The simple fact is that this Government and the Ministry of Health regard General Practice in New Zealand as a disposable resource. There is callous disregard for providers (including staff) and for the patients and wider community. Our preparations for a possible pandemic are woefully inadequate and the response can be likened to the response on the Diamond Princess - instead of possibly containing the infection and protecting the providers of care they turned the ship into an incubator of the disease.
Even if General Practice could afford to purchase all the necessary PPE (which it can't) it has no means to dispose of used equipment or to decontaminate the environment. This increases the risks. Furthermore overseas experience has shown even protected health care providers to be at the highest risk - both for contracting the disease and dying from it.
The demographic for the majority of General Practitioners and Practice Staff places them squarely in the most at risk group. Self-isolating will shut down Primary Care and quite possibly put Practices out of business. Where will patients receive primary care? DHB's are already whining that they won't be able to cope with the seasonal flu, how the hell will they cope with this?
Prior infection and recovery does not reduce the risk it actually increases it. This has so far been the Chinese experience and confirmed elsewhere in that Antibody Dependent Enhancement (ADE) significantly enhances (as the name implies) the potential impact (including increased mortality) of the disease. This is NOT the Measles or Influenza as some have implied. We need a clearly articulated and evidence-based action plan that specifies exactly who and when and where attention should be sought. And it should not be at a General Practice level. And it should not be at some vague time in the future. The time is NOW. The public deserves to know.
CLICK HERE to listen to Rick Cutfield, endocrinologist from the Waitematā DHB, give an update on managing hypothyroidism
New Zealand Doctor