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Blood test fiasco highlights the problems with prioritising Covid



When Pulse broke the news last week that GPs were being told they could only order blood tests for the most urgent cases, it was rightly broadcast across the media. Problems with Roche’s supply of chemistry analyser reagents left labs with limited capacity for chemistry testing.

But this didn’t at all affect the Covid swabs, which Roche said will be prioritised. Now, I understand why this is. Putting this extra pressure on Covid testing would feel like a step back in the Government’s (frankly awful) attempts to fight the virus.

But this more than anything clearly illustrates the point in the open letter from GPs warning about the dangers of a second lockdown. ‘Covid deaths alone can no longer be used as the unilateral measure of harm,’ they wrote.

This is an extreme example of putting all the emphasis on Covid. You don’t need me to tell you the potential harm for patients with these tests being cancelled or unavailable.

The balancing act between minimising the harm of Covid while minimising the harm of lockdown is a horrible one. But I fear as the Government gets more desperate as its policies to curb the pandemic fails, we will see more non-Covid patients being given the second class treatment.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk.

READERS' COMMENTS [3]

Vinci Ho 14 October, 2020 4:52 pm

It is amazing how ‘consuming’ Covid 19 and its ramifications have been to the system . While we were not testing enough during the first wave , we certainly did not have this problem of analyser reagent shortage . Now we are testing much more in second wave , we have to stop requesting routine blood tests .
The fundamental problem is the conundrum of knowing how to move forward against the dichotomy of ‘dammed you do , damned you don’t’:
(1) The daily increase of Covid 19 incidences is reminiscent of what we saw in March . The uprising curve needs to be flattened again . Undoubtedly, we have had less deaths associated with Covid 19 on daily basis . This is simply because we now have well proven treatments for severely affected , hospitalised patients( Remdesivir and carefully calculated dosages of systemic steroids appropriately used just before the onset of an overwhelming cytokine storm/ARDS) . I would argue the differences in fate between US president and our prime minister is the ‘right’ patient at the right time and right place . Life is an irony , isn’t it ?
(2) This , however , does not take away the fact that the number of patients seriously affected requiring hospital admission is reduced . NHS is potentially decimated by this influx , disregarding how many non-Covid fatalities will be recorded ultimately when we come out of this winter. Waiting time of elective surgeries will be in the order of 2-3 years . After all , patients are genuinely afraid of going into hospitals if they are known to be full of Covid patients . Perhaps , we do need Covid specific hospitals ( the Nightingale , for instance) completely separate from otherwise Covid free ones .
To me , unless we have developed treatment(s) which can successfully reduce the odds of patients with mild diseases moving into the serious category needing hospitalisation ( typically around day 9-10) , vaccine or no vaccine does not confer a definitive short to medium term solution . I can see why the controversy of using Hydroxychloroquine ( NOT injecting bleach into your veins!) earned so much publicity in the first wave , on hind sight .
(3) The unnatural experiences of those being shielded away in the first wave were evidently onerous , demoralising and pathological. Nobody likes it, even in countries under autocratic governments. Despite all the criticisms on the role of PCN social prescribers , I have to give credits to our PCN social prescriber (only appointed in March this year ) who worked tirelessly to help these shielded patients during the first wave up to now . Reality is shielding has become a ‘necessity’ to battle Covid 19 unless we have better alternatives.
(4) Lastly , the concept of herd immunity is reinvigorated by the recent ‘infamous’ Barrington Declaration complicated by some fake signatories. Inevitably , it will cost significant casualties before reaching the set-out objectives are reached . The concept is based on historic experiences of world pandemics in previous eras but we are supposed to be in a modern time bestowed by advanced technology and science , aren‘t we?The simple philosophical question is , however , ‘are we really any different today ?’ Well , the testing technology has certainly failed to prevent this second wave .
(5) Albeit being ‘cruel’ , I would say Covid 19 , perhaps different from previous pandemics , is somehow a call of ‘natural selection’ particularly against those older and debilitated proportion of human beings . Can we really ideally protect and shield away these vulnerable ones and let the healthy ones carry on with their lives ? Reality is , easy said than done .
The Blitz goes on ………….

Hello My name is 15 October, 2020 6:27 pm

We can not afford to have a myopic view of health. Systems need to adapt to create the extra capacity needed (hospitals, labs, GP surgeries), and we must not be led by the media to believe that Covid-19 is the only cause of harm to our patients. This is going to be a long haul and the health service, our society (and economy) must learn how to keep going.

Patrufini Duffy 16 October, 2020 4:18 pm

Post-meetings. Management suggesting we shouldn’t order ultrasounds. See patients face to face. Then don’t write clinically urgent on your blood forms. They’re cutting GP arms off. Then another meeting on palliative care. They said careful on being sued for a DNAR. Not sure what the point is. This system is rotten from the inside out. And the hyenas are out again, ready to breach you and fitness to practice you. Feel sorry for some of the best doctors on this planet.