The Expert View: ‘We will pull out all the stops. And we will prevail’

“Just a bad cold” we joked in January. No-one’s joking now, says Dublin GP Dr David Meagher, who shares his Covid-19 experience.

In early January 2020 I first became aware of a new flu-like illness that had broken out in Wuhan, Hubei Province, China. A good friend of mine regularly travels to China for work. He would often be there for five or six months at a time.

I made a joke about how he might now be in line for “a six month holiday, twice a year”. “You’ve got to be joking, sure it’s only a bad cold” he replied. “The only thing that would stop my work from sending me back to China is if it was something pure lethal”. Three weeks later his employer terminated his contract.

I am ashamed to admit that when I first heard of this new Coronavirus I was firmly of the Donald Trump school of thought.

I’m a vocationally trained GP. I have ten years experience in practice as a GP. And thirteen years as a doctor overall. I am ashamed to admit that when I first heard of this new Coronavirus I was firmly of the Donald Trump school of thought.

A new Coronavirus in town

“Sure it’s only a cold” – “It’s just a new kind of mild flu” – “What’s all the fuss” – “You’d be better off just to catch it and get it out of the way”. These are all examples of things I actually said, as a Doctor, to real-life patients. If I could take them back, believe me, I would.

As community physicians GP’s are very familiar with Coronaviruses. Coronaviruses by-in-large cause the common cold. Every year we spend an inordinate amount of time managing them. With, or hopefully without, inappropriate antibiotic prescriptions. They are almost always self-limiting and relatively benign. So when I heard there was a new Coronavirus in town; I was not all that interested or impressed.

After a number of weeks of ignoring the situation; other than to arrogantly wonder why everyone was in such a flap – my wife advised me to consider taking it seriously. She advised me that she had been looking into it, and that in her opinion, I was being an idiot. She was correct.

Instantaneous paradigm shift

I started doing some research. I can clearly remember the first time I opened the “worldometers” page on the internet. The worldometers page is based on the work of Johns Hopkins University in tracking the disease. It gives a live tally of the number of active cases. The number of deaths. The number of serious or critical cases. The number of mild cases. And the number of recovered cases. A nauseous sinking feeling overwhelmed as I read that the percentage of cases which were, at that time, classified as “Serious or Critical” was 14%.

Any medic will know that there is absolutely no way that ANY health system in the world, no matter how well funded or advanced, could come even close to coping

In one second flat I had become fully alert. An almost instantaneous paradigm shift in understanding took hold.

Any medic will know that there is absolutely no way that ANY health system in the world, no matter how well funded or advanced, could come even close to coping; if 14% of all patients, suffering from an easily transmissible infection, were to end up in a “Serious or Critical” condition in a short space of time.

Thankfully as time has passed that all-important number of 14% has been steadily dropping. Today it stands at 4%. As testing for the virus has increased we are getting more valuable and representative data to work with. Extended testing will inevitably pick up more of the cases which are mild. Every mild case is vital. They help to correct the data and give us a truer picture of what is actually happening.

Prepare for the storm

Let me walk you through some numbers;

If 40% (a very conservative estimate) of the Irish population were to contract COVID-19 more or less simultaneously then 1.9million people would become unwell. If 4% of those are “Serious or Critical” then 76,000 people would, at a minimum, need a hospital bed and Oxygen.

The task ahead of us to prepare for this coming storm is huge.

We have 14,200 Hospital beds in Ireland; total. As you already know, these beds are pretty much all permanently occupied. The task ahead of us to prepare for this coming storm is huge.

This is not a drill

The experts say that our trajectory is some weeks ahead of Italy and Spain. We MUST use this precious time wisely. We must heed the lessons of our Mediterranean friends and compatriots. We must prepare. We must Slow The Spread of the virus.

The single best thing we can do, at this time, is to manage the spread of the disease in the community. We must test – test – test. And we must trace – trace – trace every positive case. Thankfully our scientific and political leaders have shown impressive empathy, understanding and intelligence over these last couple of weeks in guiding our public health policy.

We must – every last one of us – heed all Public Health advice. We have one shot to get this right.

As Tedros Adhanom Ghebreyesus has advised us; “This is not a drill. Not the time to give up. Not a time for excuses. This is a time for pulling out all the stops”. I firmly believe that this is exactly what the people of this great country will do. We will pull out all the stops. And we will prevail.

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