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Many GPs using protective equipment for all patient consultations despite HPSC guidance

By Dermot - 09th Apr 2020 | 5 views

Abstract coronavirus strain model from Wuhan, China. Outbreak Respiratory syndrome and Novel coronavirus 2019-nCoV with text on blue background. Virus Pandemic banner concept

Many GPs are not in agreement with guidance issued by the HSE Health Protection Surveillance Centre (HPSC), which advises against the use of surgical face masks for non-Covid-19 patient consultations.

Several GPs contacted by the Medical Independent (MI) are using some form of protective equipment, such as mask, gloves and aprons, during consultations with patients who do not have, and who are not suspected of having the virus.

Full PPE is reserved for consultations with patients suspected of having Covid-19, according to GPs.

HPSC guidance on the use of PPE states: “The unnecessary use of PPE will deplete stocks and increases the risk that essential PPE will not be available for you and your colleagues when needed. This guidance does not recommend use of surgical face masks in situations other than for contact with patients with droplet transmitted infection including Covid-19”.

However, several GPs contacted by MI are adopting their own measures in surgeries due to concerns about the spread of the virus from asymptomatic patients and staff.

Cork GP Dr Ronan Boland is using a mask, gloves and apron for all consultations; all patients also have their temperature checked on arrival.

IMO President and Longford GP Dr Pádraig McGarry told the paper that for consultations with patients displaying respiratory symptoms and who need assessment, for example a child, full gown and goggles/visor are being used.

Many GPs are also providing masks to patients on entry to surgery and encouraging the use of hand gels.

Cork GP Dr Nick Flynn has devised a “patient safety station” at his practice, which involves patients attending washing their hands, having their temperature checked and using face masks.

He added that “clinicians wear risk appropriate PPE for all clinical encounters” because all patients and staff could be asymptomatic and therefore contagious.

GP Dr Muireann Leonard, based in the midlands, noted that “there is no such thing as a non-Covid-19 consult”.

In contrast, Tramore GP Dr Austin Byrne is not using any protective equipment for non-Covid-19 consultations, he said.

This is because “the highest risk of unanticipated acquisition is past. We risk assess and don accordingly,” he said.

“Patients deemed high risk are seen in a dedicated building with full PPE.”

Meanwhile, the ICGP has today urged the public to self-isolate if they have mild symptoms of Covid-19, ie, cough, fever, sore throat, aches and pains or shortness of breath.

The College underlined that community transmission accounts for 67 per cent of new cases (as stated by the Department of Health) and vulnerable people in family homes are particularly at risk of serious disease.

Dr Nuala O’Connor, the ICGP’s Lead Adviser on Covid-19, said: “People may have only mild symptoms, so they don’t realise how dangerous this could be for vulnerable people in their family home, eg, the elderly, those with chronic diseases such as diabetes or heart disease, or those with underlying conditions.”

“They must self-isolate for 14 days. That means they can’t go out, and they must not share utensils or towels with family members and must stay two metres away. I know this can be difficult in a family environment but this is the only way we can avoid spreading the virus further.”  Details of how to self-isolate are available at www.hse.ie

Dr Mary Favier, President of the ICGP, added: “We can’t afford to become complacent at this stage in the pandemic. While 80 per cent of people get a mild illness, we know that the virus can be deadly for some, including young people. We urge people to stay at home and limit the spread of the virus as much as possible.”

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