SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

Sparky Rhiwabon

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Anyone else finding they can't get a GP appointment in England, for something that can't be dealt with by phone or video call? My sister has had a painful ear for about a fortnight, she spoke to her GP who told her to put olive oil drops in it. This hasn't helped. She tried to get an appointment to actually have a GP look in her ear, and the receptionist refused to give her one. When she asked the receptionist what she should do, the answer was "look it up on Google" (seriously, that's what she said).

This is a very large practice with multiple doctors and thousands of patients. She's now going to pay to see a private audiology/ear-syringing service.
Tell the receptionist that the issue is personal and you’ll discuss it with the doctor
 

Penna

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My friend had a similar issue. He manager to get a zoom call kind of appointment. Was in absolute agony with an ear ‘infection’ and both ears blocked. Anyway, he went to a professional ear cleaner and they cleared out both of his ears with some microsuction machine. Back to normal the day after. Set him back £50 for both ears but beats the excruciating pain he was in. He couldn’t even hear on the drive to the ear cleaners!
It's not good enough - people still need to see a doctor in person sometimes, Covid notwithstanding. They can't just say "no" to you. I'm telling my sister to report what the receptionist said to her about going on Google.
 

Adamsk7

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My friend had a similar issue. He manager to get a zoom call kind of appointment. Was in absolute agony with an ear ‘infection’ and both ears blocked. Anyway, he went to a professional ear cleaner and they cleared out both of his ears with some microsuction machine. Back to normal the day after. Set him back £50 for both ears but beats the excruciating pain he was in. He couldn’t even hear on the drive to the ear cleaners!
On a side note, I’ve had that done and it’s bloody fantastic!
 

711

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It's not good enough - people still need to see a doctor in person sometimes, Covid notwithstanding. They can't just say "no" to you. I'm telling my sister to report what the receptionist said to her about going on Google.
Your sister could try telling them that if she isn't given an appointment she will go to A&E. I know GPs don't like that, I've heard they actually get charged if it happens, which seems unlikely but there must be some reason for it.

Obviously this is a totally wrong way to run a health service, I'm just thinking from her point of view.
 

Wolverine

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It's not good enough - people still need to see a doctor in person sometimes, Covid notwithstanding. They can't just say "no" to you. I'm telling my sister to report what the receptionist said to her about going on Google.
GP trainee here, sorry for what your sister went through.
Ear aches typically I could try and resolve via a video consultation. Unless she is diabetic there usually isn't a sinister cause. I'm guessing her GP thought that issue was more blockage than infection (otitis externa) hence the olive oil drops to soften wax. Otherwise its usually ear sprays like acetic acid (ear calm) or if something stronger needed a prescription drop like Otomize. Sometimes in kids they are more prone to middle ear infections so we give oral antibiotics (rarely needed in adults)

I think there definitely are patients receiving suboptimal care I hear you.

The purpose though of telephone triage is to minimise patient contact in waiting rooms especially during flu season we have shielding type patients coming in and out.
Often if patients insist I'll come them in for a face to face consultation but a big part is communicating effectively, negotiating a mutually agreeable managaement plan and safety netting or follow up. With 10 minute slots really difficult to do.

Primary care in the UK has been overburdened sadly. I don't think 10 minute slots are justifiable in any way but we simply don't have enough GPs to offer appointments so are struggling. Practice managers or deputy practice managers are good with these things too and will feed back to doctors.

We use video consultation quite a bit, a lot of people do prefer that type of consult as it means not waiting in waiting rooms, able to do consults from home or work. Vast majority of primary care presentations can be sorted virtually.

