COVID-19 Coronavirus

UPDATE 25.03.2020:

Dear Patients, 

During these unsettling times we wanted to contact you with answers to some of the questions we are frequently asked: 

Are you still seeing patients? 

Yes, the surgery is open but from this week we are primarily consulting via telephone and video. Our phone lines are fully operational but many of our staff are working from home. All the doctors are available to consult with you, both for routine medical issues as well as COVID-19-related matters. 

How can you get a prescription to me? 

If medication is required, we can have your prescriptions sent around the country to your preferred pharmacy or have it delivered to your home address. 

What if I need to be examined by a doctor? 

If, after we have spoken, we feel a physical examination is required, your doctor will try to arrange this. However, given the circumstances, we aim to keep physical examinations to a minimum for the safety of both you and our practice team. Physical examinations will need to be performed with your doctor wearing a mask, gloves and a gown.  

Should I still come for my annual medical or routine checks? 

For now, we recommend postponing annual medicals and routine check-ups 

Should I delay my child’s vaccinations because of this? 

No. Routine childhood vaccinations are still recommended but you will need to speak to your doctor about the best time and place to do this. 

My problems is not related to COVID-19. I feel I am wasting the doctor’s time booking a consultation about something else in this crisis. Should I wait? 

No, you should not wait. Although COVID-19 is at the forefront of everyone’s minds at the moment, it is very important that you don’t forget about other aspects of your health. Our team of doctors see addressing your non-COVID-19 medical problems early as a priorityat this time more than ever. We want to manage new problems quickly, and deal with your longstanding problem thoroughly so we are able to prevent an admission to already overcrowded hospitals.  If you have any symptoms that you are worried about, please don’t hesitate to book a consultation with your doctor. 

Can I still be referred to a specialist at this time? 

Yes, but inevitably services will be disrupted to some degree.  We are in contact with many of our specialist colleagues who have set up provisions to consult with their patients during this time. This is likely to be by video or telephone initially – but scans, tests and examinations are also being arranged.  

If I need to be admitted to hospital with Coronavirus, can this be arranged privately? 

Currently not. To free up as many ITU beds as possible for the NHS, many private hospitals have been given over for NHS use. However many of our specialist consultant colleagues have been able to consult remotely about COVID-19 symptoms and give advice.  

Can you tell us a little about the availability of testing? 

We are receiving many enquiries with regards testing for COVID-19, and hope that the following information answers some of your questions. 

Broadly speaking, two types of test exist:  

1) PCR Swab 

This is a swab in the nose and throat to identify if the virus is present in a patient. This is performed by a method known as PCR which detects the genetic material of the virus. This is the test being performed in the NHS. It  is currently restricted to patients hospitalised with suspected COVID-19. The major accredited and validated private laboratories in London, TDL and HCA laboratories, currently do not offer private testing in the community for COVID-19. There are various private companies offering the same type of test. Please exercise caution in believing the claims that some of the available testing platforms are making. We are yet to receive external validation for the tests many  of these laboratories are offering. However, we are happy to discuss them with you should you wish. We are in daily communication with the various labs regarding the availability of testing. 

2) Antibody test 

This is a blood test to look for antibodies to the virus.  This would give an idea as to whether an individual may have been exposed to the virus, and has developed, or is in the process of developing immunity to it. These tests are becoming available in kit form which is sent to a patient’s home. Using a finger prick blood sample, the blood is analysed for antibodies and the result is immediately available, rather like a pregnancy test. We are currently looking into these for our patients but first need to be sure that the tests are reliable, accurate and reproducible, and understand how they fit in with government protocols regarding COVID-19 advice.  Should you like to know more, we would be happy to discuss this with you.  

Are there any treatments for COVID-19? 

There are a wide range of treatments being explored, and we appreciate that many of you will want to know more about them.  These include antiretroviral medications, hydroxychloroquine and some antibiotics and well as more complex ICU interventions. At this point none have been shown to be clearly beneficial and supportive therapy remains key.  

What is the best thing I can do to help? 

