Dear Courtfield Patient,

Welcome to the final Courtfield coronavirus bulletin, prior to the summer break.

It is good to be able to highlight the many positive medical events of the past two weeks.

The biggest breakthrough comes from the result of an Oxford-led trial (the “Recovery” trial) which this week reported on the significant benefits for hospital patients given the drug dexamethasone who required oxygen therapy or ventilation.

This showed a dramatic 33% reduction in deaths for those patients on ventilators and a 10% reduction in deaths in those patients requiring oxygen, probably by damping down the exaggerated immune response which occurs in many patients with advanced disease.

Unfortunately this treatment is not helpful for patients in the earlier stages (so is unlikely to be used in general practice), but at last it starts to give us an effective, cheap and easily available treatment for patients with advanced COVID 19.

Whilst frustratingly there is still no proven effective treatment for use in the early stages of this illness, there is promising data from trials on a Japanese medicine (Favipravir) which has been shown to stop the virus from replicating in the body, and depending on the results of the final trial data, could possibly be used in the earlier stages of Covid 19. Colleagues from Chelsea and Westminster Hospital (one of whom is an ex- GP) are actively involved in research on this drug.

The past week has also been noteworthy for the launch of trials of another UK vaccine – this time developed by the research team at Imperial College.


Schools reopening

Concerns that the reopening of schools may lead to an upsurge in cases of Covid 19 in our area, appeared to be unfounded so far. We have been involved in assessing a small number of children who developed fever after returning  to school in the past two weeks. All have been tested for Covid 19 and all found to be negative.

Two of our local schools report no problems so far with the health of either their pupils or teachers. Whilst it is still early days, this is very encouraging news and should give confidence for the full reopening of schools in September (as long as the two metre rule is downgraded to one metre to facilitate the practical aspects of return to school).


Mental health

A number of studies published during mental health week highlighted the significant negative impact on the mental health of many of us and particularly our children.

One of our local child psychologists, has sent us two very useful links, available in multiple languages to help families and children cope with the ongoing impact of Covid 19.

For our adults, the mental health charity, MIND, provides excellent information and support, available on their website: ‘Coronavirus and your Well-being’


An update on testing

We have been informed this week that home testing will resume in the near future – now that the Abbott home testing kits have received formal reapproval from the Medicines and Health Regulation Authority.

Our own results have shown that out of 620 patients tested so far, 124 (20%) have tested positive for the IgG antibody against the nucleus of the virus.

As mentioned in previous newsletters, it has been clear that a number of you who have had clear clinical symptoms of COVID-19 have tested negative (we have noted 10 such very surprising negative tests).

This observation has also been noted in a study from St George’s hospital this week which showed that out of 177 patients with proven COVID-19 (following positive throat and nose swabs) nearly 10% failed to produce antibodies.

We have discussed possible reasons for this in previous newsletters.

On a more positive note, the same study showed the antibody levels have persisted on sequential testing – suggesting at least in the short term that immunity is enduring .

We are also aware of more sophisticated antibody tests being developed e.g. against the “spike protein”, and will be sure to keep you updated.


The next few months

As lockdown restrictions ease in society, so the medical world is also “opening up”. Consultants are available again to see patients face to face and hospital investigations are becoming easier to organise.

At Courtfield, we have created a safe space for you to visit, with staggered appointment times and separate designated waiting areas. We ask that you continue to come alone to your appointments wherever possible with only one adult to accompany children.

Our opening hours remain restricted to 9-5 Monday to Friday and 9-1 on Saturday but from September we hope to be able to re-introduce regular early morning and late evening appointments.

Let’s hope by then that there have been no significant increase in cases and the “new normal” progressively becomes the “old normal”.

The best way to ensure this is to continue to maintain safe distancing, to wear masks when inside buildings and on public transport and to wash or gel our hands frequently.

From a general health perspective, staying active, maintaining a healthy weight, stopping smoking and perhaps taking Vitamin D supplements of 1000units per day (more about this another time) remain common sense approaches to minimising risk.

We wish you all a happy and healthy Summer.

Updates will be sent out again as and when there is significant “new news” to tell you.