‘We’ll pay for this’: No end in sight for GPs under pressure from Covid, flu

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In his 35 years as a GP, this winter has been his toughest ever, says Bruce Stewart.

Feilding’s GP, also medical director of primary care for the MidCentral District Health Board, says the latest wave of Covid, coupled with the return of the flu, has created a perfect storm.

There may be a glimmer of light that flu cases might just go down – but with the sudden rise in Covid cases, that’s cold comfort.

“Over the past week, we’ve probably doubled the number of Covid (cases) we’ve been dealing with on a daily basis,” Stewart says.

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“We always knew July and August were going to be the worst…..so it’s expected, but it’s not fun to live with. It’s tough, there’s no doubt about it.

Stewart says his practice is adapting, but he says it’s thanks to the systems they have in place and the people who work there, who don’t like to let their community down.

And while he doesn’t agree with those who think the system is on the verge of collapse, as hospitals and GPs are battered by wave after wave of critically ill patients, he can sympathize with this feeling.

“I think it’s very stressed, but I don’t think it’s breaking down…people are stressed, they need breaks, they need relief. But no relief is in sight at the moment. It’s just a matter of one day at a time.

GP Bruce Stewart:

WARWICK SMITH / Stuff

GP Bruce Stewart: “At some point we’re going to pay for it.”

The medical director of the Royal New Zealand College of General Practitioners, Dr Bryan Betty, said the country’s GPs were either at capacity or above capacity, and the latest wave of Covid is expected to n hasn’t even reached its peak yet.

Saturday’s Covid figures showed there were 761 people in hospital with the virus, including 15 in intensive care or high dependency units. There have been 29 additional deaths recorded in the past five days.

“It’s definitely one of the worst winters I’ve had in terms of demand. It’s tough for a lot of surgeries, they have to put off routine work and focus and deal with what we call acute demand. It’s also probably a reflection of a system that’s running at full capacity most of the time and this year has been pushed to the limit,” Betty said.

“At the end of the day, that’s the situation we find ourselves in and we have to deal with it. It’s also following two very difficult years of Covid that we’ve come up against this – there’s just a feeling of tiredness The system flares up a bit, that’s what happens.

Dr Bryan Betty, Medical Director of the Royal New Zealand College of GPs.

KEVIN STENT / Stuff

Dr Bryan Betty, Medical Director of the Royal New Zealand College of GPs.

“The challenge ahead is how to avoid this kind of thing (in the future).”

But there are also worries about the other legacy of Covid, patients with chronic but less immediately fatal illnesses being forced to stay at the back of the queue.

Betty said while most people in need of acute or urgent care were seen earlier, those who needed chronic routine care for issues such as diabetes or heart disease had to wait up to six weeks for an appointment. -you.

“We have a lot of surgeries that have closed their books to new patients because they are at capacity, so this is a new feature that has come into play quite dramatically recently. In some areas, up to 80% of practices are closed to new patients because they can no longer keep up with the demand – it’s difficult. »

The problem is even more acute in hospitals.

THINGS

Health Minister Andrew Little speaks with Stuff reporter Rachel Thomas about the pressures on the healthcare system, nurses’ pay and how he plans to address labor shortages.

The government announced this week that it would make free masks and rapid antigen tests more widely available, and also widened the criteria for Covid antiviral drugs that can improve outcomes for the most vulnerable patients.

He hopes to reduce pressure on hospitals, some of which have said they can only operate on cases considered life-threatening or cannot be delayed, with all other surgeries postponed or cancelled.

Stewart said her clinic had to cancel regular clinics to divert people to pinch areas. This included their regular pap smear clinic, to free up a nurse to care for respiratory patients.

“So it impacts everything else…at some point we’re going to pay for it (as a country).”

People also had to wait a few weeks for their flu shot or Covid boosters.

There are, meanwhile, concerns that antiviral drugs that could help some of the most vulnerable people to cope with Covid are difficult to access, due to huge pressures on GP clinics.

The government said last week while there was plenty of stock available, some people at risk of serious illness from Covid-19 who could benefit from the treatments had been unable to access it.

Clinic owner Riccarton and GP Angus Chambers said extending the access criteria was positive, but would have a limited effect.

He said most people who would benefit from the drug already had access to it under existing criteria.

Current pressures on primary care providers risked people running out of it and it was “probably” happening already, but he said he was “nervous” about making it available in pharmacies.

“There are a lot of interactions with these drugs, so you may need to change the doses, so I just don’t know if going to see someone who doesn’t know your medical and prescription history, to work all of this out. , always go to be sure.”

He said the move was an attempt to reduce pressure on hospitals, driven largely by a surge in Covid-19 hospitalizations among the elderly.

But Chambers said the benefits [of antivirals] would remain out of reach for many as the government failed to act on the primary care workforce crisis.

Making masks compulsory in schools would limit the transmission of Covid-19 without increasing pressure on primary care.

“Antivirals are the ambulance at the bottom of the cliff, masks are the fence at the top.”

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