Experts warn of risks over ‘stay home’ policy for infected patients

Fears that deterioration may be missed or virus carriers might not adhere to isolation guidelines

MEDICAL experts have called for careful handling of NHS plans for those with mild cases of coronavirus to stay at home, raising fears that patients who take a deadly turn for the worse could end up being missed.

On Thursday, health officials said about half of patients who had then been diagnosed with the virus were being treated at home, with plans to make this the future advice for all such cases if an epidemic takes hold.

Experts said the approach was sensible, given warnings that the NHS has too few hospital beds to cope with the high numbers who may fall ill.

But they expressed concern about how it would be ensured that patients at home were properly assessed.

Dr Bharat Pankhania, senior clinical lecturer at the University of Exeter medical school, said: “If you suffer shortness of breath you need to be assessed by a doctor immediately – you could be developing pneumonia, and the situation can change rapidly.

“At that stage you need a clinical judgment. I would be very worried if this relies on an algorithm.”

Dr Susan Hopkins, from Public Health England, said the patients told to stay at home were given phone numbers to call daily, including the 111 phone line, with named clinicians for those thought to be at higher risk.

But health officials yesterday declined to answer detailed questions about how assessments are carried out now, or how they will be in the future, should the practice of patients being treated at home become the blanket policy.

Jonathan Ball, professor of virology at the University of Nottingham, said the new policy was a “necessity” given the pressures an epidemic could place on the NHS.

“There’s not capacity in hospitals and there’s no medical or clinical reason to keep someone with something that is essentially a cold in hospital,” he said.

But he added the risk of the approach is that it is “reliant on goodwill”.

“Patients really do need to adhere to not wandering around the community,” he said.

Health officials are preparing to double the number of tests being carried out each day, with more laboratories involved in testing, as current services are overwhelmed.

Under the plans, the NHS will be able to carry out around 4,000 tests a day – compared with the current 2,000.

So far 20,338 patients have been tested, but some patients are waiting up to five days for results, with officials admitting to “ongoing pressures”.

If a major outbreak takes hold, the majority of patients will be told to stay at home, without being tested. And GPS have been ordered to screen patients who try to book appointments to assess if they may have coronavirus before they set foot in a surgery.

In a letter, Dr Nikki Kanani, NHS England Director of Primary Care, said: “To mitigate any risk that potentially infected patients book appointments online and attend the practice when they should be receiving advice to selfisolate or go through testing, all practices are now being advised to change face-to-face appointments booked online to triage appointments via telephone or video.”