The UK’s rapid COVID-19 vaccine rollout has meant that the majority of people aged over 80, and a large number of over-70s, have now been vaccinated against the virus. This is very welcome news.

On 1st February, Prime Minister Boris Johnson announced that ‘virtually all’ elderly care home residents had now been offered the vaccine. This is with the exception of a few whose visits had been deferred for safety reasons due to a local outbreak.

However, data from the Care Quality Commission (CQC) has shown that infection rates among the elderly remain high. This is particularly true of the oldest group, those aged 85 and over. The number of suspected outbreaks in individual care homes also reached a second wave record in January. This was despite the best efforts of all concerned to get the most vulnerable members of society vaccinated quickly.

Sadly, the number of deaths in private homes has also risen, suggesting many elderly people are suffering alone at home, without seeking diagnosis or treatment.

Why are older people not seeking help?

There could be any number of reasons why elderly people living alone are not asking for help when they feel unwell. One explanation is that getting to a GP or COVID-19 testing centre to have symptoms checked can be very difficult if you have mobility problems.

Many elderly people don’t have access to a vehicle, and the idea of using public transport during a pandemic can be frightening. Social care services are short staffed. And many carers don’t want to put themselves at higher risk by coming into close contact with a suspected case of coronavirus.

What to do if you need help

If you or an elderly person that you know has COVID-19 symptoms, The Mayfair GP can help.

We are very happy to perform home visits. To give you peace of mind, we can come and carry out a COVID-19 test at a convenient time. Your sample will be couriered to the lab, to get the result comes through as quickly as possible. In the meanwhile, we will treat your symptoms to make you more comfortable.

Should you need treatment beyond what we can offer, we can arrange referrals and transport to hospital.

Experts in elderly care

Even if you aren’t displaying symptoms of COVID-19, if you are an elderly person there is a high chance that the pandemic is having an impact on your healthcare needs.

At The Mayfair GP, we are highly experienced in caring for our elderly patients. We can help with management of long-term illness as well as treating acute problems. We offer regular reviews and routine recalls, ensuring your blood tests and other checks are all up to date.

You can contact us by phone, at any time of day or night. We can even come to you, and can organise your medicines to be delivered. You don’t have to leave the comfort of home.

If you would like to find out more about our elderly care services, please contact us by phoning us on 07568 369455 or emailing info@themayfairgp.com.

When it’s cold and wet outside, the days are short and we’re stuck at home, it can be tempting to reach for ‘comfort’ foods. Or we might indulge in a glass or two of wine.

But enjoyable as these things might seem in the moment, they won’t help your mood, or your health, in the long term.

We’ve put together some of our top lifestyle medicine tips, to ensure you stay fit and well this lockdown.

Exercise

When we’re not allowed to leave the house as often as we normally would, getting some form of regular exercise becomes a must. A twenty-minute run will boost endorphins and lift your mood for the rest of the day. Even a short walk can do wonders for your state of mind.

Try meeting a friend for a walk, a run or even a bit of outdoor circuit training. So long as you make sure you keep your distance from each other. This allows you to meet your social needs as well as getting that much-needed fresh air and exercise.

Diet

Foods that are high in fat and sugar provide a short-lived boost in mood, often followed swiftly by feelings of guilt and self loathing.

Tip: if you are having a craving or feel like snacking, try one of the following:

  • Try drinking a glass of water to see if your craving to eat is subsided by this
  • Wait 20 minutes between the initial craving, and reaching for the snack. If at 20 minutes you’re still thinking about wanting the snack then have it.

Did you know that there are plenty of foods that do actually help to lift your mood in the longer term? Nutrition psychologists claim there is a strong link between the brain and the gut, so try eating more of these foods if you want to avoid feeling low this lockdown:

  • Leafy greens
  • Nuts
  • Beans
  • Seeds
  • Organ meats, like liver or kidney
  • Wild salmon
  • Shellfish like clams, oysters and mussels

It goes without saying that excessive alcohol or caffeine consumption will cause more problems than it solves. Instead, try reaching for a herbal tea? Teas containing turmeric, lemon balm or ginger are particularly good, as these are all proven mood-boosting herbs.
Remind yourself that the craving will pass and that you are helping to improve your health and wellbeing.

