Helen Salisbury: Planning for the peak
BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1408 (Published 07 April 2020) Cite this as: BMJ 2020;369:m1408Read our latest coverage of the coronavirus outbreak
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Dear Editor , Surely Helen Salisbury should be suggesting that those perceived at increased risk should spend a few pounds and purchase their own oximeters rather than lending them out. Many households may well have one anyway in this day and age particularly if any member is engaged in physical training. Just how one uses the information from the gadget is another matter.
Competing interests: No competing interests
Dear Editor,
We read with interest Salisbury’s Planning for the peak from the perspective of hospitals managing patients in the current pandemic. There are many shared similarities with general practice in terms of the uncertainty associated with COVID-19 and the need to consider business as usual for the majority of patients who are not infected, if that is at all possible.
The evolution of new models of care in hospitals has brought together administrators and clinicians and merged historically separate departments to help deliver a seamless and unified response against the contagion. We agree with Salisbury that there has been a visible dissolution of traditional hierarchy within the workplace and positioned all at a common level to effectively deal with an unknown but common enemy. This has happened at local, national and global levels with shared information, collaborative research and the mobilisation of medical supplies, equipment and workforce to areas most in need.
The need however for community services and family medicine to continue to provide usual care in what is anything, but usual times cannot be underestimated. Keeping the majority of the population stable and away from hospital services is no less important than dealing with inpatients who are infected. Enablers such as Telehealth, remote patient monitoring, upgraded pharmacy services (1) and enhanced community outreach are powerful and now necessary in providing the much needed care while supporting global government strategies on social distancing and infection control (2, 3). Doing so effectively not only reduces maldistribution of staff and resources from dealing with the COVID outbreak but potentially minimises the most vulnerable in our community to unnecessarily acquiring infection. Our learnings post this pandemic will be both important and transformative. It is certain that global healthcare delivery will merge from this pandemic to become more uniform, agile and connected as the world will no longer accept that this will never happen again.
References:
1. Cadogan CA, Hughes CM. On the frontline against COVID-19: Community pharmacists' contribution during a public health crisis. Research in Social and Administrative Pharmacy. 2020 Mar 31. pii: S1551-7411(20)30292-8.
2. Rockwell KL, Gilroy AS. Incorporating telemedicine as part of COVID-19 outbreak response systems. American Journal of Managed Care. 2020 Apr;26(4):147-148.
3. Michael S. Putman, Eric M. Ruderman. Learning from Adversity: Lessons from the COVID-19 Crisis. The Journal of Rheumatology Apr. 2020, jrheum.200411; DOI: 10.3899/jrheum.200411
Competing interests: No competing interests
Re: Helen Salisbury: Planning for the peak
Dear Editor,
Helen Salisbury is right to highlight contamination of pulse oximeters. In a small study(1) we showed that ward oximeters were contaminated with "organic matter", which could surely include viruses. Use of a simple transparent disposable glove did not alter the oximeter reading significantly. It appears that oximeters should either be patient specific or used with a disposable glove for each patient.
Malcolm Green
David Russell-Jones
1. BurgeA, Green M, Russell-Jones D. Patient power-Kidd gloves. Clinical Medicine 2018, 18: 437–8
Competing interests: No competing interests