Bonn A family doctor says she notices that patients are staying away from her medical practice out of fear of contracting the coronavirus. Patients who suspect they have coronavirus are screened in advance on the phone.
At her family practice in Bonn, Dr. Kühn (not her real name) begins every morning with a look at the new emails she has received. They are full of new regulations: Which patients can receive a Covid-19 test? Which examinations or consultations can be invoiced? Who gets which vaccinations? “There is much more bureaucracy since the coronavirus and it is difficult for us doctors to follow," says Kühn. That's why she has come up with her own strategy: "Everyone with cold symptoms gets tested," she says. Because although most patients only think of the virus when they have a fever, coronavirus sometimes manifests itself with a simple cold. "For most patients, the diagnosis comes as a complete surprise," says Kühn. "Some were even at work before the test.”
So far, her medical practice in Bonn has tested 20 persons who turned out to be positive for Covid-19. She also has other patients who have tested positive elsewhere. After a few coronavirus cases in spring, it was a very quiet summer, the doctor said. But in the last two weeks, her medical practice has seen a clear increase in the number of cases. "Many contracted the virus during leisure activities with groups or during long-term stays abroad.” The test results have only recently become available to patients online. "Before that, I called people at home on Saturdays and Sundays," says Kühn.
Disinfecting routine and open windows
To keep patients safe, corona testing is done before and after consultation hours. Constant disinfecting and open windows have long been part of the routine at the family practice. "We have got used to the higher stress level," says the doctor. Suspected cases are usually identified over the phone. "We ask callers with cold-like symptoms about the contacts they have had, about their work, and other symptoms," says Kühn. This is time-consuming, but it gives an early impression of the clinical picture.
Despite the precautions, significantly fewer patients are taking their ailments to doctor’s offices than was the case before the pandemic. "Since last weekend, most people have really become aware of the increased risk of infection again," says Kühn, "we notice this very clearly at our practice.” Those who come anyway, often need urgent assistance. "We have to continue to provide regular care for heart patients and diabetes patients," she says. Many of these people suffered greatly from the pandemic even without having coronavirus. "Due to working from home, many diabetics have gained a significant amount of weight over the past few months, routine exercise is lacking," she says. Older people in particular miss the regular contact with others: "Some are even met with hostility when they go to a bakery, judged on why they even leave their own home since they are members of a high risk group.”
Add to that, there are mental health issues: "With the beginning of autumn and the rising number of infections, we increasingly have people with depression and stomach problems in our practice," Kühn has noted.
If a patient has Covid-19 and is at home, the physician calls him/her at least once a day. And there are additional problems. "It was hardly possible to get a dentist appointment for a coronavirus patient who had an acute toothache," says Kühn. To get an appointments with radiologist, this also required some persuading of her colleagues. “Yet a quick diagnosis is often urgently needed.”
Coronavirus information is too complicated
Dr. Kühn also sees deficits in how the virus is explained to people. "The discussions on television are much too complicated for many people," she says. The experience she has had at her medical practice: A negative coronavirus test is misunderstood by many patients as a carte blanche for weeks. “Yet this is only a snapshot in time," explains Kühn. Only a few days later, a person could contract the virus and then infect others as well. “Usually at that point the relatives or friends are then affected, and the patients blame themselves, and feel very distressed about it.”
The family doctor is rather critical of the current lockdown plans. "It should have been planned in a much more targeted way," she says. "Germany has so far had the pandemic well under control, and we know much more about the risks of infection than we did in the spring.”
Flu vaccine supply assured
Dr. Kühn believes that all patients who wish to receive a flu vaccine will be able to get one as a new supply is coming. But she sees a shortage of pneumococcal vaccines (to prevent pneumonia) for high-risk groups. Because of the limited supply, only persons 70 years and older can receive the vaccines, whereas it used to be reserved for patients 60 and older. "This has caused a lot of people to be upset," she says. "But the high risk groups have priority.”
During the pandemic, the doctor’s day sometimes ends with a visit to a wholesale store. In spring, for example, patients who came to her family practice not only stole toilet paper but also siphoned disinfectant from the dispenser in the restroom. The doctor had to go out and buy supplies in the evening: "I was stunned.”
Orig. text: Delphine Sachsenröder