STAY AT HOME. Stay away from people. Help all your friends and family do the same.  If you are elderly or in a high-risk group don’t see anyone if you can possibly help it, especially children or young people who are most likely to be asymptomatic carriers. Try to communicate with friends and family by telephone or video.  

How long is this going to last? 

No-one knows, but it is likely to go on for some months. Cases are broadly expected to rise in the next weeks, with the impact of social distancing on case numbers taking many weeks to take effect.  Experts expect social distancing measures to flatten the curve, then a waxing and waning adoption and release of social distancing measures will likely occur in response to case frequency.  

How do I stay healthy if I am self-isolating? 

Remember to eat, drink plenty of water and exercise. Try your best to stop smoking if at all possible, and call us for help if you need it. 

If you can’t get out of the house just moving around the house is better than nothing. Do something you enjoy whilst you are at home. Keep in touch with your family and friends and try to talk to someone every day. If you are feeling anxious, try not to spend all day watching the news or on social media. Be kind to yourself and those around you. 

A psychologist colleague has told us some patients find remembering the four M’s useful: 

Movement: keep exercising, safely, indoors or strictly following government guidance; 

Meaningful connections: connect with those close to you in a meaningful way, everyday; 

Meditation: which can take many forms, but many of our patients have found Headspace and Calm apps very useful; 

Mastery: You have overcome struggles that seemed overwhelming, new and frightening in the past, why should this be different. 

We will get through this together. 

Please do let us know if you need anything from us. 

Yours, 

The Sloane Street Surgery Team 

Further reading: 

ASTHMA & COVID-19: 

www.asthma.org.uk/advice/triggers/coronavirus-covid-19/ 

HYPERTENSION & COVID-19: 

www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang 

ELDERLY SOCIAL DISTANCING: 

https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

DIABETES & COVID-19: 

www.diabetes.org.uk/about_us/news/coronavirus 

UPDATE 17.03.2020:

We have received various queries about whether it is safe to take Ibuprofen with suspected Coronavirus, as there have been some reports from France, and now from Ireland, that it may interfere with recovery from the virus. Currently there is not enough evidence available to give clear advice on this. We are therefore advising our patients to take regular Paracetamol for a fever initially. If the fever does not settle with Paracetamol alone, please feel free to contact us.

There are also a number of reports relating to the use of blood pressure medications known as ACE-inhibitors and Angiotensin II receptor blockers being implicated in a worse prognosis in patients affected by COVID-19. So far, there is insufficient evidence available to support changing medications. This is supported by a position statement from the European Society of Cardiology. Again, we are watching the evidence very closely and will report any changes to you.  

We would like to reassure you that we are regularly reviewing the available guidance and scientific literature.  We aim to give our patients evidence-based advice, during a time of inevitably conflicting information delivered by social media and other channels.

If you have any further concerns, please do not hesitate to contact us. We are currently doing lots of telephone, email and video consultations with our patients in various parts of the world.

UPDATE 15.03.2020:

Dear Patients,

Coronavirus COVID-19 Advice   

There is, of course, concern amongst our patients regarding the current COVID-19 Coronavirus outbreak. It is an unprecedented and rapidly evolving situation that is understandably causing a certain amount of anxiety. We appreciate your concerns and hope this email is able to answer some of your questions and explain the approach the surgery is taking. Please note that advice is changing on a daily if not hourly basis. We will update you with changes that are relevant to our patients and our website will be updated as necessary but please use the links we give you to keep up to date.   
   

Please note that you should not hesitate to contact the practice if you have any medical concerns and we will be more than happy to advise. The advice below is meant for general guidance.   

Commonly Asked Questions   
   

What should I do if I am unwell with flu-like symptoms / persistent cough or fever?   
   

If you are under 60 and otherwise fit and well, please stay at home and self-isolate. You do not need to call 111. All our doctors are available for telephone consultations and remote treatment if necessary. You should rest, drink plenty of water and take over-the-counter cold and flu treatments (containing paracetamol).  
   

If you are over 60 and have mild symptoms which you are able to manage at home please follow the advice above.   
   

If you are over 60 and / or are having concerning symptoms such as difficulty breathing or high fever which does not go down with Paracetamol or please call 111. In an emergency call 999. You can of course also call the surgery to speak to your doctor at any point or indeed email us directly for advice.  
   

