Sick, Untested, Confused. A bewildered UK Doctor
Edit 12th April 2020: Since writing this article, I worsened and got a secondary lung complication of COVID-19. I’ve described it here, and hope that my experience can help others. I’m starting to feel better now after a month of sickness.
Iflike me, you were confused by British Health Secretary Matt Hancock appearing on BBC’s Flagship Question Time SIX days after saying he tested +ve for COVID19, don’t be. This current level of bewilderment and complacency is par for the course.
I’ve been unwell for the last 18 days. Starting with four days of fever, the symptoms of malaise and low energy persist, and I have an ongoing dry cough which is much worse at night than during the day. My days seem to be getting slowly better, even if my energy levels remain non-existant Conversely, the last five nights have been particularly horrendous, although I have found that sleeping prone has helped.
I am otherwise healthy, and don’t have any other medical issues. As an Ophthalmologist, I am susceptible to higher risk of transmission and severity of illness based on how close I work to the nose, eyes and mouth, and the length of time needed to examine patients. An account I wrote much earlier on in my illness is available here.
I was scheduled to go back to work yesterday, but am still not well enough. I still have no idea about antibody testing, in order to know whether I am immune or not. Diagnostic testing has been rolled out very slowly in the United Kingdom, and labs were unprepared in comparison with many other nations. Some private labs and practitioners have sought to profiteer early on. The United Kingdom’s ability is particularly odd, given its position as a leader in biotechnology and diagnostics.
The only possible argument is that the UK was late and complacent in its approach to this global health emergency. This is summed up very effectively in this article by Richard Horton, doctor and editor of the Lancet.
“Something has gone badly wrong in the way the UK has handled Covid-19. Somehow there was a collective failure among politicians and perhaps even government experts to recognise the signals that Chinese and Italian scientists were sending. We had the opportunity and the time to learn from the experience of other countries. For reasons that are not entirely clear, the UK missed those signals. We missed those opportunities.” Richard Horton, Lancet Editor
Guidance has been difficult to find. There is a clinician-led national number for advice regarding healthcare workers who have suspected COVID19, but only non-medical service managers are allowed to call it.
It feels that, at least from a healthcare worker perspective, things have been better organised when speaking to colleagues in Spain and Italy, let alone nations which have a much lower mortality rate like Germany and Korea. I dread to imagine how things will be in a week or two, here in the United Kingdom.
Some important questions which remain unanswered are:
- Why are we still not prioritising testing in the United Kingdom? Surely the only way to track and strategize response to a pandemic. As a healthcare worker I shouldn’t be unsuccessfully trying to hunt for an antigen test to find out if I remain infective, or antibody test to find out if I have presumed immunity?
- Why are we still following this 7-day self-isolation rule, compared to the 14-day rule in pretty much every other country, and which the WHO advises? This is a virus which still actively sheds between 7–10 days. Why are we releasing people to infect others? I had a colleague pressurised to return to work, and got his (privately bought from overseas) COVID19 antigen test return positive on his day back. He was still infective. He may have infected people on that day.
- This virus produces markedly different clinical courses, and healthcare workers can get high viral loads (which is why there are so many young, fit healthcare workers with ARDS). Why isn’t this being acknowledged properly?
Response to this pandemic has been complacent, late, and exceptionalist in the United Kingdom and the United States. We can only hope that the damage done can be mitigated now, and that it isn’t too late