COVID had "totally new pattern of presentation"

Tuesday 09 June 2020

GP Dr Mat Dorrian has recalled the first chest X-Ray he saw of someone suffering with COVID-related pneumonia, which he has described as his abiding memory of the pandemic.

Express spoke to Dr Mat Dorrian, a GP at Queens Road Medical Practice, about his experience of working through the peak of the island's corona virus crisis for a longer feature within our Connect magazine.

BE: What changes have been made at the practice to adjust to public health advice and what difference has it made to the way you work?

MD: We have fundamentally restructured how we work during the pandemic.

Early on we organised to assess all patients with symptoms possibly related to COVID in a separate location to the rest of our general practice patients. That was initially at the Longfrie surgery and now is at the Chest and Heart clinic located at the PEH.

This has required coordination of care across the three primary care practices and has been a great example of effective teamwork at speed in a rapidly evolving situation.

We have also structured delivery of our care home support in an entirely different way.

Instead of patients in nursing homes being seen by their registered GP (our normal system can lead to multiple doctors attending a nursing home to review patients each day), we restructured the homes into three groups.

Pictured: Each of the three island practices, Queens Road, Healthcare and Island Health were allocated one of these nursing home groups.

The individual care homes are then allocated a GP who has taken over care for all residents at the care home. That GP then performs daily ward rounds, often virtually, of all residents ensuring that all our patients get the care they need without risking exposure to multiple doctors. GPs have played a crucial role in visiting care home patients in need of medical care ensuring that all their requirements are met.

In addition we have been managing our normal work load of reviewing patients predominantly over the telephone which has led to many doctors working remotely.

BE: How important is it that patients with illnesses and conditions unrelated to the coronavirus continue to seek medical care?

MD: It is extremely important that patients continue to contact their surgery with any medical issues that they feel need addressing. This includes on-going conditions that require follow up but also new problems that we can help with. 

Working in the Emergency Department, my colleagues and I have seen patients presenting later with problems that we would normally have seen sooner.

This can cause real issues with patients becoming avoidably unwell. My advice would be to call your GP as normal who will be able to advise.

BE: How have you and your fellow front-line colleagues found it working through this crisis?

MD: Speaking personally, working through this crisis has been a largely positive experience with proactive teamwork across parts of the island’s health service at a level I have not seen before and it has been a privilege to be involved in it. The level of public support has also been most uplifting.

There has been some anxiety amongst healthcare workers generally but supporting each other seems to have helped greatly with this.

BE: What has been your abiding memory/image/event of the pandemic so far?

MD: My abiding memory professionally is that of the first chest X-Ray I saw of someone suffering with COVID-related pneumonia. Medicine is generally about pattern recognition and this is a novel disease and a totally new pattern of presentation. Thankfully the patient did really well and made a full recovery.

To read the rest of this feature, which includes interviews with key workers across the local industry, click HERE or pick up a free physical copy of CONNECT. 

Note: This interview took place in mid-May and therefore reflects what the working environment was like for Dr Dorrian and Queens Road up until that time. 

Pictured top: Dr Mat Dorrian (Credit: Chris George).