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Coronavirus detected in patient through random GP practice testing

by Eleanor Philpotts
6 March 2020

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Opportunistic testing in GP practices has already identified two cases of coronavirus (Covid-19), Management in Practice’s sister publication, Pulse, has learned.

Public Health England confirmed to Pulse that the new programme of ‘random’ testing within GP settings detected two cases, both in Surrey.

It comes after the first UK death of a patient with diagnosed Covid-19 was confirmed yesterday. The elderly patient had underlying health problems.

The Government has also updated its advice, stating that people who have visited any part of Italy – and not just the northern regions – should self-isolate if they have any symptoms, even mild.

Coronavirus has also been listed as a ‘notifiable’ disease, meaning GPs are required to report all cases of Covid-19 to Public Health England.

Patients presenting to 100 participating GP practices with severe respiratory infections have been receiving testing since last week. 

When it launched the surveillance system, PHE said there was ‘no evidence’ that the virus was ‘circulating in the community’ in England. However, since then, five patients who had not travelled from coronavirus-affected countries, or had known contact with patients who had, have been diagnosed.

The PHE surveillance system has since been rolled out to all hospital trusts in England.

Earlier this week, the Government announced a UK-wide action plan to deal with the outbreak, which it said could affect 80% of the population in a worst-case scenario.

The Government said its strategy was to ‘contain, delay, research and mitigate’ a coronavirus outbreak – but yesterday chief medical officer Professor Chris Whitty said it has already moved into the ‘delay’ phase.

This will see a focus on trying to delay the peak of the virus until warmer months, when NHS services are expected to be less busy.

Addressing MPs on the House of Commons health and social care committee yesterday, Professor Whitty said more community transmission is now highly likely.

He said: ‘There are several, not large cases, but several cases where we cannot see where this has come from, in terms of a clear transmission.’

Dr Richard Cook, a GP in Brighton, said: ‘It will be interesting to see whether a positive result from PHE’s surveillance in primary care will change the Covid-19 advice to GPs.

‘In particular, whether more widespread testing will be recommended over time, or how to manage patients with symptoms but not deemed, at this stage, to be in a high risk.’

Professor Witty offered condolences to the family and friends of the patient who died.

He said: ‘The patient, who was being treated at the Royal Berkshire Hospital, was an older patient who had underlying health conditions. We believe they contracted the virus in the UK and contact tracing is already underway.’

Planned measures for the NHS to tackle the epidemic includes the GMC re-registering retired doctors, cancellations of routine care, and NHS staff being allowed to forcibly detain patients suspected of having the virus. 

NHS England has already declared the outbreak a ‘stage 4’ emergency, meaning it can take control of local NHS resources, such as emergency bed planning.

Across the UK, at least 20 GP practices have been forced to close for deep cleaning after potential exposure, while a small number of practices have now moved to a telephone-first model of consultation to avoid walk-in cases.