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Letters Covid-19: remote assessment in primary care

Removing the handle of the Broad Street pump: measures to slow the spread of covid-19 in primary care teams

BMJ 2020; 369 doi: (Published 12 May 2020) Cite this as: BMJ 2020;369:m1841
  1. Simon de Lusignan, professor of primary care and clinical informatics1,
  2. Tamsin Carlyon, general practice partner2,
  3. Ajit Lalvani, chair of infectious diseases3
  1. 1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6ED, UK
  2. 2Woodbridge Hill Surgery, Guildford, UK
  3. 3Imperial College London, St Mary’s Campus, London, UK
  1. simon.delusignan{at}

John Snow removed the handle of the Broad Street pump to halt a cholera epidemic. His approach was not to find the organism but to block transmission.1 One way to contain covid-19 is to assess patients remotely,2 but what about transmission within primary care teams? Research reporting the effectiveness of strict infection control measures34 and about the aerosol and surface stability of SARS-CoV-2 provide5 the basis for measures to reduce transmission in general practices.

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