Speaking at the RCGP 2021 annual conference, Somerset GP and educational leader for the Primary Care Breathing Society, Dr. Steve Holmes, said healthcare professionals were learning more all the time about the impact to medium and long term of COVID-19.
He urged GPs to take care of their colleagues, warning that pandemics have historically pushed significant numbers of doctors into early retirement, as surveys suggest could happen in the current crisis.
Dr. Holmes also highlighted the impact of COVID-19 on people who have not had the disease itself, for those who have lost their jobs, their income, and family or friends.
“In the UK, at the moment, there are more people than ever going to food banks,” he told the conference. “That kind of impact on the social life of a large part of the population results in increased healthcare.
“In Somerset last month, we saw practically half the population face to face – an incredible amount of work is being done, and I know it is happening across the country.”
The social impact of COVID-19, from increased domestic abuse, increased waiting times and delays in care, as well as the ‘predictable legacy of protection’ in terms of increased isolation and loneliness, it would be ‘with us for a while,’ warned Dr. Holmes. “It’s not just about having the disease,” he added.
For patients who have protected themselves for a long time, he said doctors need to be alert to risks related to ‘deconditioning’ after prolonged periods of isolation, which can increase the risk of falls, poor mental health, osteoporosis, infection and cardiovascular and respiratory deterioration. results.
He said all GPs would likely have encountered patients who experienced a prolonged recovery from COVID-19. But he said they were often patients who had not initially experienced the most serious illness and had developed longer-term symptoms that ‘probably cause us a lot of stress in primary care, where they are challenged to think: is there something else underlying this? ? .
Dr. Holmes said that post-COVID syndrome could be considered in patients who had “signs and symptoms after 12 weeks and do not have an alternative diagnosis.”
But he cautioned: ‘It’s not always easy. We still need to keep our brains open to anemia, cancer, COPD, myocarditis, polymyalgia, thyroid dysfunction, diabetes. ” He warned that all of these could present symptoms that ‘overlap with post-COVID syndrome.’
He cited the case of a patient who had experienced fatigue for several months after a COVID-19 infection, which the patient and several doctors had attributed to post-COVID syndrome. However, Dr. Holmes said that after investigation it turned out to be polymyalgia, which was treated relatively quickly.
Initial estimates that as many as one in 10 people infected with COVID-19 may experience long-term symptoms are “ declining, ” Dr. Holmes said, urging doctors to follow advice to “ investigate carefully. selective after careful history and appropriate examination. ”
He told the conference that there was no one-size-fits-all answer on whether patients should exercise or rest during recovery from post-COVID syndrome. Dr. Holmes added: “I would suggest encouraging people to be active, but not foolishly active.”
Citing the advice of an occupational health professional, he said that the best advice was to “be kind to yourself,” and that this was advice that should apply to both patients and GPs themselves.