Sleep

A good night’s sleep can make everything seem brighter, so staying on top of your sleep pattern is vital to maintaining a positive outlook and generally staying fit and well during lockdown.

Ensuring that you get fresh air and exercise every day, eating a healthy, balanced diet and avoiding caffeine and alcohol will all go a long way to helping you sleep. Some other things you can do are:

Go to bed and get up at the same time every day

If you don’t have to go into an office or get the children to school, it can be tempting to stay up late and lie in, but studies have shown that having regular bedtimes and wake-up times helps your body know when it is time to sleep.

Avoid screens for at least an hour before bed

The blue light in your phone or TV screen decreases melatonin, making it harder for us to switch off.

Develop a bedtime routine

We can all benefit from a routine around bedtime. Make yourself a chamomile tea, have a bath, read a book for half an hour… whatever works for you.

Relationships

This might seem like the hardest thing to achieve in a lockdown situation, but it is vital to maintain social interactions in whatever way you can.

As mentioned above, meeting a friend for a walk can be a great way to achieve this. In fact, many people find they have much more meaningful conversations walking side by side with someone than they would face to face in a café.

If you’re shielding, video calling can be a great way to keep relationships going. Or why not consider getting a pet? There is a reason that demand for cats and dogs has skyrocketed in the past year, pets are a great company.

If you would like to find out more about lifestyle medicine, or how you can look after yourself during lockdown, please get in touch!

The pandemic has had a major impact on the way we live our lives, across the whole globe. Many of us have been lucky, and careful enough to avoid contracting the virus ourselves. But a large portion of society has not been so fortunate.

With all the publicity, you’d be hard pressed not to recognise the symptoms of COVID-19. The first symptoms include a high temperature, shortness of breath, loss of taste and a persistent cough.

The majority of us will recover within a couple of weeks, but there have been an increasing number of reports of some long-term effects. The quality of life, even for some previously ‘healthy’ people, has been affected long after the virus should have gone away. People are suffering from what has been termed ‘long Covid’.

What is long Covid?

‘Long Covid’ is the term that is used to describe the illness of people who have recovered from the virus but continue to have intermittent symptoms for a long time afterwards. It can also include those who have ongoing symptoms long after the virus should have left their body.

As the phenomenon becomes more widely known, a number of studies have been conducted to investigate just how many people are affected by long Covid.

One such study, published in The Lancet in January this year, looked at confirmed Covid patients discharged from Jin Yin-Tan hospital in Wutan, China, between January 7th and May 29th, 2020.

Researchers studied 1733 patients, with a median follow-up time after symptom onset of 186 days – or around six months. Participants completed a series of questionnaires, to evaluate symptoms and health-related quality of life. They underwent a series of physical examinations, as well as taking part in a six-minute walk test and providing blood samples.

The results were quite striking, with 63% of participants experiencing fatigue or muscle weakness. Of those who had suffered the most severe Covid symptoms during their hospital stay, 29% fell below the lowest normal rate of walking in the six-minute walk test.

What about patients who aren’t hospitalised?

Although the findings of the Wuhan study are alarming, one expects a period of convalescence after a lengthy hospital stay. Particularly one that involves admittance to the ICU, as so many COVID-19 cases do.

Perhaps more alarming is the number of people who experience fairly ‘mild’ Covid, but still can’t shake the symptoms several months later. One study conducted in the Netherlands found that nine out of ten people polled reported having problems with normal daily activities three months after the first symptoms of the virus occurred.

