Dear Courtfield Patient,

As we reported last week, Coronavirus activity in our area continues to decline, and we’ve had no new coronavirus cases since Good Friday. For those of us with family members working “on the front line”, they also report reduction in admissions and despite press reports, good availability of PPE, medical staff, and ventilators.

For those of us that have volunteered to work for the NHS, we have been told that we are “no longer needed”, as coronavirus related activity continues to drop.

This is all excellent news – at least for this phase of the pandemic.

Thank you to those who donated PPE to us earlier this week when the PPE “hotline” went lukewarm(!), and masks and aprons which were ordered on the 3rd April still had not arrived. We are now well stocked – thank you.

At Courtfield, the reduced activity has allowed us time to make contact with our more vulnerable patients, particular those with ongoing mental health problems.

If you are reading this and have not heard from us, or would like to speak to us about any health concerns at all, then please do contact us – we now have good capacity not only to talk to you, but to also see you at the practice when it is safe to do so.

If you would prefer, home visits can be organised, although an additional fee will apply. Home visits are particularly important to keep our very vulnerable patients safe.

An update on testing

  1. Testing for the presence of infection if you have symptoms (swab test)

We now have a Public Health England approved private antigen test i.e a nose and throat swab that checks whether you have active Coronavirus infection. This is being provided by our usual laboratory (The Doctors Laboratory) and involves a kit being posted for you to take your own swab which is then returned to the lab via their courier service. Results typically take 48 hours to come back. This test has passed the necessary “quality mark” for sensitivity and specificity, although occasional false negatives results are still possible. All positive results are reported to NHS England and included in national daily figures.

If you therefore think you have symptoms of Coronavirus and would like to be tested, please contact the practice – we will make the necessary referral for the test to be posted to you. We will then contact you to inform you of the results and to counsel you on the interpretation of the test. Given the incomplete understanding of the natural history of this virus and the lack of clear national guidelines, each test result will require careful interpretation based on your individual circumstances.

The cost for this service will be £125 plus the doctor’s consultation fee.

  1. Testing for evidence of recent of past infections (blood test)

As previously discussed, the current finger prick “cartridge” test for immunity to Coronavirus has proved to be very unreliable – particularly due to the large number of false negatives. Positive results are usually accurate but nonetheless the occasional false positive has also been reported. The “gold standard test” will therefore be a serum “ELISA”, laboratory-based test which we hope will become available in the next 1-2 weeks. This will involve taking a blood sample either at the surgery or the laboratory. We will let you know as soon as an approved test becomes available.

Consultations at Courtfield in the next few weeks

Even once the lockdown period is over, we will continue to offer appointments only after discussion with your GP.

We will aim to take as full a history as possible from you before you come in for a consultation, and expect you to wear a mask and to gel your hands (both will be provided), before entering the consulting room. The doctor will also wear a mask and gloves as a minimum protection, and occasionally a visor and apron.

It may be that a discussion about your symptoms may take place after the physical examination via the phone if necessary, to minimise face-to-face contact time.

We will ensure that there is no delay in you seeing the doctor on arrival, and you should not expect to come into contact with any other patients in the waiting room, as we will have longer gaps between appointments to ensure that we keep crossover of patients to a minimum.

Whilst this may feel a little strange to start with, this new “norm” is important to minimise risk to you, our staff and ourselves.

Research

In a week when the first UK based vaccine went on trial, and evidence from treatment trials start to accumulate, we thought you may be interested in taking part in a national trial of symptoms – being led by the research team at Kings, Guys and St Thomas’s hospital. This involves downloading a “Covid 19 symptom tracker app” and then reporting your symptoms (even if you have none) on a daily basis. This allows us to help understand the progress of this virus and its associated symptoms. Download the app at https://covid.joinzoe.com.

You may also be interested to learn that a trial will start next week at Chelsea and Westminster Hospital looking at early drug treatment for patients with Coronavirus symptoms, in the hope that early treatment will prevent progression of this disease. This is being led by Dr Pallav Shah, consultant and respiratory specialist and will be one of the first trials on early intervention in the UK.

Please continue to keep yourselves safe and observe the rules on social distancing which are clearly starting to show benefit.

We are aware that for many of our patients, Ramadan has started, which is such a special time for getting together – nonetheless for all your safety we would encourage you to continue to observe the current rules to keep you safe.

Remember one of us continues to be available on the out of hours number 07801 748 692 up to 11.30pm in the evenings and weekends. At other times our colleagues from Concierge Doctor are available on 020 7792 1355.