Usually we bring people in if clinical examination or to check vital signs or if diagnosis in doubt or possible admission. I'd say its about 20% of my consults I'm bringing in but I'm quite junior. So people are being face to face but minimising it is to protect patients as much as ourselves (i've got full PPE to see people in, so I've got no issue calling somebody in from a safety point of view)

It isn't great though for a lot of people but given how long covid will last this way of seeing people is here to stay for atleast another year I reckon.
 

golden_blunder

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GP trainee here, sorry for what your sister went through.
Ear aches typically I could try and resolve via a video consultation. Unless she is diabetic there usually isn't a sinister cause. I'm guessing her GP thought that issue was more blockage than infection (otitis externa) hence the olive oil drops to soften wax. Otherwise its usually ear sprays like acetic acid (ear calm) or if something stronger needed a prescription drop like Otomize. Sometimes in kids they are more prone to middle ear infections so we give oral antibiotics (rarely needed in adults)

I think there definitely are patients receiving suboptimal care I hear you.

The purpose though of telephone triage is to minimise patient contact in waiting rooms especially during flu season we have shielding type patients coming in and out.
Often if patients insist I'll come them in for a face to face consultation but a big part is communicating effectively, negotiating a mutually agreeable managaement plan and safety netting or follow up. With 10 minute slots really difficult to do.

Primary care in the UK has been overburdened sadly. I don't think 10 minute slots are justifiable in any way but we simply don't have enough GPs to offer appointments so are struggling. Practice managers or deputy practice managers are good with these things too and will feed back to doctors.

We use video consultation quite a bit, a lot of people do prefer that type of consult as it means not waiting in waiting rooms, able to do consults from home or work. Vast majority of primary care presentations can be sorted virtually.

Usually we bring people in if clinical examination or to check vital signs or if diagnosis in doubt or possible admission. I'd say its about 20% of my consults I'm bringing in but I'm quite junior. So people are being face to face but minimising it is to protect patients as much as ourselves (i've got full PPE to see people in, so I've got no issue calling somebody in from a safety point of view)

It isn't great though for a lot of people but given how long covid will last this way of seeing people is here to stay for atleast another year I reckon.
My local GP (ireland) has been doing telephone triage and video consultations since about April. The doctors themselves call you for 10 minutes and decide whether you need to come in or not. From personal experience I think it works well but obviously there are things that need physical investigation. My wife has had a sore ear for weeks. She’s in agony and 2 weeks ago was given an antibiotic which hasn’t worked. Assuming next time she will have to go in. Actually this has been ongoing issues with ear infections for ages so thankfully she has an appointment next week with ENT consultant (telephone)
 

Penna

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@Wolverine, thank you for this. Funnily enough, before I retired I used to work with GP practices on performance issues, and I know how hard the job is - it must be very difficult right now. I agree that a great deal can be done on the phone of by video consultation.

@711, I think quite a few people would just take the A&E option, but as you say, it's not the right thing to do for many reasons including Covid.
 

Wolverine

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My local GP (ireland) has been doing telephone triage and video consultations since about April. The doctors themselves call you for 10 minutes and decide whether you need to come in or not. From personal experience I think it works well but obviously there are things that need physical investigation. My wife has had a sore ear for weeks. She’s in agony and 2 weeks ago was given an antibiotic which hasn’t worked. Assuming next time she will have to go in. Actually this has been ongoing issues with ear infections for ages so thankfully she has an appointment next week with ENT consultant (telephone)
I would have loved to work in Ireland, primary care always had a great vibe especially in rural areas when I did medical school rotations there (in Wexford, Galway and northern part of Dublin). But the way the HSE treats doctors in secondary care and some of the horror stories would make me think twice unless its somewhere in a private hospital its pretty grim to do junior doctor level jobs there.

Haven't kept up too much with how covid has been handled there though but always worried there given lack of ICU facilities comparatively
 

Pogue Mahone

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I would have loved to work in Ireland, primary care always had a great vibe especially in rural areas when I did medical school rotations there (in Wexford, Galway and northern part of Dublin). But the way the HSE treats doctors in secondary care and some of the horror stories would make me think twice unless its somewhere in a private hospital its pretty grim to do junior doctor level jobs there.

