Thousands of people are currently sick at home from the doctor. That creates unrest. Because do they have corona? And why are they not seen by the doctor? Six questions to Jako Burgers, general practitioner and advisor to the Dutch College of General Practitioners.
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A common complaint from corona patients is that the GP does not visit. Why doesn’t that happen or less?
“In some regions, such as in Brabant where there are now many corona patients, this has to do with the crowds. We also try to make telephone consultations as much as possible to prevent the further spread of the coronavirus. Another factor: it often makes little sense to see a patient physically. As with the flu, there is no treatment for this virus. In most cases it is a matter of getting out, no matter how annoying. ”
But people also die from corona. How can you – without seeing the patient – estimate how serious the complaints are?
“We ask as many questions as possible to determine the severity of the complaints. We pay attention to alarm signals such as fever and shortness of breath. The latter is especially important. A healthy person breathes about twelve to fifteen times per minute. Elite athletes and people who practice yoga are often still included. If that breathing rate goes up, above 25 times per minute, it could be a sign that the patient is short of breath and not getting enough oxygen. ”
That seems difficult to measure on the phone.
“It is true. Just when you think about your breathing, you no longer breathe normally and you can’t keep up with the frequency. We therefore pay attention to the speech of patients. If someone can no longer pronounce sentences, but gasps in between, this is a signal that it is not going well and we will want to see the patient to measure the oxygen level. We have special corona consultation hours for these people in which GPs wear protective clothing from head to toe. ”
However, the advice is often: call back when the symptoms get worse. Does the patient have to be in breathlessness before taking action?
“We also hear that criticism regularly. The complaints must indeed be very serious to be admitted to hospital. The main thing they can do there is to administer moisture and oxygen. If the patient deteriorates further, for example in case of lung failure, he can be put on ventilator in intensive care. He can also receive experimental medication, such as virus inhibitors. But that only happens in life-threatening situations. The majority of corona patients feel bad for a few weeks and can easily endure that at home. They should only sound the alarm when their temperature rises – measure it twice a day – or when they get more tight or feel sicker. General practitioners follow exactly the same policy with regard to flu complaints. ”
There are also stories of stuffy patients who call 112 themselves, but are still sent home.
“When you are in mortal danger, you should always call in help. However, if it turns out that the patient’s oxygen level is still good and that he keeps enough food and drinks in, the hospital has not much more to offer. Then he will occupy a hospital bed, which we really have to reserve for people who need it more. ”
– In many general practices, notes have been hung or signs have been placed with instructions for coughing patients. Photo: Sacha Wunderink
Can GPs do nothing for the thousands of people who are now home sick?
,, We recommend six to eight paracetamol per day against the pain. Nasal spray can provide relief from a stuffy nose. Cough drinks are not very effective. Products such as codeine or noscapine can help against the tickly cough. ”
Many people who are now at home are eager to know if they have the corona virus. But they are not being tested. Why not?
“RIVM has adjusted the policy after many corona patients were unable to trace the source of the infection. From that moment on, we no longer knew who passed the virus on to whom. All we can do now is stay home as much as possible and stop spreading the virus. In addition, there is also too little material and manpower to conduct many more tests. Of course I understand that many sick people would like to know if they have corona among the members, but it does not change the policy. They still have to stay at home. So a test does not provide any guidance. ”
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