair Professor Martin Marshall warned that the advice around patients who don’t present with all symptoms of Covid-19 was proving problematic.

Professor Chris Whitty, the chief medical officer, last night said the UK is ‘very close’ to telling anyone with even mild symptoms to stay at home.

However, the latest guidance for primary care was updated on 25 February, and it states that unwell patients with a ‘relevant travel history’ should be identified when they book in at reception. If Covid-19 is considered possible during the consultation, the GP should withdraw from the room.

Since this guidance was released, there have been cases of Covid-19 being transmitted to people with no relevant travel history or contact with people who have been to the affected areas.

Professor Marshall said: ‘We are in an ever-changing situation and it is important that everyone in the NHS has clear, concise guidance about what they need to do to keep both themselves and their patients safe.’

He added: ‘We are aware that there is some confusion around triage and the appropriate steps that GPs and their team should take, particularly for patients who don’t fit all the current criteria for Covid-19.

‘We are also aware of some concerns around community testing and the information on cases being made available to GPs.’

Last night, Professor Whitty said the Government was moving to 'phase when we will be having to ask members of the general public to do different things than they would normally do'.

‘Within 10-14 days, the UK will move to a situation where everybody who has even minor respiratory tract infections or a fever should be self-isolating for seven days afterwards,' he said.

Discussing plans to move from the 'contain' to the ‘delay’ phase, he added: 'There is a risk if we go too early people will understandably get fatigued and it will be difficult to sustain this over time.’

Readers' comments (7)

  • er white tower people - its spreading in the community as we speak,. either we isolate every one at home with a cold now or we don't bother and carry on as normal, forget about testing etc and just treat the sick. this inbetween nonsense is really not helping.

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  • its all gone wrong in Belfast- we can't contact the trust or public health to refer cases for testing as they wont answer the phone. I suspect they're overwhelmed and the burden falls to us- the lowest common denominator as usual

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  • I think it’s time for professionals to use their expertise and common sense to do what they think is right in the face of real time changing environment. Don’t wait for them in high to tell you what to do for goodness sake.

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  • Vinci Ho

    I called this Covid-19 the perfect virus when I started to follow the story from January.
    It is certainly not another flu but also not quite deadly dead virus .
    80% with mild illnesses
    But attack rate of about 83% ( figures from Lancet ) which means in a close household and environment gathering , almost all will be infected ( as seen in many examples so far ). Attack rate of flu us about 10-30% .
    10-15% with severe illnesses , 5% with critical illnesses(over 65% developed Adult Respiratory Distress Syndrome , ARDS , hence fatal) These patients are the ones that might need mechanical ventilation .
    Death rate is debatable , probably between 1and 3%( for flu ; only up to 0.1%). Fatalities were certainly associated with the availability of advanced medical facilities to support those critical 5%. I think Iran clearly has a problem on this ( Both China and US fall into this category in different ways as well ; the latter will suffer because of lack of universal access to medical care ).

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  • Vinci Ho

    Obviously, like to like comparison , death rare of SARS-2002/3 was around 10% ; MERS 2012 was well over 20%

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  • Vinci Ho

    My conclusion so far is that the political , economic and social consequences will be even more serious than the medical ones .

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  • They are trying to do perfect management when just not possible- everyone with a cold stays at home = economic meltdown with far more long lasting health consequences due to that. Not even mentioning all the health staff going off sick so greater mortality from those more severely affected

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