Haven't kept up too much with how covid has been handled there though but always worried there given lack of ICU facilities comparatively
Safe to say those chickens have come home to roost...
 

ryansgirl

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That's a very weak viewpoint, to even consider that the virus is being over-hyped due to continual testing. With less testing you would have a higher case rate, and an increase of testing in principle will help lower the case rate as you're finding people with the virus early enough before they spread it.
Clearly your 'poster of the year' award at some time was before this reply to me. A case of reading what you want to read into what I wrote.

The daily, non-stop media coverage of covid-19 compared to other pandemics , some of it junk science from both sides as a virologist I know who is advising a govt on the pandemic says, is unprecedented. The role of social media is playing a big part and if you think there is no obsessing over this virus as opposed to rational debate in the mass media and society as well as no exploitation of the virus by govts and unelected powers, then cloud dwelling seems your choice.

You picked at the simple fact I mentioned and I will refer to it again - there has never been the mass testing to determine the presence of a virus as there has been with covid-19. The more testing that is done, the more people will turn out to have the virus or at least evidence they had it at some point. Studies on the water supply in Italy for example indicate the virus was around for at least 3 years prior to the outbreak this year.

You're putting a slant on that which is different as well as putting a slant on what I mentioned about the increase in suicide rates linked to job losses and fears for the future.
Nobody is saying that without mass testing we wouldn't be able to take early measures.
The fact that covid-19 to date has been fairly mild for the majority of those who have tested positive for it, makes the over-hype worse.

And enough of digs like 'cloud cuckoo land' - sorry to let you know that people can have different perspectives from you without your feeling threatened enough to trot out the catch-all 'conspiracy' or 'on the way to conspiracy' slurs.
 

ryansgirl

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Stressed by the “pandemic talk”? Stressed by the pandemic, you mean. Likewise the job losses.

You seem to be implying that economic hardship and psychological stress is being opportunistically foisted on young people by those in power, just because they can, while ignoring the far more obvious cause i.e. the pandemic itself.

Basically you’re on a slippery slope to cloud cuckoo conspiracy land. Be careful out there.
Sorry to the poster who I mistakenly quoted, my most recent post was for our friend Pogue. I was addressing his or her clouded interpretation of my post.
 

Wibble

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Pretty brutal takedown

I agree with him 100% and the point by point criticism he makes in his Twitter thread is very good, very scientific - if anything he is being kind. The article is a weird mishmash and often either conflates or at the very least isn't clear about the differences between actual evolution and social evolution which are too very different things even if the latter can (or likely is) to some degree driven by the former.
 

Wibble

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other viruses such as swine flu and influenza in its different strains, those viruses too would have shown up in large numbers.
Except neither are anywhere near as fatal or novel, there is a degree of immunity in the population and we have vaccines for them. The death toll this year for SARS-CoV-2 is already 10 times more than the total for the H1N1 swine flu outbreak in 09.

Which leads me to my point. So what?
 
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Hound Dog

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I lead a team of software developers in a large company. There are 200 of us in the IT department, working from home is optional, no questions asked. Out of those 200, around 40 come to work anyway and there are around 800 people in the company building in total, a half of which work from the office.

We had a confirmed coronavirus case with one of our programmers last week and everyone in contact were asked to isolate. So far, three people sharing the office with her were confirmed positive and our head of department lost his sense of smell and taste today.

In the meantime, he refused to isolate and was coming to work every day. He constantly moves from one office to another, has had dozens of meetings and even held 3 on-site job interviews this week.

Talk about a super spreader..
 

711

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Clearly your 'poster of the year' award at some time was before this reply to me. A case of reading what you want to read into what I wrote.

The daily, non-stop media coverage of covid-19 compared to other pandemics , some of it junk science from both sides as a virologist I know who is advising a govt on the pandemic says, is unprecedented. The role of social media is playing a big part and if you think there is no obsessing over this virus as opposed to rational debate in the mass media and society as well as no exploitation of the virus by govts and unelected powers, then cloud dwelling seems your choice.

