Today, I would like to announce a series of measures to ensure that people who have a COVID-19 infection are coming forward at the right time to get the medical support they need.
This is a new disease and we are continuing to learn how it affects people and when people should seek help. For most people this will be a mild illness. Some people won’t get symptoms at all and for many who develop symptoms, they will be unpleasant but not serious. However, as we know all too well some people will develop more serious illness and require hospitalisation. We have been reviewing how people are presenting across NHS Wales and whether we need to adapt our approach. Other parts of the UK are undertaking their own reviews.
For instance, normal medical experience of a respiratory pandemic would see people who are deteriorating struggling with breathlessness. This would be the main symptom to look out for. But experience has shown that COVID-19 is different. Breathlessness can occur but many people who are becoming seriously unwell don’t become breathless, despite their blood oxygen levels falling as they struggle to absorb oxygen in their lungs. This strange fact seems to be the reason some people may not realise they are becoming quite unwell, as they aren’t struggling to breathe.
We have also identified several other factors that may be associated with deterioration, such as symptoms not improving after seven days or becoming worse and including vomiting, breathlessness or fatigue. Therefore, we are advising people who are isolating at home with COVID-19 to look out for these symptoms and to contact 111 or their GP if they have them. The clinical advice for GP and community services has already been updated since 16 June, so that clinicians in the community know to look out for these symptoms. I know many people will not want to bother their GP during this difficult time but it is important that people don’t try to cope too long on their own and don’t leave it too late to get help.
The level of oxygen in the blood is the most important part of the clinical assessment. The main way of measuring this is by using a pulse oximeter. These are small portable devices that attach to the end of a person’s finger and can indicate levels of oxygen in the blood. It’s important these devices are used and the results interpreted correctly. That is why at the current time we see their role as an important part of the clinical assessment done in primary care. GPs and district nursing teams already have these devices. However, we will be distributing several thousand additional devices to GPs in order to help them make more use of pulse oximetry.
The Chief Medical Officer has also written to general practice highlighting these findings and recommending GPs have a lower threshold for conducting pulse oximetry in line with the new advice on symptoms. This will clearly require a greater use of face-to-face consultation. Practices may wish to use hubs or drive through approaches if they think this is necessary, as it will be important to reduce the risk of infection as much as possible.
We will continue to monitor the impact of the pandemic and provide guidance to the NHS as further evidence emerges.
This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Senedd returns I would be happy to do so.