How To Initially Identify Infected Individual With COVID-19 Infection And Isolate Them At Home
Common illness are common, but rare ones are rare, but symptoms of serious treatable illness also present with symptoms like common illness.
How can you differentiate the two?
Patients suffering from common symptoms like fever, cough and generalised body pain, were scared to consult due to fear of being diagnosed as COVID-19, infections and quarantine. They would have labelled your self as “Common cold”, and stayed at home, call the NHS 111 or your GP. 59% of patients with similar symptoms are said to self medicate and not rush to consult a doctor.
Families, friends, neighbours, the pharmacist, previous prescribed drug, or suggestions from an advertisement in newspapers or popular magazines are common sources of self‐medications. Self‐medication should be seen as the “desire and ability of people/patients to play an intelligent, independent and informed role, not merely in terms of decision‐making but also in the management of those preventive, diagnostic and therapeutic activities which concern them.”
In UK, The NHS increasingly encouraging self‐care of minor illnesses, including self‐medication. Licenced nurses to diagnose and prescribe medication. Although responsible self‐medication help to reduce the cost of treatment, travelling time as well as doctor’s time, consultation time and waiting time to consult primary care physician, this un-ethical medical practice resulted in scandals.
Doctors who challenged this and rebelled to protect fellow human were systematically harassed and humiliated by managers and the General. Medical Council. One hundred and fourteen doctors have committed suicide in the last eight years.
COVID-19 PANADAMIC
During COVID-19, pandemic, the media hype labelling virus as the killer, and “Save The NHS” campaign by kindled emotions of people and imparting fear resulted in a significant crisis. I do not hear much about pneumonia caused by secondry infections that follow viral infection as the killer. More people with treatable infections and illness must have died, due to delay in presentation and or complications like pneumonia caused by superbugs.
Patients were only encouraged to contact the NHS 111, we’re often advised to stay at home and avoid contact. The advice given may have been the right advice in the past, but was certainly not the one during COVID-19 pandemic.
This was my concern and so created a simple tool called “MAYA” (Medical advice you access). Now concerns have been raised by a senior official in the NHS that children with illnesses unrelated to COVID-19 are going the o hospital too late and coming to harm. The possible reasons for the late presentation include general advice given about COVID-19; patient access to NHS 111, and parental concern about bringing children to hospital during the coronavirus pandemic.
The coronavirus crisis led to a massive drop in the numbers of people going to accident and emergency units in England compared with March last year, official figures show. The calls to NHS 111 rose to nearly three million, twice as many as in the same month in 2019.
Minsters say people must continue to stay at home to stop the virus. This I feel is a serious mistake because the duty of doctors is to alleviate pain and suffering and not “Save The NHS”. A patient suffering from COVID-19 or illness that may not be coronavirus. A doctor must listen to the story of the symptoms for which they are seeking professional attention, they are also reporting the story of an illness as they have lived, and remember. The duty of a doctor is to offer a solution and not necessarily a prescription”.
MEDICAL ETHICS: A physician must have complete clinical independence in deciding upon the care of a person for whom he or she is medically responsible. The physician’s fundamental role is to alleviate the distress of his or her fellow human beings, and no motive, whether personal, collective or political, shall prevail against this higher purpose.
There is also evidence the number of people seen in hospital in England with a suspected heart attack has halved since the start of March – from 300 per day to 150.
NHS England and the Department for Health and Social Care said people should always come forward for urgent care. They expect parents with serious concerns about the health of their child should use the online NHS 111 service or call 999 for an emergency, but how can layperson differentiate “Minor from Serious illness”?.
In one case, a mother reported that she was waiting to be spoken to on NHS 111 for more than 60 minutes while her child “arrested” – medical terminology for the heart or breathing stops. The child subsequently died.
In another case referred to in the email, a mother says she was told the ambulance service was too busy while her child was “semi-conscious and vomiting”.
