A senior GP in Drogheda, Co Louth, has said general practice is "on its knees" as a result of Covid-19, and the situation at the moment is as bad as he has ever seen in 25 years working on the ground. Prof Daragh O'Neill described Covid-19 figures in the town as "frightening".

The latest Covid-19 figures from the Central Statistics Office show Drogheda now has the highest incidence rate of the disease in the country. Its 14-day rate of 2,400 cases per 100,000 (the equivalent of almost one person in 40) is more than twice as high as it is nationally.

Prof O’Neill, a GP at the Clann Medical Practice in Drogheda, said the disease was being driven by a relatively young population in a commuter town. “The current rise is proportionate to the relaxation of the rules and the reopening of the schools after the mid-term break. It is all children and carers of young people getting it as a result.”

Hospital Report

Prof O’Neill, who is also associate clinical professor of general practice in UCD, warned that general practice is “on its knees” as a result of Covid-19, and that if he had to go off sick he would not be able to hire a locum because none were available. “It’s quite a frightening time to be a GP. This is as bad as I’ve ever seen it.”

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Calls to family doctors across the State reveals many are worried about the misuse of antigen tests. Dublin-based GP Dr Ray Walley said doctors were “astounded” at the number of symptomatic people who use them.

He was at a couple of webinars with other doctors last week and they estimated 90 per cent of symptomatic cases presenting to them had used antigen tests wrongly.

The patients involved had been falsely reassured after having a Covid-19 antigen test and did not self-isolate as recommended and get a more accurate PCR test.

Dr Walley fears the message is not getting through to symptomatic people that they really should be getting a PCR test and not relying on antigen tests.

Longer

Dr Mary Favier, who works in the Parklands surgery in Cork city, said many GPs were putting in 12-hour days at present trying to deal with Covid-19 and the backlog of other cases.

“The volume of work is unrelenting. Last year we literally shut everything down to deal with Covid. We can’t and won’t do that this year. Days are getting longer and longer.

“Our patients are divided into two, largely between those who are young and really feeling impervious to the virus and those who are older, more vulnerable and anxious. We spend half our time encouraging one lot to take care and the other lot not to be overwhelmed by anxiety.”

However, Dr Favier said the Covid-19 workload was not as bad as it was last January because of the vaccines. Fewer people were presenting who were really sick. “There are huge numbers but not as many seriously ill.”

She said there was a necessity for public health information around antigen testing, echoing sentiments from other doctors that too many symptomatic people were using them.

“They are not good enough if you are using them in a symptomatic population,” she said. “The public have gone ahead on antigen testing without a significant amount of public health messaging.”

Five weeks ago Longford town had the highest rate of Covid-19 in the State. It is no longer the worst affected, but Dr Paul Trueick said the numbers have not gone down in the town. Other places have simply overtaken them.

“On the ground there is an awful lot of Covid-19, more than I have seen at any time, definitely more cases. Numbers have increased, but they increased a bit more elsewhere. It is absolutely more prevalent than it was three weeks ago on the ground. It’s more the younger age group and people with children.”

He says after-match celebrations have played a role in the increase in numbers, as have the general congregating of people.

Really scary

Dr Denis McCauley, who is a GP in Stranorlar, Co Donegal, has pointed out that case numbers in the Republic were now higher than they were across the Border in Northern Ireland.

“If there is going to be any spread across the Border it is going from west to east, not east to west. If there is any risk of passage it is going the other way now,” he said.

“There is a lot of very sick people about. We don’t want January again. January was really scary, it was touch and go. We don’t want to ever go there again.”

He echoed comments made by other doctors that symptomatic people were “using antigen tests as an absolution and they continue on as usual. That’s madness. They are going out to spread it when they should be staying at home.”

He blamed widespread non-compliance with the Covid-19 cert system as another factor in rising case numbers. “I have heard anecdotally of one Covid pass getting 20 people into a nightclub.”

Waterford also recently had the unenviable reputation of having one of the highest rates of Covid-19 in the country despite a near blanket level of vaccination in the adult population.

Dr Darach Brennan, who works in the Johnston Medical Practice in Waterford city, believes the rest of the country is now where Waterford was previously.

“As a GP it is worse than other surges because there are a lot of other respiratory illnesses out there which were not here this time last year – respiratory syncytial virus (RSV) in children, asthma or chronic airways disease in adults.

“People are now circulating so they are getting the normal respiratory illnesses. The complicating thing for us is that you have to rule out Covid first and that adds a whole new level of stress.”

Switched around

Monaghan GP Dr Illona Duffy said they had a brief hiatus of a couple of weeks without a substantial number of cases in her area, but that has switched around now and the numbers in Monaghan town were starting to rise again.

She said the disease was so prevalent everywhere that factors like proximity to the Border do not matter anymore.

“Whole households are testing positive. Those who are most unwell are those who are unvaccinated, but we are seeing vaccinated people get sick.”

She has advised many people who are symptomatic that they have to go for a PCR test and not rely on antigen tests.

“The fear factor is gone. People are getting it and not getting very sick. They are forgetting that young people might not get very sick but they can spread it to other vulnerable people.”

Dr Duffy added that many non-Irish nationals were presenting very sick with Covid-19 especially from Eastern Europe.

“Back home none of their family are being vaccinated either. They feel that they don’t need the vaccines. It is very hard to educate those people through public health measures.”

She has encouraged those from migrant communities who get sick from Covid-19 to spread the word that being unvaccinated has potentially serious consequences.