You picked at the simple fact I mentioned and I will refer to it again - there has never been the mass testing to determine the presence of a virus as there has been with covid-19. The more testing that is done, the more people will turn out to have the virus or at least evidence they had it at some point. Studies on the water supply in Italy for example indicate the virus was around for at least 3 years prior to the outbreak this year.

You're putting a slant on that which is different as well as putting a slant on what I mentioned about the increase in suicide rates linked to job losses and fears for the future.
Nobody is saying that without mass testing we wouldn't be able to take early measures.
The fact that covid-19 to date has been fairly mild for the majority of those who have tested positive for it, makes the over-hype worse.

And enough of digs like 'cloud cuckoo land' - sorry to let you know that people can have different perspectives from you without your feeling threatened enough to trot out the catch-all 'conspiracy' or 'on the way to conspiracy' slurs.
What other pandemics are comparable in terms of numbers of deaths going from zero to over a million in under 12 months?
 

Sparky_Hughes

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I lead a team of software developers in a large company. There are 200 of us in the IT department, working from home is optional, no questions asked. Out of those 200, around 40 come to work anyway and there are around 800 people in the company building in total, a half of which work from the office.

We had a confirmed coronavirus case with one of our programmers last week and everyone in contact were asked to isolate. So far, three people sharing the office with her were confirmed positive and our head of department lost his sense of smell and taste today.

In the meantime, he refused to isolate and was coming to work every day. He constantly moves from one office to another, has had dozens of meetings and even held 3 on-site job interviews this week.

Talk about a super spreader..
Interesting spelling of dickhead :lol:
 

Pexbo

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I lead a team of software developers in a large company. There are 200 of us in the IT department, working from home is optional, no questions asked. Out of those 200, around 40 come to work anyway and there are around 800 people in the company building in total, a half of which work from the office.

We had a confirmed coronavirus case with one of our programmers last week and everyone in contact were asked to isolate. So far, three people sharing the office with her were confirmed positive and our head of department lost his sense of smell and taste today.

In the meantime, he refused to isolate and was coming to work every day. He constantly moves from one office to another, has had dozens of meetings and even held 3 on-site job interviews this week.

Talk about a super spreader..
This should be a police matter. He could be responsible for the death of someone’s loved one. Incredibly arrogant, ignorant and reckless behaviour.

Why can you not force him to stay away?
 

11101

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I lead a team of software developers in a large company. There are 200 of us in the IT department, working from home is optional, no questions asked. Out of those 200, around 40 come to work anyway and there are around 800 people in the company building in total, a half of which work from the office.

We had a confirmed coronavirus case with one of our programmers last week and everyone in contact were asked to isolate. So far, three people sharing the office with her were confirmed positive and our head of department lost his sense of smell and taste today.

In the meantime, he refused to isolate and was coming to work every day. He constantly moves from one office to another, has had dozens of meetings and even held 3 on-site job interviews this week.

Talk about a super spreader..
Is that not now a matter for the police? Up to a 10k fine for refusing to isolate after a positive test (and i would think the sack).

Really? Source?
I think they mean 3 months. There were traces found from samples taken in December. I assume as the whole post has a hint of conspiracy ranting it's just a typo made in anger.
 

Sarni

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Another restrictions from tomorrow here, restaurants have to be closed (only takeaway permitted). 330 people died over last two days, almost 60 of them without any comorbidities whatsoever. Lots of people do not believe virus kills anybody and think doctors are only putting it into death certificates to get money so there are going to be protests in all big cities tomorrow. In the meantime our government has sneaked in a change in legislation in another controversial topic, which means women will not be able to get abortion due to fetal impairment (we are going to have the strictest law in all of Europe, essentially meaning you can get abortion only if there's direct and undeniable threat to woman's life), which prompted another protests from people who are not necessarily covid denialists, so you are going to have tens of thousands if not hundreds of thousands of people protesting on the streets tomorrow. Dare I say Poland is right now in the deepest shit of all the countries in the world when it comes to containing of this pandemic.
 