And another set of parents were reported not to have taken their unwell child to the hospital for five days as they believed there was “risk in hospitals of COVID-19”. The child also died.
Dr Martin Marshall, chair of the Royal College of GPs, said that children coming to doctors with symptoms similar to COVID-19 were “more likely to have a non-Covid condition”.
Dr Richard Brown, a consultant paediatrician at Addenbrooke’s Hospital in Cambridge, said adults and children with ruptured appendixes, severe sepsis in young children who had not come to the hospital as soon as they should.
When I worked as a streaming GP in an A&E when COVID-19 was spreading in China, there were too many patients coming to A&E with a trivial problem. The nurses and even the consultants were callous and said they are not worried. One fine day, I noticed a sharp decline of patients walking into A&E. It was not just amongst children that they saw a drop in people coming to seek medical care.
The kinds of things we’d expect to see in general practice that we’re concerned we might not be seeing would be the early presentation of cancer type symptoms, for example, which we’d usually recognise and refer rapidly for assessment.”
Fewer patients than doctors and nurses were in A&E, and I think the majority of patients may have received suboptimal care because resources have been diverted elsewhere.
I think there’ll be a spike in all-cause mortality and morbidity for all different reasons, not just COVID-19. This will potentially be a significant financial strain on NHS due to litigations and management of disability and long term complication when compared to previous outbreak including the 2009 swine flu pandemic
In the previous pandemics both overseas and in the UK when they’ve hit mortality from other conditions has gone up. In the flu crisis ten years ago in the UK, we saw a higher mortality rate for heart attacks and strokes.”
DR MAYA TO RESCUE
Doctors must start using my contribution Dr Maya App to avert this sad situation and help reduce avoidable death and stop giving more importance to COVID-19. This can also help us avoid lockdown that will result in bankruptcy and serious consequence of civil unrest.
‘Medical Advice You Access’, named as Dr MAYA is the mobile phone application will also help one know if his condition needs medical intervention or managed with over-the-counter drugs. Dr Maya – is helps one understand the severity of the disease and seek help when necessary and avoid when the combinations of symptoms are not serious. I have also increased the colour (blue) code to differentiate between common illness and COVID-19.
The original idea behind the App is to identify an infected individual and isolate them at home to protect family, friends and abort epidemics. Quarantine may be necessary, but not when thousands of people are infected. These bugs that we cannot see have ripped families apart in China, so we must do all that we can to protect you and healthcare workers.
A doctor must “Protect Humanity”, knowing visits to the doctor, chemist or hospital will increase cross infections, we must share the knowledge and experience to help you diagnose and manage your illness at home.
Asking patients to undergo unnecessary tests to make a definite diagnosis when treatment or vaccination to prevent are not available is un-ethical and lead to psychological sickness. The patient might only go back anxious. Instead, by using the application, one might decide whether or not a consultation is necessary. If used aptly, visits to surgery, hospital or Walk-in-clinic can be avoided.
The application is available for both Android and iPhones. The App can be downloaded free of cost. On signing up, the form will ask the user to specify three symptoms. “For instance, if one has a cough, as one of the symptoms, the App will prompt to choose the type of cough, and then two associated symptoms and so are specific, to help differentiate familiar from a severe illness.
The three symptoms would be colour coded red, yellow and green. If all the three signs are highlighted in red, it signifies that the user must visit the hospital if two of them are red, then one might need to see a doctor, and if just one is red, a telephonic conversation will do.
The application also enables one to call or send messages to their respective doctors and use the video to offer face to face consultation, see rashes and lumps. Using an advanced form of the App, one could directly refer the patient to specialist care, thus reducing delay, cost and contact.
If a large group of patients and doctors use Dr Mya application, it would be helpful to keep tabs on spreading infections and help reduce people visit. Say, for instance, many in Richmond report similar symptoms such as flu; the health department could save costs and warn others to avoid visiting the area, by sending warning messages to people travelling to Richmond.
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