Well the world has changed a lot in the last month. I would like to thank everyone for listening to the lockdown advice! Well done. It is not easy I know.
In our GP setting, patients have quickly become used to telephone and ‘video’ consultations. There is a huge amount of goodwill and the few patients who absolutely have to be seen respect all the precautions.
The big word in a coherent containment situation is TRUST. We have to trust the HSE, the Government, the WHO, and one another to step up to the plate and do the right thing.
The media have suggested that there has been a mass exodus of Dublin 4 residents to holiday homes in West Cork over Easter to incite a class war and erode trust. This, like a lot of media stories, is not true, erodes trust in our Gardaí and, the majority of Dubliners who are obeying the rules.
In the hospital where I now work fulltime, isolation units were erected almost overnight with staggering efficiency. I receive at least 10 emails a day detailing the latest advice and rates of infection.
In the evening, we watch webinars from all over the world to learn from the Singapore, Wuhan and so on experiences, the trials on new anti-virals and the stringent measures that the most successful countries in this War are having to take.
I have a huge respect for the frontline staff and there is a great ‘esprit de corps’ in the hospitals. We still live in fear of a major surge if containment measures are not maintained.
Routine work has stopped and, in general, the patients we see in A&E are in much smaller numbers allowing us to concentrate on the sickest. There is active recruitment of doctors and nurses who find themselves free to help during this crisis.
Our old friends; the homeless, the addicts and habitual drunks keep coming, some on a daily basis. Bless them!
As much less routine elective work is being done, our surgical and medical colleagues are much more approachable, and referring patients to them a lot more amicable. I see many more consultants in A&E now giving expert advice, which is great.
We have fast-track routes for sick children and the elderly, but not Covid 19, which saves them hanging around high risk areas. By elderly, I mean over 65.
The three patients I have seen with Covid-19 have had the obvious symptoms, that is; a flu-like illness, which suddenly gets a lot worse, the breathing rate increases, a high temperature, and usually an underlying illness, and yes, of the older generation, but not exclusively. They have usually had symptoms for a week or so but towards the end of that week things fairly suddenly became much worse. Don’t forget Covid-19 is most infectious at the very beginning of the illness so act early to self-isolate.
Happily they are all doing well and one has just been discharged after a few days on a ventilator.
I am usually stopped three times on my way up to Cork. It was pouring down last Sunday and there was a lovely lady Garda in the middle of the road in Ballinascarthy – a cheery smile, a quick check and she thanked me for what I do! This is a team effort and the Gardaí are doing a fantastic job.
If you ask me should we relax lockdown, I would say definitely not. What we are doing is working, the collective response has been great, and we have to continue.
The Nursing Home situation is difficult; families and patients have the most difficult decisions to make regarding respecting advance directives, living wills, respecting the quality of life and the pros and cons of ventilator therapy in the very vulnerable patient with limited life expectancy.
We have to listen to one another and have trust in what the carers advise.
We might learn a thing or two from Covid. Where do our priorities lie? What is happening to the Planet? The flights we take, the plastic in the seas and the poisoned rivers…time to reflect.
This might not be Armageddon but it is certainly ‘Cop On’ time. Let’s make a change for the good!
Stay Well,
Dr. Jeff
