General Practice, Safeguarding and Coronavirus: A Blog (Part 3)

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


Wednesday March 11th, 2020

Today we started telephone triage for any patient with a fever, cough or shortness of breath. It’s quite easy once you’re used to it and most people are very understanding. We have developed a good set up for at risk patients – they come into the back of the surgery, avoiding reception, dispensary & the waiting room & directly access the easily cleaned treatment room.  Initially we tried seeing people in their cars in the car park, but high winds and hail today made that frankly bonkers.


The PPE has been issued. It seems a bit insubstantial, not like the white Hazmet suits you see on the news.


The quarterly Cluster Safeguarding meeting went well.  I considered cancelling, but it was surprisingly well attended in the circumstances & the opportunity to talk about our local response to corona virus as well as safeguarding was useful. We’ve joined a local Covid19 Whatsapp group to share ideas and concerns.  We reflected that it isn’t just the elderly or people with underlying health issues who are dying. I feel afraid for us all.


Thursday March 12th, 2020

The message now is to avoid any meeting that can be managed by phone, or any journey not absolutely essential. Our lives are changing. It’s uplifting to be part of the real appetite for effective collaboration between GP practices to cope with this. We want to establish a community hub for seeing all high-risk Covid19 patients in a safer & supported environment.


I can’t believe the Cheltenham Festival is going ahead. I have a horrible feeling the images of tightly packed crowds are not going to age well.


We are honing our clinical skills in new ways, and although there’s so much fear I’m enjoying this challenge. I was trying to assess a shy and taciturn teenager with respiratory symptoms. I asked him to read and was treated to a Greek Myth with beautiful expression & punctuation. No catching his breath during long sentences, I decided his chest was okay.


After almost an hour of filming, I had a 30-second appearance on BBC Wales Today, highlighting the importance of hand washing and encouraging people to avoid public gatherings - “We’re going to work our hardest to keep going and make sure we do our very best for our patients".  I hope I can rise to this challenge. What if one of the boys gets ill and I have to self-isolate?


Saturday March 14th, 2020

We are having constant planning meetings at the surgery & have recognised we will need community support. I put a couple of messages on Facebook and Twitter & we have been overwhelmed with the positive response. The news elsewhere is less uplifting. 21 people have died – double where we were yesterday. America has banned travel from the UK & 200 scientists have written to the government questioning their non-isolation strategy to build herd immunity.


I was speaking on Radio 5 Live this evening with a virologist from Nottingham. He suggested there might be 300 people in need for every ICU bed available. It felt terrifying, but talking to worried listeners about  Covid19 was a welcome reminder of how much I love my job, and what a privilege it is.


"I don't think any of us can be complacent... hand washing, hand washing, hand washing. We've actually seen a drop in cases of the winter vomiting bug which could well be because people are doing so well with this”.


Sunday March 15th, 2020

The death rate has increased to 35. People are starting to worry that the government strategy might not be right.  I’ve had several patients asking whether Ace Inhibitors which they take for high blood pressure could exacerbate Covid19. Uncontrolled high blood pressure might also increase their risk, & there also seems other evidence that these drugs are protective. Managing a pandemic of a totally new & unknown illness is difficult.


One of our amazing patients has set up a ‘ Trellech Tribe’  volunteer website  today. It ‘s beautiful & our team morale has been hugely boosted by the huge response.

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