A note from the distant past

Tim Senior

doi:10.3399/bjgp20X709805

Everything has changed. At the time of writing, Boris Johnson has just been diagnosed with the novel coronavirus, COVID-19. Right now, I can’t tell what is likely to happen this weekend, let alone what things will be like by the time you read this in May. And yet, COVID-19 has taken over every waking thought, as well as some sleeping ones. I watch old TV shows now and start shouting at the TV if people shake hands or hug, or even gather in groups of three or more.

The early days of this pandemic feel like they happened years ago. Here in Australia we had just come through a horrific bush fire season, and in the UK you had floods that caused a great deal of devastation. In those days, news reports were of each individual diagnosed with COVID-19, but this moved on pretty quickly to only reporting celebrities and politicians with the disease.

I try to imagine myself forward a month or two, but my crystal ball is cloudy. The next stage is presumably knowing those with COVID-19 personally, and not relying on the news to hear about it. In clinic, the whole Australian health system has done a huge, very fast pivot to telehealth, which hopefully will become more comfortable over the next few weeks. However, so far, my days in clinic feel more familiar than my days at home. At work, all the preparation has been for COVID-19, all the patients have been anxious about it, but the problems I’ve managed have been diabetes, heart disease, eating disorders, bipolar, thyroid disease, and, sadly, a newly diagnosed brain metastasis.

We are preparing for our flu season too, where we will get the same posters as previous years telling everyone to ‘Sneeze into your elbow. Clean your hands. Stay at home.’ This now sounds eerily familiar, like a melody turning up at the end of a symphony that, surprisingly, was there in the first movement when we weren’t listening properly.

I’ve learnt so much in the last few weeks, about personal protective equipment, about interpretation of epidemic curves, and about changing the background to my video in meetings on Zoom. But all the old things I knew are thankfully still in my head. My job has always been to help people navigate and make sense of their illness, and give them some control, in the face of an uncertain future. We help balance and prioritise multiple problems at once. This hasn’t changed.

The uncertainty is more acute, and it’s affecting ourselves, and our colleagues too, but the skills we have, and the values we work by as GPs, are what will get us through. And we are sometimes wrong, but, hopefully, our relationships with our patients will help us not to be too wrong.

Importantly, we’ll keep people out of hospitals, where resources have been diverted towards COVID-19. These are the constant stars by which we can navigate these stormy times coming at us now.

I don’t have any particular insights on this pandemic that you can’t get better elsewhere. I am writing these reassuring words mainly for myself, hoping that by the time you come across them, you won’t be in as much need of reassurance, that familiarity with these strange times and their new habits has made things more certain and less fearful.

In the meantime, I’ll be here in the distant past planning to stay home this weekend.