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Dr Dan Goyal Profile picture
@danielgoyal
Mar 4, 2022 • 15 tweets • 8 min read • Read on X
Covid hospital admissions rising in the over 60s.

Some tips if you do get Covid.

Job 1: Do NOT delay seeking medical care if you are concerned or there are worrying signs.

BE prepared!
🧵
1/12
If you don't have them already, get:

1. A thermometer
2. A Pulse Oximeter*

*this is a small device you place over your finger and it measures how much oxygen is in your blood. It costs about £30 and can be shared and reused.
Secondly, find out if you are in a 'high risk group'. There are new treatments available including antibodies and antivirals that if taken within 5 days can make a HUGE difference.

More info here:
nhs.uk/conditions/cor…
Thirdly, bear in mind the majority of Covid-19 resolves without event. Typical symptoms are similar to the cold or flu and tend to start improving after two or three days. The vast majority of cases, including the extremely vulnerable and older patients resolve without event.
But, Covid can progress. Some more details below, but this one golden rule applies always when considering getting help:

USE THE SAME JUDGEMENT AS YOU WOULD BEFORE THE PANDEMIC!

Ask yourself...would I call the doctor or '111' if there wasn't a pandemic? If yes, call. If no..
...look out for worrying symptoms.

We recently published a review of this (see pinned tweet). In short:

Certain symptoms require urgent clinical contact:
➡️Shortness of breath
➡️Confusion
➡️Persistent, unremitting fever
Also, be wary of fatigue! Feeling a bit washed out is quite normal, but if you are getting really tired doing basic things (e.g. going to the toilet, going upstairs), then make contact with healthcare provider.
Be aware of silent hypoxia! This is when you don't feel short of breath, but have low oxygen. Generally you will feel rough, fatigued, maybe a bit confused or not thinking clearly. This requires urgent medical attention!!!

(see video at the end).
This is the reason we are all encouraging the use of Pulse Oximeters now. They are life saving pieces of kit!

You may be eligible for an NHS one if you have symptomatic Covid and are over 65 yrs or have a high risk condition. Even if you have your own:

england.nhs.uk/nhs-at-home/co…
Here is an animation about some of the warning signs that Covid has become more serious.

Key points:
1. Any problems breathing at all = urgent help!
2. Oxygen levels < 95% = urgent help!
3. Worried = seek help!

Some people think they are doing the hospital a favour by staying away. That other people could benefit from the treatment more. Or we are too busy and you need to rough it out at home. This is WRONG.

If you are trying to save the NHS resources, then SEEK help earlier!!!...
It is much much easier for us to treat you and get you home quickly if you get help earlier!

Remember, many GP practices will follow-up older and higher risk patients anyway. And most HIC countries follow-up all at risk patients.

It is the opposite of a burden!

TREAT EARLY!
@NHSMillion @theAliceRoberts @EricTopol @trishgreenhalgh @SusanMichie @chrischirp @dgurdasani1 @Kit_Yates_Maths @jburnmurdoch @JeremyFarrar @EmergMedDr @AlisonGeorge10 @HelenRSalisbury @doctor_oxford @DeborahMeaden @MichaelRosenYes @mvankerkhove @MarinaPurkiss @daraobriain
A UK GP got in touch to inform me of a FREE app that helps you track you and your family members oxygen levels (and other obs) - even from a distance.

Signed up the family.

Check it out:
"Bubble Medical"
@BeyNaveed

apps.apple.com/gb/app/bubble-…
Our paper on detecting severe Covid early.

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More from @danielgoyal

Dr Dan Goyal Profile picture
Apr 29
I have no inherent obligation to work in the NHS

My obligation is to my patients, whoever they are and wherever they live.

But I want to work in the NHS…

Selfishly speaking, I appreciate not having to say no to treatments because a patient can’t afford it..

But…

🧵 1/6
After 14 yrs of Tory rule and a cowed and complicit NHS Leadership, patients are being denied treatment due to lack of resources. It is hard to witness, day in and day out.

The very principal of the NHS - access for all - no longer exists!

2/6
So do I blame any doctor seeking work elsewhere? Absolutely not. Better to survive and help patients than to be broken by a system that makes treating patients harder and harder, in a country increasingly polarised. Staying in the NHS now can be very damaging for staff.

3/6
Read 6 tweets
Dr Dan Goyal Profile picture
Apr 21
This is simply unbelievable.

The way the Tories go on about it you’d think we spend all our money on the sick and unemployed

But check out the stats!

We should be paying much more…

Near bottom for incapacity benefit Image
Bottom half for social spending

France spends 50% more

Germany 25% more Image
Spending on unemployment is actually just ridiculously low..

Bottom of the table

About TEN times less than other comparable nations Image
Read 5 tweets
Dr Dan Goyal Profile picture
Feb 19
The first episode of Breathtaking was so spot on:

The chaos

The fear

The top down diktats ignorant to what’s actually happening on the frontline

And the kick in the teeth: there was no need for such chaos…we had plenty of warning!
1/n
You may be asking why only testing if travel history?

There were limited tests available, even though we had months of warning

It should have been a clinical call who gets tested not a management call
And remember at the time the UK was downgrading PPE, we were an international outlier. WHO never changed the advice. Even in poorer nations, medical staff were still kitted out in FFP3. Germany, France, Spain, Norway,…never downgraded.
Read 8 tweets
Dr Dan Goyal Profile picture
Feb 18
It’s been a brutal winter for most of us in the NHS.

Now I’ve a got a few weeks off I’m reflecting on medicine in the NHS in 2024
🧵
To be clear, as a general medicine consultant in the NHS we get an unselected patient group. We see all sorts from sepsis to heart attacks to strokes to cancer to drug overdoses to alcohol withdrawal…I will see most of them from admission in A&E through to discharge or death.
My impression
Medicine is way more advanced than it was when I qualified in 2001. For example, we used to have two or three medications to treat heart failure and most patients with heart failure died in three years.

Not anymore!
Read 17 tweets
Dr Dan Goyal Profile picture
Dec 12, 2023
The Covid Inquiry has been asking questions about whether Lockdown could have been avoided. Some (like Sunak/Johnson) have interpreted this as suggesting we shouldn’t have locked down. It’s the entirely wrong interpretation and not the question the Inquiry is asking…

1/14
It is true that some countries didn’t lockdown and did far better than the U.K. But it was not the presence or absence of lockdown that determined the outcome. It was the presence or absence of an effective pandemic response executed early and well that determined outcomes
Lockdowns are ultimately a failure of basic pandemic management - isolating cases, tracing contacts, infection controls, treating the sick, etc.. A last ditched, heavy handed measure when you have completely lost control of the outbreak.
Read 14 tweets
Dr Dan Goyal Profile picture
Dec 9, 2023
Johnson’s Testimony - Opinion

After 13 years of seeing this govt attempting to spin even the most damning of self-inflicted catastrophes, Johnson’s attempt to spin the UK’s tragically incompetent pandemic response takes the biscuit. It was as arrogant as it was hopeless.

1/n
It should have come as no surprise that Johnson would treat the UK’s Covid Inquiry with the same contempt as he had shown the British people throughout the pandemic.
But, in truth, I had hoped he would have contained his overwhelming sense to serve only himself for even a moment, so as to help the British Public avoid a repeat pandemic disaster - which is, after all, the primary reason for his appearance. He didn’t.
Read 33 tweets

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