COVID-19
In September 2019 the Johns Hopkins Center for Health Security published Preparedness for A High-Impact Respiratory Pathogen Pandemic, with ten recommendations to health systems around the world.1 The report had little traction in western countries. One narrative of the COVID-19 pandemic describes an early, coordinated, community and public-health-based response, with strong political and medical leadership, in several African, eastern, and southern hemisphere countries. In contrast, a slow and confused response, based largely on improving the provision of treatment, rather than dealing with the spread of infection, was seen in many western countries, including the UK. Countries with well-developed, high technology healthcare systems would, hubristically, be able to treat their way out of trouble. The fact that entire national health systems came within a hairsbreadth of total collapse served as a stark reminder of the folly of ignoring ‘the science’. Effective vaccines against coronavirus infections are now within reach, but it is vital to strengthen public health and primary care structures to respond more effectively to future, as yet unrecognised, pathogens.
COVID-19 AND GENERAL PRACTICE
General practice, like most sectors of the NHS, was forced to make rapid, radical, and previously almost unimaginable adjustments to working patterns and patient care. Recent commentators have recognised that beyond these crises, and the tragedies of the pandemic, lie opportunities to rethink what constitutes the core of general practice, and must be retained, which new modes of consultation and treatment can best support core activities, and which need to be scaled down or discarded. In a June editorial in the BJGP,2 Royal College of General Practitioners (RCGP) officers reflected on the dangers to general practice posed by the COVID-19 pandemic and the opportunities to rethink priorities for the future. More recently, Denis Pereira Gray and colleagues, in a BMJ editorial,3 described a ‘fork in …
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