If you have underlying medical conditions such as heart disease or lung disease or your immune system is suppressed, and you develop symptoms, please do call to speak to one of us at the practice.   

When should I contact my doctor at The Sloane Street Surgery?   
   
If you have any health concerns at all you can call the surgery and speak to your doctor.   

When should I contact 111?   

You should contact 111 online or via the telephone if:   

  • You feel you cannot cope with your symptoms at home
  • Your condition is getting worse or you are experiencing breathing difficulties. 
  •  Your symptoms do not get better after 7 days   

You can use the 111 online coronavirus tool: https://111.nhs.uk/covid-19   

Can I get tested for Coronavirus privately at Sloane Street Surgery?   

Currently not. Validated COVID-19 testing is not currently available privately UK although there are various unvalidated tests around.  We will let you know if this changes.   

Can I get tested for Coronavirus on the NHS?   

Currently patients requiring hospital treatment are being prioritised for testing although Public Health England are continuing to investigate outbreaks. This means that you will only be tested is you are unwell enough to require hospital treatment or if you have had direct contact with a confirmed coronavirus case.   

If I have been advised to stay at home because of symptoms, what should I do?   

  • Rest and drink plenty of fluids  
  • Take Paracetamol if necessary    
  • Try to stay 2 metres away from others in your home.  
  • Sleep alone if possible  
  • Wash your hand regularly for 20 seconds  
  • Cough or sneeze into a tissue and dispose of it in a bin  
  • If possible, use a different bathroom from the rest of the household and do not share towels.   

If I need to be admitted to hospital with suspected Coronavirus, can I go to a private hospital?   

Currently private hospitals in London are not accepting patients with suspected Coronavirus so admission would be to an NHS hospital.  This may change so please still contact your doctor at the surgery as well, as we are in regular contact with consultant respiratory doctors who can advise.  Our NHS is extremely well prepared for the current situation.  

What if I think my child has Coronavirus?   

Children do not seem to be seriously affected by coronavirus so you should manage it at home as you would with any other viral illness and follow the stay at home guidance above.   

Your child can have regular paracetamol if required.  

If your child has asthma or any other respiratory illness, treat them as you usually would with their regular medications and call us 111 or take them to hospital if they develop breathing difficulties. Again, you can call to speak to their doctor here at the surgery at any point.   

Should I come into the surgery for routine appointments?   

If you require an appointment for another reason please call the surgery to arrange it.   

We have implemented various infection control measures in the surgery to reduce risk to patients and staff. These are outlined below. We are happy to provide telephone or video consultations with one of the doctors if that is preferable.  If you are due a routine medical please consider deferring this.  

What infection control measures are the surgery implementing?   

  • Screening of everyone who comes to the surgery to prevent patients with possible coronavirus from entering the building. 
  • Regular hand washing for 20 seconds / use of hand sanitiser for patients entering the surgery and for staff members   
  • Regular disinfecting of medical equipment as well as door handles and surfaces.  
  •  Removal of reading material and toys from the waiting room to prevent viral spread.   

What can I do to protect myself and my family?   

  • Keep educated and informed using trusted sources.  
  • Wash your hands frequently and well  
  • Stay at home if you are unwell  
  • “Social distancing”, i.e. avoiding too much contact with other people can help slow the rate of infection and thereby the impact on our health services  
  • Try not to visit elderly or vulnerable friends or family  
  • Buy a thermometer and have some Paracetamol at home  
  • Most importantly please don’t panic. Remember that although many of us will be infected, most will only experience mild symptoms.   

Information & Advice   

The following link has the most in-depth and up-to-date guidance on COVID-19 and is our recommended website for information:   

Gov.uk/coronavirus   

The following link also has excellent guidance that we recommend you read: 

https://www.rcgp.org.uk/-/media/Files/Policy/A-Z-policy/2020/covid19/RCGP-GP-guidance-march-2020.ashx?la=en

Further Updates   

We will of course continue to update you as the situation changes and as we receive further guidance.   

Many thanks for your patience and co-operation during these exceptional circumstances. 


The Sloane Street Surgery