Christmas, and Covid-19, is coming

In usual circumstances, this time of year provokes a range of responses.

There will be those who ignore the commercialism to concentrate on the religious significance of Christmas. Others may be in a different heaven, loving the gift buying, the tinsel, the planning for turkey and trifle, and even hearing Snoopy’s Christmas for the umpteenth time. But it can be hell for others — those who feel pressured into spending money they do not have and worrying how they will financially survive the Christmas break, the lonely, fractured families, those for whom the reason for the season seems to just highlight the difficulties they face.

This year, even the festive season enthusiasts may feel the tinsel is already tarnished.

Our last Christmas at Covid-19 Alert Level 1 seems a lifetime ago as Covid cases edge their way down the country, and we wait for Delta-dogged Auckland to open and release its pent-up inhabitants.

Like those garish socks from an aunty which we might be expected to wear on The Day, in the South Covid-19 may be the Christmas present nobody asked for. Even if it does not turn up in time for Christmas, it may not be far away.

If we accept the inevitability that Covid-19 will spread our way, there is still much unknown about what might happen next.

The longer it takes to get here, the more opportunity there will be to increase the number of those over 12 who have received a double vaccination against the disease. Vaccination certificates are expected to be in play by Christmas and will have an impact on our lives, regardless of whatever colour of the new (and possibly still confusing to many) traffic light system we are at.

But even with high numbers vaccinated, there may be outbreaks, although, of course when the fully vaccinated encounter the disease they are much less likely to require hospitalisation.

Southern District Health Board projections suggest the worst-case scenario would see 900 cases a week in its area, with 40 people in hospital.

Primary care providers are expected to look after at least 95% of all cases in the community.

Those in the Southern area will be hoping that the system for managing such cases here will be better than that we have seen in Auckland.

This month, both the existing Health and Disability Commissioner Morag McDowell and former commissioner Emeritus Prof Ron Paterson raised concerns about the level of care being provided to people self-isolating in Auckland after three deaths of people in that situation.

There were reports suggesting little or no contact with those self-isolating, difficulty for the sick being able to access help and concerns they were not always receiving appropriate advice. Also, some people, aware the health system is under pressure, may have been reluctant to seek help when a patient’s condition was deteriorating.

WellSouth, the Southern primary health network, has given assurances that patients in the area will get the care they need.

A report that the primary care team and general practitioners would have daily contact with Covid-19 patients, over video chat, seems unnecessarily ambitious. Apparently, smartphones and data would be provided to patients who did not have this technology for such contact. It is difficult to understand how a sick person with no experience of such technology would cope.

Experience in Ontario, outlined by GP and Professor of Family Medicine at University of Otago and McMaster University Prof Dee Mangin suggests telephone contact was enough, and that the last thing an unwell person wanted was to wrangle Zoom.

As she puts it, good primary care does not have to be elaborate — all you need is a clinician and a patient and a way to communicate.

A system we can all understand which can be relied on to provide appropriate care is the Christmas present we want.

 

 

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