The symptoms of long Covid

So what are the symptoms we should be looking out for? Well, as with the virus itself, reports are varied, but these are the main contenders:

  • Breathing problems
  • Fatigue/muscle pain
  • Insomnia
  • Dizziness
  • Chills
  • Purple toes
  • Arrhythmia (irregular heartbeat)
  • Tachycardia (racing heartbeat)
  • High temperature
  • Vomiting
  • Diarrhoea
  • Hair loss
  • High temperature
  • Chest pain
  • Memory loss/confusion

Some patients report suffering all of these symptoms at different times. Others say they can feel fine for weeks at a time, then have a period of a few days when it feels like they’re coming down with the virus all over again.

If you, or a family member, think you might be experiencing long Covid, please contact us today to find out how we can help.

Since the 15th December last year, travellers arriving in the UK can shorten the duration of their self-isolation. This is by undergoing a COVID-19 test five full days after leaving their country of departure.

If the test result is negative, the traveller no longer has to self isolate. But lockdown rules must still be observed.

What does it mean to be a provider?

Travellers must pay to undergo the test privately, and The Mayfair GP is on the list of ‘test to release’ private providers. The providers on this list are meeting the standards laid out by UKAS (the United Kingdom Accreditation Service).

Has ‘test to release’ recently changed with the new travel rules?

The short answer is ‘no’. Travel corridors have been temporarily suspended, and all travellers to the UK must now produce a negative Covid test prior to embarking on their journey.

The 10-day period of self-isolation on arrival still applies, however, and you can still shorten this period by choosing to undergo a *Covid test with an approved provider.

*some countries are excluded from the test to release scheme – please speak with our team to discuss this further.

How does a ‘test to release’ Covid test work?

Here at The Mayfair GP, we can offer both the PCR swab test and the antibody test. For the test to release scheme, currently only a PCR swab test has been cleared for use.

The service we offer is as follows:

  • A pre-visit phone call to establish which country you have travelled from, whether you have experienced any symptoms, and to discuss any queries you might have
  • We will then come to you to perform the test either at your home or your hotel, wherever you are spending your self-isolation period, wearing full PPE
  • Once the test has been performed, we will courier the swab or blood sample to the lab for testing
  • As soon as we have the results we will get in touch via telephone or email to discuss the next steps

What if my result is positive?

If your Covid test produces a positive result the doctors will contact you via telephone to discuss your symptoms and advise you further with regards to caring for yourself and further isolation.

If the result is negative, however, you are free to leave self-isolation. You can resume your normal daily activities, as far as the current lockdown rules allow.

The Mayfair GP can offer tests in your home or hotel, with 24/7 availability. Please contact us by emailing info@themayfairgp.com for more information or to book your test.

The Mayfair GP has been added to the government list of private sector COVID-19 testing providers.

This news means that we can offer both the COVID-19 PCR Swab Test for the virus, and a COVID-19 Antibody Test. These tests are done at different points of the illness, but one of our doctors will talk to you beforehand to make sure you have the right one.

We are also able to offer COVID-19 PCR testing for the ‘Test to Release’ scheme and for international travel.

Safe, quick and easy testing in your home

Our COVID-19 testing service gives patients, families and visitors staying in the London Mayfair/Maida Vale/Marylebone/Chelsea area, the opportunity to have a check performed safely and conveniently in the comfort of your home or other place that is suitable to you.

For nervous patients, those with limited mobility or no transport, it allows quick and easy access to a test, as well as speedy results. You will not then need to travel to a testing centre.

How do I book a COVID-19 test at home?

The first step is to contact The Mayfair GP, either by emailing info@themayfairgp.com and let us have your contact details. Alternatively, you can call us on 07568 369455 and leave us a message.

One of our doctors will call you back, will go through your medical details and will explain what happens next.

What happens on a home visit?

When we have organised a home visit with you, we will ensure that all full PPE is worn by the visiting doctor. You don’t need to worry about them entering your home.

The Mayfair GP can provide both antibody testing and viral testing at home, the latter will show if you do or don’t currently have the virus.

We can see patients that are symptomatic or in at-risk groups. We can also register new patients, so you do not need to be an existing patient to access this service.

