General Practice, Safeguarding and Coronavirus: A Blog (Part 2)

Dr Rowena Christmas is a GP at The Wye Valley Practice in Trellech. She is an RCGP Council Representative & Safeguarding lead for the college in Wales, as well as being a Bevan Exemplar for Safeguarding work. 

In this blog, Rowena shares her account of the Covid-19 situation as it develops, from a professional and personal perspective.

Follow Rowena on Twitter - @ChristmasRowena

Monday March 2nd, 2020

We’re all pushing the message to wash your hands often & thoroughly with soap, cough into a tissue or your sleeve (yuck!) and avoid large crowds, shaking hands and hugs. My son Will is studying Macbeth for his English GCSE, so I’m hoping that reciting ‘Out damned spot’ may bump him up a grade.

Chris Whitty’s calm pragmatism is consistently reassuring, even when the news is not. Today, Coronavirus cases in the UK have reached 90 and we’re moving towards the ‘Delay’ phase of the plan. We need to stay calm, but take this seriously. I wish I could stop waking up at 5am.

We’re trying to keep up with many emails about it each day, the advice is continually being updated. I’m not sure of the ethics of encouraging retired HCPs to return to frontline work. Aren’t older people, who are more at risk of having underlying conditions, the people we are trying to protect? Plus haven’t we already been trying to encourage them back to ease shortages for the past five years?

I may buy a little extra pasta and biscuits with the weekly shop, just in case we have to quarantine for a fortnight. The aisles are low on toilet roll, baked beans and Dettol.

Sunday March 8th, 2020

I wish there weren’t so many people politicising Covid19. If ever there was a time for us to work together and seek solutions not blame it’s now. Let there be public enquiries when this is over. Italy reported its biggest daily jump in deaths and according to government data, 4.25% of individuals with confirmed infection there have died. It’s hard not to feel anxious on Sunday night, wondering how best to keep patients and the practice team safe. I have a new waterproof phone, so I listened to Leonard Cohen’s Famous Blue Raincoat in the shower. It helped a bit.

I keep looking at exponential graphs. They’re talking about people working from home, closing schools, the elderly self-isolating, even releasing low risk prisoners. It’s ridiculous, but it feels hard to know whether this is going to be really serious, or just go away like the Millennium Bug.

Monday March 9th, 2020

Tedros Adhanom Ghebrey, the Director General of the World Health Organisation said today “The great advantage we have is that the decisions we all make can influence the trajectory of this epidemic - Let hope be the antidote to fear”.

There’s a lot to learn about inspiring leadership at the moment.

To balance his uplifting message, I went to certify a patient who had died at home (not Covid19 related) and his ancient rescue dog escaped from the garden. Poor boy was anxious and unsettled.  The district nurse and I had a terrible job catching him, despite his hobbling gait. It’s never a professional look, crawling about under cars and making enticing noises behind hedges.

Boris Johnson suggested today that we could take Covid19 on the chin to minimise the economic fallout.  Visiting a Care Home I thought about all the residents I know so well, and the people who work there, and what would happen if the home is infected. My stomach feels in a constant knot.

Tuesday March 10th, 2020

Very happy to hear that Joy Shacklock, the RCGP Clinical Champion for Safeguarding was named an Inspiring Woman for International Women’s Day. She has done so much to raise the importance of safeguarding in Primary Care. We used the day to highlight the excellent Pathfinder toolkit by Iris Interventions to help us recognise and respond to domestic violence.

Today we reached 382 cases of coronavirus, with 6 deaths. People I trust are quietly starting to talk about there not being enough ventilators in Wales. The situation in Italy sounds terrifying.  They report they are using strict criteria before people are even assessed for ventilation.

We have decided not to let anybody with a cough, sore throat or fever into the waiting room. I think they are going to advise the elderly to self-isolate next week. How will that be managed by those with carers coming regularly into their homes? Every tentative plan creates so many questions. We will be making a lot of risk versus benefit decisions shortly.

More to come on #RowenaChristmas

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