LEAKED details from a meeting between Northern Ireland's most senior doctor and those representing GPs, dentists and pharmacists have laid bare the scale of the challenge in tackling coronavirus.
The private discussions took place last Friday during which chief medical officer (CMO) Dr Michael McBride outlined plans for the weeks and months ahead - with doctors expressing "concern" about projections in terms of deaths and self-isolation for the elderly.
Health professionals were told a "rapid rise" of the virus is expected within the next four to six weeks - after which the north "will enter an extremely difficult phase of 13-16 weeks isolation of our most vulnerable and at risk".
"There will be increased deaths," the briefing heard.
Security may also be required in some pharmacies due to stockpiling and panic buying, with many chemists reporting major shortages in over-the-counter medication such as paracetamol.
Fears about the future of dental surgeries and optometry services were outlined, with "very significant concerns" that their work and funding "will dry up completely", with warning this will be "very destabilising".
Sources say the information contained in the high-level meeting "should have been made public" given the level of anxiety in the north following the lockdown in the Republic and closure of schools.
It was accepted during the discussions that efforts will be "stepped up" by the Department of Health in improving communication, which they said was "vital".
Dr McBride headed up the meeting and gave an overview to leading representatives of those at the frontline of community care or "primary care" as they ramp up preparations for a widespread outbreak.
Many GP surgeries are already using extensive telephone triage, whereby patients are assessed over the phone, with pharmacists struggling to cope with a massive spike in the number of people presenting.
"There has been a huge surge on community pharmacies and panic on occasions and they may need to introduce security in some areas to deal with this," according to briefing notes seen by The Irish News.
Concerns were also expressed last Friday about the impact of a widespread outbreak on special schools as well as nursing and residential homes.
"We are looking at models to protect them and manage within them," according to the notes.
All of Belfast's 10 special schools announced on Sunday they would close "indefinitely".
Others issues and plans revealed in the meeting included:
- impact of "surge buying" of over-the-counter medicines could lead to supplies being "depleted"
- 'rapid testing' of healthcare staff, "particularly medical staff' is required to retain them at work
- supply chains for specialist masks and equipment worn by staff must be maintained
- "reprofiling" of some staff working in dentists and optometry to "work in other areas"
- while there are no current problems with supplies of prescribed medicines, serious concerns have been raised about the impact of three-month/84 day prescribing leading to CMO to request there is a move to "56 day prescribing"
- proposal to move to electronic self-certifications for sickness
- retired GPs to assist in telephone triage but discussions around some medical students also assisting
The 'community model' being proposed to deal with coronavirus will resemble a "24/7 out-of-hours type arrangement" with advice and assessments given over the phone - while GP practices will be kept "clean" for "other" work.
It was stressed during the meeting that GP surgeries will "not shut" and there is "no risk" to general practice, with GPs viewed as "significant and vital partners" in tackling the virus in a primary care setting.
Some doctors who attended the meeting said they were"assured and impressed" by the "level of planning" but "at the same time very concerned about the projections".