When will I get my test results?

The Antibody (blood) Test will give you an instant result, but we will courier the PCR Swab Test to the lab immediately. The Swab results are normally back within 24 hours but occasionally this can take a little longer in the event the result is not conclusive and has to be run again.

There will be a follow up phone call with the results, and we can advise you what to do next.

How much does a COVID-19 test cost?

The COVID-19 PCR Swab Test costs vary in pricing and will depend on the type of test you are having and depending on your location. The tests start at £300 for the Antibody Test and £342 for the PCR Test. You can find out about the price you will pay when you book a test.

If you need to arrange for The Mayfair GP to visit you, please get in touch by emailing info@themayfairgp.com .

Dermatologists have noticed an uptick in a type of skin sore known as chilblains — painful red or purple lesions that typically emerge on fingers or toes, and usually in very cold temperatures — in patients with Covid-19.

The lesions are showing up mostly in children, teenagers and young adults with mild or even asymptomatic cases. Some experts believe it to be a healthy immune response and a sign that a body is fighting the infection. While federal health officials do not include toe lesions on the list of coronavirus symptoms, dermatologists are pushing for a change, saying so-called ‘Covid toe’ should be sufficient grounds for testing.

If you or a family member develops these symptoms, please contact us at The Mayfair GP, for further advice.

By and large, we have had very few reports of children getting affected or indeed infected by this virus. However, this does not mean that children cannot get infected. The commonest involvement for children is as asymptomatic carriers. This means that they have no symptoms but could transmit the virus from, say their teachers to their parents, or from their parents to their grandparents.

Similar to the cases in adults, the children that we see suffering severe symptoms with this infection and requiring hospitalisation are those that have pre-existing medical conditions. Again, as in adults, this does not mean that a relatively healthy child cannot be infected and suffer from symptoms.

Rather than receiving and forwarding messages on social apps like WhatsApp (and contributing to panic), we would prefer if you called the doctor and had a chat. This can also help you to disseminate more accurate information to your loved ones and friends.

Something worrying that has recently come up and prompted this is the following article:

Children and Covid-19

Again, if unsure, please speak to our doctor who can help clear things up for you and your children. Call us on ‭07568 369 455‬.

dental hygiene in lockdown

‘Lockdown’ your Dental Hygiene

This is not our area of expertise; however, as most dental surgeries are closed we are trying to manage the conditions that we feel comfortable doing with a telephone or video consultation.

We have attached below some advice on dental hygiene.

Brushing your teeth

Brush for at least 2 minutes, twice-a-day using a toothpaste that contains at least 1350ppm-1500ppm Fluoride. Children under 3 years should use a smear of toothpaste, whilst children aged 3-6 years should use a small pea-sized amount. It is important to brush last thing at night and at least on one other occasion in the day. After brushing, spit out the excess and remember not to rinse your mouth or use a mouthwash immediately after. (Activity idea: Brushing technique would be a great skill to pencil into your child’s learning schedule.)

Interdental brushing and flossing

To ensure your gums stay healthy, anyone over the age of 12 should use interdental brushes between their teeth daily. For really tight spaces try dental floss or tape. Lockdown is the perfect time to experiment with interdental brushes and floss so you can incorporate this into your daily routine. (TIP: if you’ve never used interdental brushes before try a small size first then work up to the largest size that fits in the space comfortably.)

Snacking

We have all been reaching for the snack drawer a little more than usual during this period. Aim to keep snacks between meals sugar-free, and keep an eye out for those hidden sugars particularly in ready-made meals and ‘healthy’ snacks. Try and keep the sugar in yours and your children’s diet as low as possible by reducing the amount of sugar you consume, and the frequency of how often you consume sugar during the day; Eat less sugar, and eat it less often. (Activity: As part of your child’s learning get them to identify healthy foods from a selection from your cupboards)

Braces

Your orthodontist will have given you instructions on how to care for your braces when you had them fitted. It is important to follow these instructions so that you get the best result for your smile from your braces. Brushing twice a day and limiting the sugar in your diet is very important. You can use an interdental brush between the teeth to keep the areas around your brace and in-between your teeth clean, as well as using other brushes recommended by your orthodontist.

