As he looks to a future in which we all queue up six feet apart for the new coronavirus vaccine, Maurice Gueret asks if all care homes now need a full-time doctor.
Eight billion doses
It isn't easy to plan ahead in the midst of a once-in-a-lifetime pandemic. But many of our parents came through a very long world war, and many of our grandparents lived through two of them, with a civil war thrown in for good measure. Humanity will come out the other end. Bruised, perhaps, but with lessons learned to pass on to those who come after us. I hope a new vaccine against this coronavirus will be announced this year. It's good to see major pharma companies banding together in a collaborative effort. But announcing an effective immunisation is one thing. Manufacturing enough for up to eight billion earthlings is another. Let's hope we don't see nations squabbling with each other over supplies as we did with masks and protective gowns.
There will need to be an orderly line when a coronavirus jab appears. Frontline healthcare workers will demand first batches, and only fools would deny them this privilege. I would assume that older people, and younger folk with long-term illnesses, will be next to receive a vaccine when it comes. This would include long-term residents of nursing homes, psychiatric hospitals, care centres and disability services who survive this pandemic. When these key groups are looked after, other recipients will be considered. Every week, new information is coming out about this virus. As I write this column in mid-April, there is an interesting theory being discussed in America, postulating that the severity of the disease that this virus causes, could be proportional to the dose of the virus you receive. If true, the implication would be that picking it up in a supermarket or playground may be less dangerous than picking it up from a very sick family member or patient. Another theory circling is one suggesting that countries which routinely vaccinate babies with BCG against tuberculosis may be faring better against Covid-19 than those that don't. The wise words of that senior World Health Organisation doctor who was asked earlier this year how serious this disease could be, ring true. He said to ask him the question again when the outbreak is over.
Home from home
A lady rang Joe Duffy's Liveline programme last month demanding that ventilators be installed in nursing homes. Those with experience of operating these in intensive-care units may have guffawed at the suggestion, but the concern behind her plea was genuine. She knew first-hand just how helpless nursing homes had been left early in this crisis. Patients were dying with acute respiratory distress, and hospitals were not exactly queuing up to receive them. The Department of Health will learn many lessons from Covid-19, none more important than the fact that medical cover in many nursing homes can be inadequate at the best of times, let alone in times of pandemic. Family doctors have tried to double up as medical officers in nearby care centres for far too long. The time has surely come to insist that every care facility of a certain size in the country has at least one doctor on site during daytime hours. The comfort this would bring to residents, families and nursing staff would be immense. Having at least one medic who admits and gets to know all the patients, who can do a daily ward round, and possesses a diploma in medicine for older persons, could change the face of this sector. Any minister who cares more for the patient than the profit-line of an increasingly corporate care sector, should institute this measure now. It will be of lasting benefit to those residents who survive, and those of us who come afterwards.
Reading the obituaries to racing driver Stirling Moss, I concluded that I'm the only person on these islands who was never stopped by the police and asked if I was him. He was a great favourite of my parents' generation, always the 'nearly' man, never winning the Formula One World Championship. His only speeding fine was for £50 in 1960, with a year-long ban for dangerous test-driving of a Mini. An endearing trait was that he excelled at doing household chores poorly - so badly that he was never asked to do them again. It reminded me of my own honeymoon many moons ago in an Austrian aparthotel. One evening, I mistook washing-up liquid for a similar-looking bottle of cooking oil. Two rainbow-coloured bubbling fillet steaks ensued. It was a long time before I received a culinary mandate again.
Dr Maurice Gueret is editor of the 'Irish Medical Directory'
Sunday Indo Life Magazine