From the President: March 2020

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I am saddened but not surprised that I continue to write about the impact of COVID-19, or what continues to be colloquially called Coronavirus. As the disease spreads and efforts to contain it become increasingly robust, it is important to recognize and honour the family doctors and primary care teams who are the front-line clinical staff.

[This week’s published editorial by Donald Li: Li DKT. Challenges and responsibilities of family doctors in the new global coronavirus outbreak. Family Medicine and Community Health 2020;8:e000333. doi: 10.1136/fmch-2020-000333 ]

Family doctors across China and in a growing number of other countries are responding to the crisis using the best information and resources available. Research continues apace to determine the cause and mutation of the virus: much knowledge has already been gained. But it will be some months before an antidote or vaccine to the virus can be available. Until then, patients displaying symptoms, as well as people who are not but who have been in contact with someone who has the virus, are either self-isolating or are being put into isolation for the required incubation period.

Family doctors globally have access to information to help them make informed decisions about admittedly sometimes vague flu-like symptoms and what needs to happen to alert public health agencies to a possible case. In addition, family doctors are also having to deal with the ‘worried well’, some of whom are presenting with high levels of anxiety about the potential for contracting the virus, even when it is extremely unlikely, and those who are already vulnerable through pre-existing comorbidities and old-age. The central role of primary care in emergency preparedness and response is an issue I have written and talked about throughout my Presidency of WONCA. The latest publication on this, in BJGP open, written with colleagues including Amanda Howe, can be viewed here.

As the virus continues its path we continue to learn. We have talked about disaster preparedness on a number of previous occasions and it is right to mention it again. There is a vast array of professionals working on the features of this virus, it’s transmission, and projected spread. Scientists from numerous respected agencies and organisations are working together to develop and project, using increasingly fine-tuned algorithms. Dealing with the cases and potential cases on the ground takes a different sort of expertise. Those involved in trace-contacting are a separate but equally crucial component of the momentum to reduce and contain the spread of the virus. Numerous highly-skilled professionals, all with the same goal. And as they work, people in every country continue to live and present with ‘normal’ illnesses and diseases, which also have to be assessed, diagnosed and treated.

It is important that we listen to the wise advice of Michael Ryan, Executive Director of WHO’s Health Emergencies Programme. Calm in the face of a rapidly changing environment, Michael Ryan urges the global health sector to learn from this outbreak. He argues that while the world responds well to each outbreak of a serious virus, once it is contained the lessons are often lost. Professionals go back to their normal jobs; people drafted in to help are stood down; when the outbreak becomes manageable, health systems return to how they worked previously. Everyone is exhausted and relieved. The world is not learning the lessons from outbreaks. Instead, Michael Ryan urges each and every country to learn from the global knowledge gained; to absorb it into their training of health professionals and their continuing development programmes.

As COVID-19 continues, I ask three things from our family doctors. First of all, keep informed with the latest reliable information available. Second, use your skills and expertise wisely. And third, stay safe. Everyone needs their family doctor to be there for them in this increasingly worrying world. We are, as ever, the first in and last out, irrespective of what challenges our communities face.