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QCovid is rocket science


e-consults


Hang on. I get that QCovid is damn clever. I’ve just tested it on myself and it takes into account pretty much all the risk factors you’d expect: age, sex, ethnicity, postcode, illnesses, inside leg measurement etc. And it gave me a one in 2577 chance of dying of Covid in the next 90 days, which I can live with (or rather, which I have a 2576/2577 chance of living with).

And I get that the computer coding and patient informing is all sorted centrally, which means that, for once, GPs have dodged a work-dump.

And I also get that this means another 1.7 million patients will now be viewed as clinically extremely vulnerable, to which they might respond: ‘A bit bloody late now’ and: ‘Can I have my Covid jab then?’, which will lead to them phoning we GPs, so we haven’t actually avoided that workload dump after all.

But what I don’t get is why, among all this clever number-crunching science, Newton’s third law of motion doesn’t apply. After all, if QCovid can refine our view of who should be added to the shielded list, why isn’t there the equal and opposite reaction of subtracting those who never should have been put on it in the first place?

And I don’t get why they don’t realise there are plenty of those. After all, about a year ago, we GPs were specifically asked to augment the centrally generated shielded list using some rapidly dreamed up criteria courtesy of the RCGP, BMA and probably other esteemed bodies. It’s all a bit of a blur now, but I recall those criteria seeming at best vaguely logical and at worst frankly whimsical. But it gave us something to do in those bizarre post-apocalyptic weeks of the first lockdown.

Also, I don’t get why those with a legacy CEV label who, using the QCovid retrospectoscope, shouldn’t have been shielded in the first place, can’t be liberated from their restrictions. True, some are perfectly happy hunkering down binge-watching box sets while waiting for the NHS volunteer to stagger in with their Government funded D Vits. But the majority would view their reclassification as a relief.

So I don’t get why QCovid can’t cut both ways. Run the same search on those already coded as CEV, and unshield those beneath the threshold. Maybe it’s Newton’s first law – something about inertia. Then again, I never did get physics, either.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

READERS' COMMENTS [6]

Dave Kew 18 February, 2021 11:05 pm

Surely everyone with a QRISK>0.5% should be on a statin and given a free Boris Bike immediately

Decorum Est 18 February, 2021 11:43 pm

Even more confused………just want to roll up and……

Nicholas Chiappe 20 February, 2021 2:07 pm

Unfortunately all these things rely on accurate coding in the first place. They assume that everyone’s notes is coded with accurate data, and estimate probable risk, not actual risk. I do not think all clinicians code equally, and not all patients have their weights and blood pressures recorded recently . Hence we have over 320 mostly low risk patients on our list given group 2 priority because they were seen by a health professional and coded as BEING that health professional. Others will also not have coded the insignificant gestational diabetes which makes a fit women of 25 a serious high risk!
The figure might well have been useful to choose priority when the vaccine rollout was initiated, and covid rates very high. However, at a stage when vaccination is marching forward, and covid infection rates are on the decline, perhaps it would have been preferable to park the data and spend more time vaccinating all the remaining adults, as quickly as possible, rather than spending resources writing more letters, and worrying people inappropriately. I believe vaccinating in family groups would be more efficient and reduce footfall and virus spread, rather than the “Sorry your wife/parent/caree is group 3 (so eligible) but you are group 5” conversations which mean double footfall in the long run.

John Elder 22 February, 2021 10:36 am

One of the most fascinating things to have come out of the whole vaccination exercise is the sheer number of opticians & social workers we have registered as a practice – many of them only 4 or 5 years old!!
It would seem some enthusiastic admin staff in – mainly System One Practices – have coded incoming optician reports as “optician” – similarly for nursery nurses & social workers…… rubbish in = rubbish out as ever!

David OHagan 22 February, 2021 11:56 am

Of course the ‘data issues’ are all the GPs fault; the fact that NHS D is nationally using them inappropriately way outside the reason they were collected is our fault…

David OHagan 22 February, 2021 12:03 pm

..and 2ry care data/coding is rarely reviewed by anyone clinical, so may be even less robust…