djembatheking

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Another restrictions from tomorrow here, restaurants have to be closed (only takeaway permitted). 330 people died over last two days, almost 60 of them without any comorbidities whatsoever. Lots of people do not believe virus kills anybody and think doctors are only putting it into death certificates to get money so there are going to be protests in all big cities tomorrow. In the meantime our government has sneaked in a change in legislation in another controversial topic, which means women will not be able to get abortion due to fetal impairment (we are going to have the strictest law in all of Europe, essentially meaning you can get abortion only if there's direct and undeniable threat to woman's life), which prompted another protests from people who are not necessarily covid denialists, so you are going to have tens of thousands if not hundreds of thousands of people protesting on the streets tomorrow. Dare I say Poland is right now in the deepest shit of all the countries in the world when it comes to containing of this pandemic.
Doesn`t sound good, look after yourself Sarni.
 

fergieisold

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Is that not now a matter for the police? Up to a 10k fine for refusing to isolate after a positive test (and i would think the sack).



I think they mean 3 months. There were traces found from samples taken in December. I assume as the whole post has a hint of conspiracy ranting it's just a typo made in anger.
Quick google shows it is December 2019 - I think it's highly likely the virus was circulating in Europe including the UK from December.

https://uk.reuters.com/article/us-h...d-19-was-there-in-december-2019-idUKKBN23Q1J9
 

Compton22

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Anyone else seen the news that the Oxford vaccine is looking promising?
Yes, working exactly as they expected it to in human cells which boosts the chances of there being long lasting immunity. It hasn't yet been peer reviewed but it looks very promising.
 

fergieisold

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That's a very weak viewpoint, to even consider that the virus is being over-hyped due to continual testing. With less testing you would have a higher case rate, and an increase of testing in principle will help lower the case rate as you're finding people with the virus early enough before they spread it.
I think the only concern is false positives with increased testing. You wouldn't expect false negatives to increase but the test is so sensitive it the false positive rate could increase.

This is a really nice write up. But a bit of a head scratcher understanding. Essentially false positive rate is estimated to be as high as 4% but I think (could be wrong) this was judged when testing was limited and in a clinical setting with sick patients whose pre test diagnosis would be suspected covid. Now more and more people are being tested when they either have no symptoms or symptoms that are not consistent with covid. This could push the false positive rate up because the test is very sensitive. The recommendation is that any person with low pre test probability of covid should be tested again to confirm.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30453-7/fulltext
 

redshaw

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Yes I read about the vaccine before on Sky
https://news.sky.com/story/coronavi...ne-behaves-as-desired-analysis-finds-12111085

" Dr David Matthews, of Bristol's School of Cellular and Molecular Medicine, who led the research, said: "This is an important study as we are able to confirm that the genetic instructions underpinning this vaccine, which is being developed as fast as safely possible, are correctly followed when they get into a human cell. "

The person who died in the trials was taking the placebo as well.
 

Hound Dog

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This should be a police matter. He could be responsible for the death of someone’s loved one. Incredibly arrogant, ignorant and reckless behaviour.

Why can you not force him to stay away?
I have no idea how that happened, I have not gone to the office since June.

Is that not now a matter for the police? Up to a 10k fine for refusing to isolate after a positive test (and i would think the sack).
But he did not have a positive test. He was just in contact with someone who did have. Which does not make his behaviour any less insane.
 

Stanley Road

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I lead a team of software developers in a large company. There are 200 of us in the IT department, working from home is optional, no questions asked. Out of those 200, around 40 come to work anyway and there are around 800 people in the company building in total, a half of which work from the office.

We had a confirmed coronavirus case with one of our programmers last week and everyone in contact were asked to isolate. So far, three people sharing the office with her were confirmed positive and our head of department lost his sense of smell and taste today.

In the meantime, he refused to isolate and was coming to work every day. He constantly moves from one office to another, has had dozens of meetings and even held 3 on-site job interviews this week.

Talk about a super spreader..
Jesus, what a nob. Our govt has the power to close offices that have outbreaks.