I’m going to start at the end- with the topic of death. Doctors around the country deal with death on a daily basis- aiming to prevent it, acknowledging when it is unavoidable, aiming to make it a better experience and lastly attending to the associated bureaucracy. When a person dies, a death certificate is issued- this will either be by the patient’s usual medical practitioner or in the minority of cases if uncertainty exists around cause of death, by a coroner usually following a postmortem. The cause of death is used to inform public records and to track disease and morbidity, accuracy is therefore paramount. In the vast majority of deaths, clinical acumen informing diagnosis determines this. Additional externally imposed control is not applied to alter these records. Until now.
In the beginning, a patient attended a local surgery with a cough and flu like symptoms, she had been moving freely in society, mixing with usual contacts, working and carrying out daily chores. A routine swab undertaken as part of a limited pilot confirmed Covid-19 and immediate close contacts were isolated. At this point, despite borders being fully open and our close European neighbours groaning under ever escalating cases, Public Health England was confident we were unaffected.
The contract tracing performed was limited, a few swabs were undertaken, other close contacts were simply advised to stay at home.
4 weeks after this, my practice received official notification from Public Health England that 2 of our patients had been swab positive. By working backwards using very rudimentary contract tracing principles, it was clear to us that significant exposure had occurred within the community prior to confirmatory swabbing and going forward with the very limited contract tracing that had been performed.
We now have a massive outbreak, multiple community cases of mildly affected patients, numerous hospitalised cases and a local residential home crippled by cases and deaths.
On contacting Public Health England, we have been told that they do not want to be notified of cases we are diagnosing in community patients, even if they die.
In our residential home, with 20 plus cases, 5 patients only were allowed swabs after which we were advised there was no point swabbing as an outbreak was confirmed.
Since that point 15 have died from Covid-19. We have issued death certificates faithful to this. Only 5 of these deaths will be included in the government data. Unprecedented is a word I am truly sick of; however, this distortion truly is unprecedented and truly is wrong.
It is hard to not feel that political agenda and spin has been prioritised over medical principles. The secrecy and delay surrounding our 2 first index cases are something that I have not experienced at any other time in my career. This coupled now with a manipulation of cause of death recordings leads me to the conclusion that we are left facing huge challenges- the virus itself and the political coverup.
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