Dear Courtfield Patient,
Happy New Year!
INTRODUCTION
Just when we all thought we knew where we were going, along comes COVID-19’s aggressive little cousin (B117), and sends us back into lockdown!
At Courtfield, we are aware of nearly 100 cases in the past 4 weeks, which is our busiest ever month.
Many have required daily monitoring at home but the vast majority have recovered or are recovering.
However, 4 patients have been admitted to hospital and sadly we learnt today of the first death of one of our elderly patients abroad.
Our local hospital colleagues are under enormous pressure, with many staff being redeployed to COVID wards from other areas of the hospital and many having leave cancelled and being asked to work longer hours.
The next 2-3 weeks will be particularly challenging for the hospital sector.
It has therefore, never been more important to keep your distance from others, wash hands regularly (PARTICULARLY IMMEDIATELY AFTER REMOVING YOUR MASK), and to wear masks indoors.
Despite the gloomy feel to the beginning of 2021, we still have many reasons to be optimistic for the weeks and months ahead:
- THE RATE OF INCREASE IN CASES IN LONDON IS STARTING TO SLOW, suggesting that we are very close to the peak of this particular wave (Evidence: COVID-19 symptom tracker; Prof Tim Spector).
- A new class of anti-inflammatory drugs (“Interleukin 6 “inhibitors namely Tocilizumab and Sarilumab) have been shown to reduce mortality by 24% in the more seriously ill patients with COVID related pneumonia (REMAP-CAP trial)
- We now have approved 3 vaccines in the UK and the vaccine rollout across the country is accelerating with the target of “those most at risk” receiving their first dose of vaccine by mid-February. This should ensure that pressure eases on the NHS, with a significant chance that lockdown measures could start to be eased from that time
- A study from Texas published this week showed that the Pfizer vaccine IS EFFECTIVE against both this new strain and the “South African” variant of the virus.
- A Belgian study published in the Lancet in mid-December confirmed persistence of protective antibodies in those that had previously contracted COVID, confirming the results of previous studies from Iceland and the USA.
Therefore, one perverse positive from the current increase in cases should be an associated increase in immunity within the population.
WHAT TO DO IF YOU THINK YOU HAVE COVID
Although fever, cough and loss of taste or smell are the classical symptoms, even the mildest of symptoms (including just headache and fatigue) could be due to COVID. Muscle pain, headache and fever seem to be more common symptoms with the new variant.
If in doubt, it is important to organise testing (i.e., a throat and nose swab) either through the Government testing facilities (go to gov.uk/coronavirus or dial 119) or by contacting us at Courtfield. In order to protect staff and other patients, testing of patients with symptoms is not conducted on the practice premises.
HOW TO MONITOR YOUR HEALTH AT HOME
Most of you who contract COVID-19 will have mild symptoms including, headache, cough, muscle aches and fatigue, which can be safely managed with rest, fluids, Paracetamol and/or Ibuprofen
Regular monitoring of your health at home can help you spot whether you are getting worse and decide whether it is time to seek medical assistance.
It is very helpful for us when assessing your symptoms over the phone to know:
- Your heart rate-normal resting heart rate is between 60-100 beats per minute, although may be slower if you exercise frequently or take medication like a beta blocker. This rule does not apply to children under 12 who may normally have a pulse of greater than 100 beats per minute. A pulse rate that is persistently above 100 (or a pulse that is irregular) would be an indication to contact us for further advice.
- Your temperature: Normal body temperature varies slightly but is usually between 36.1 and 37.5. A fever of greater than 38.5 despite Paracetamol or Nurofen would be an indication to contact us for further advice, especially if it has been present for more than 48hrs.
- Your Oxygen levels- using a pulse oximeter (a simple device which can be bought on-line-see last month’s newsletter). Normal oxygen levels are above 97%. Levels may drop a little with COVID without the need for intervention, but please contact us if your levels are consistently between 92-94%. Levels consistently below 92%-particularly if associated with shortness of breath at rest, or on mild exertion, would usually be an indication for hospital assessment and Oxygen.
It is particularly important to contact us if your symptoms are not improving or worsening after one week.
Apart from a few beds at the Cromwell Hospital, the private sector is not accepting/treating patients with COVID at the present time.
All patients must self-isolate for a period of 10 days, as must any contacts. If any contact subsequently develops symptoms, then their 10-day quarantine period has to start again.
IF YOU HAVE ANY CONCERNS AT ALL, PLEASE CONTACT US FOR ADVICE.
The Government website also contains excellent advice on how to assess and manage symptoms (https://www.nhs.uk/conditions/coronavirus-covid-19/)
COVID IN CHILDREN
Although we have seen a significant rise in cases in teenage children, this is much less in children under 10, and no surge in hospital admissions or adverse outcomes despite some media reports to the contrary.
This has led Professor Russell Viner, President of the Royal College of Paediatrics and Child Health to issue the following statement this week:
“As of now, we are not seeing significant pressure from COVID-19 in paediatrics across the UK. As cases in the community rise there will be a small increase in the number of children, we see with COVID-19, but the overwhelming majority of children and young people have no symptoms or very mild illness only”
VACCINATION
Still no sign of vaccine(s) being made available to the Private Sector. We hope that once the Governments top 8 priority tiers have been offered the vaccine (see last month’s newsletter), that we will be “given the green light” to vaccinate the rest of the population (i.e., the under 50’s). If the current schedule is met, then we estimate that this will be around May. For those of you aged over 50 (especially in a high-risk group), we repeat the advice of the last newsletter i.e. to register with a local NHS GP to ensure that you are called for immunisation at the earliest opportunity.
Since the last newsletter, the vaccine has now been declared safe in pregnancy and when breastfeeding
TEST TO RELEASE
We are accredited for the Government “Test to Release” scheme which, when returning from abroad, allows you to reduce your quarantine period from 10 days to 5, on proof of a negative PCR swab result.
Results are available within 24 hours with a certificate provided direct to your email.
The fee for this test is £195.
Please note you will need to register for this scheme by visiting https://www.gov.uk/provide-journey-contact-details-before-travel-uk
KEEPING YOU SAFE AT COURTFIELD
Over the past 9 months we have developed systems to ensure that we keep you (and us!) safe when visiting Courtfield. Of course, if you would prefer to consult with us by email, phone or occasionally zoom or face time, then please ask the reception team to arrange this.
One of the lessons that we learnt from the first wave, is the risk to your health caused by delaying assessment of symptoms, particularly if they involve
- a cough that has gone on for more than 2 weeks
- unexplained weight loss or abdominal pain
- unexplained diarrohea or constipation
- noticing blood in your stool or urine
(Figures released last week show that we are now seeing “excess deaths” from non-COVID causes such as heart disease and cancer).
CONCLUSION
Despite the current gloom, we really are at the beginning of the end of this Pandemic.
The next few weeks require us all to redouble our efforts to stay safe during which time we should expect to see numbers of cases dropping in association with protection for the most vulnerable via the vaccine.
As long as another stroppy COVID cousin does not appear, there is every reason to believe that children may be returning to school after the February half term, when we will see numbers of cases, hospital admissions and deaths dropping.
Best wishes from the team at Courtfield Private Practice