Covid-19: out-of-hours providers are drafted in to manage non-urgent patients in communityBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m959 (Published 09 March 2020) Cite this as: BMJ 2020;368:m959
All rapid responses
The key message from Tedros Adhanom (WHO head) on 16th March was “test, test, test”. (1) This contrasts with the limited testing capacity in the UK. Individuals with mild symptoms are asked to self-isolate at home without calling NHS 111, and without being offered a test. (2) However, without a call to NHS 111 and without confirmatory test, it seems unlikely that these patients will have the information or motivation to comply with the stringent home isolation measures required for both them and their household members. Should we not have built up the capacity for large scale testing, as it has been done in South Korea? Large-scale testing in that country has been more successful than the use of lockdown in Italy. (3)
UK’s limited testing capacity is a concern also in relation to hospital admissions, as a testing delays (as experienced now) would impair the ability to separate Covid-19 patients from other hospital patients.
Furthermore, the recommended duration of self-isolation for mildly symptomatic patients (7 days from the onset of symptoms) is confusing (14-days is recommended for their household members) and can be inadequate as Covid-19 symptoms and infectivity can continue for longer than 7 days. (4)
1. Feuer W, Higgins-Dunn N, Lovelace Jr B. World Health Organization says some nations aren’t running enough coronavirus tests: ‘Test every suspected case’. CNBC. March 2020. https://www.cnbc.com/2020/03/16/who-says-some-nations-arent-running-enou...
2. Covid-19: stay at home guidance. https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance
3. Parodi E, Jewkes S, Cha S, Park J. Special Report: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics. Reuters. March 2020. https://www.reuters.com/article/us-health-coronavirus-response-specialre...
4. Fei Zhou, Ting Yu, Ronghui Du etal. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet published online on 11th March 2020. https://doi.org/10.1016/S0140-6736(20)30566-3
Competing interests: No competing interests