You will have followed the news and hopefully have not become too turned off by it.
The developments of the last few weeks are certainly quite startling. While we consider our village as remote and a bit locked off of the world, many of us are working, holidaying and traveling wide and far. Considering how connected the world has become it may only be a matter of days or weeks before this virus becomes a matter of concern for us too.
There is ample official documentation and it is changing daily at the moment so I can only advise everyone – particularly employers, commuters, travelers and hosts of holiday makers – to stay on top of the news. Below are some links.
One question I get asked a lot is “Is it actually serious?”
The short answer is yes, in a variety of ways.
The mortality appears on first glance low – 2%, not massively different to, say, seasonal influenza – but we can and we do vaccinate all those who are vulnerable against seasonal influenza. We can not vaccinate against this virus. Further, it appears that some – particularly young and fit – will stay healthy while infected and spreading the virus. Hence the need to self isolate when told to do so – even if not (too) ill.
Vulnerable here appear to be those above a certain age and those with health conditions. Further – to keep the mortality that low the Chinese as the most affected so far had to use extraordinary measures (they build a 1000 bed hospital in a week!) and hospitalised and quarantined huge numbers. While we all want to trust official pronouncements of preparedness it does not take a huge imagination to see services at least temporarily overwhelmed – particularly in rural areas and if people are not following guidance.
Further – this virus appears to spread faster and wider and much more easily than expected – so a worst case scenario of the virus running unchecked could easily mean that the bulk of the population will eventually have to go through with the illness – at which point 2% becomes suddenly a huge overall number.
This means that we as a village could in such a worst case scenario have very significant numbers of ill and of sick, too. i.e. if the virus comes into the village undetected and spreads unchecked. And unfortunately we might then also have eventually significant numbers of dead, particularly if health services become overwhelmed or depleted by illness themselves (that is here in Lochgoilhead my staff and me…)
If the virus can get successfully slowed down this will achieve a number of things:
1) Services will not get overwhelmed, increasing availability of e.g. intensive care beds to the seriously sick
2) Spring will eventually come which will make the virus hopefully fizzle out
3) A vaccine or better medication might eventually become available
The developments in Italy and the headlines of the last few days show a couple of things:
1) Authorities are seriously worried
2) Even if it were all a “pile of poo” the impact on individual lives could be significant if we are not really careful.
3) Panic and associated unrest could have even more impact than the illness itself.
I therefore ask everyone to
a) ensure that they stay on top of the news
b) fully respect if they, employees, co-workers, friends, neighbours etc learn that they need to self isolate – that is the one single key we have to slowing down the virus
c) stay on high alert in regard to holiday guests, neighbours, friends, employees and co-workers who might be ill
d) ensure that the suggested hygiene measures are kept everywhere – in the house and at work, by yourself and by your staff and co-workers
We as a practice will NOT issue Med 3 forms (“Sick note”, “Fit Note”) for patients who need to self isolate.
Self isolation is a public health measure, amply backed up legislation and not illness for which a Med 3 form is necessary. If your employer tries to tell you to get a note (or if you try to tell your employees to get a note) please consider that this is completely against the meaning of self isolation – as a doctor I do not want my staff or self get entirely unnecessarily into contact with someone infectious to us – unless there is an actual medical need, i.e. someone so sick that they need our medical help.
I will try and continue to update as things happen but here are pages of relevance which are updated by government
Health Protection Scotland:
https://www.hps.scot.nhs.uk/a-to-z-of-topics/wuhan-novel-coronavirus/
Public Health England page on Novel coronavirus (2019-nCoV)
https://www.gov.uk/government/collections/wuhan-novel-coronavirus
and a lot of practical guidance
Please do not hesitate to contact me for any queries – but please understand that my priority are my sick patients, confidentiality remains paramount and information which can be sought from the above sources should be looked up there first.
Some will say, considering the newspaper panic around swine flu a few years ago, this this will all become a damp squib – but the swine flu DID kill a fair number of young otherwise healthy people, it did nearly overwhelm the UK’s provision of specialised resources for seriously ill (ECMO beds) and it was only stopped by the combination of careful containment and eventually vaccination. I will be very pleased if this turns out a similar “damp squib” in hindsight. As the world grows ever closer situations like these are one of the prices we pay for our ability to be on the other side of it within a few hours.
Your doctor
Peter von Kaehne