Covid-19: a remote assessment in primary care
Cite this as: BMJ 2020;368:m1182 http://dx.doi.org/10.1136/bmj.m1182
A 37 year-old healthcare assistant develops a cough. Next day, she wakes with a fever (which she measures at 37.4°C) and shortness of breath. She manages her condition at home for several days, experiencing increasing tiredness, loss of appetite, and a persistent dry cough. On the fifth day of her illness, she develops mild diarrhoea, and her chest feels quite tight. She takes her temperature, which has gone up to 38.1°C. Feeling unwell, she contacts her GP surgery for advice. She would like someone to listen to her chest, but the receptionist tells her not to come to the surgery and offers her the choice of a telephone or video consultation. She was previously well apart from mild asthma (on occasional salbutamol). Five years ago, she took citalopram for anxiety. She is a single parent of three children.
What you need to know
- Most patients with covid-19 can be managed remotely with advice on symptomatic management and self isolation
- Although such consultations can be done by telephone in many cases, video provides additional visual cues and therapeutic presence
- Breathlessness is a concerning symptom, though there is currently no validated tool for assessing it remotely
- Safety-netting advice is crucial because some patients deteriorate in week 2, most commonly with pneumonia