Dentures

Ensure you remove your denture at night and clean it thoroughly using warm soapy water and a brush over a basin filled with water (in case you drop your denture: you don’t want it to hit a hard surface.) If you prefer you can soak your denture overnight in water with added denture cleaning solution, please use the solution that is correct for the type of denture you have.

Also, remember to be extra careful with your denture as it may be difficult to repair or replace the denture during this period.

As always, if you have any queries or concerns about your health or your child’s health then please do get in touch with our doctor.

Credit: Rodericks Dental Clinic, Marylebone

HRT and Coronavirus

HRT and Coronavirus

It is estimated that around 75% of menopausal women experience symptoms and that around 25% of these women experience severe symptoms that are having a negative effect on their lives, often affecting their family and work lives.

The menopause symptoms that affect women the most include:

  • low mood
  • anxiety
  • reduced self-esteem
  • poor memory and concentration
  • reduced libido
  • vaginal dryness

Managing women with symptoms of the menopause is a very rewarding aspect of clinical practice. There are now excellent guidelines available, both national and international, for healthcare professionals on the management of the menopause 1-3. However, these guidelines have not been read by many healthcare professionals which means that many women are being denied evidence-based treatment. All the guidelines support the notion that for the majority of women starting HRT when they are under 60 years old, the benefits of taking HRT usually outweigh any risks.

Please do contact us if you are worried about being in the menopause and wanting to start HRT (Hormone Replacement Therapy).

A new statement has been released from the British Menopause Society, along with RCOG, RCGP and FSRH, urging all doctors to avail HRT consultations via video or telephone. This is in addition to providing easy access to repeat prescriptions (which is a service that the Mayfair GP provides).

The societies mentioned above realise the importance of HRT and thus the aim is to ensure that menopausal women do not struggle to obtain their HRT prescription in these difficult times.

Please read the British Menopause Society statement below from the 25th of March 2020:

We recognise that many women are likely to experience difficulties in obtaining HRT supplies due to the current coronavirus situation. We also appreciate that continuing HRT intake is likely to help many women control their often difficult menopausal symptoms, which is particularly relevant given the additional stress some women may be under in view of the strains of the current situation on society.

Furthermore, General Practitioners’ surgeries have also been put under additional pressure, with consultations and advice prioritised to dealing with serious and potentially life-threatening medical issues.

Recognising the current constraints, we recommend that General Practitioners and healthcare providers consider advising women about menopause issues through telephone and virtual consultations where at all possible to reduce face to face engagement, and with easy access to repeat prescriptions of HRT supplies (especially to women who have been on HRT and have not been experiencing any problems with their intake). This will help to avoid the need for many women to visit their GP surgery to discuss these issues and assist with obtaining repeat prescriptions.

Haitham Hamoda, Chairman, BMS

Edward Morris, President, RCOG

Martin Marshall, Chair, RCGP

Asha Kasliwal, President, FSRH

Coronavirus and heart disease

Coronavirus and heart disease

We have seen it fit to share the below information from the British Heart Foundation. However, should you be unclear or feel you need to speak to someone in more detail, please call to speak to our doctor.

I have a heart or circulatory condition – am I at increased risk of coronavirus?

We know that this is a frightening time for lots of people, especially if you have an existing health problem. Most people with coronavirus (COVID-19) have mild symptoms and make a full recovery. Having a heart and circulatory condition probably doesn’t make you any more likely to catch coronavirus than anyone else. But if you have a heart condition it may mean that you could get more ill if you catch it, which is why it’s really important to protect yourself.

Anyone with a heart condition is considered high risk of more severe complications of COVID-19 coronavirus.

Should I still call 999 or go to hospital if I’m worried about my health?

Whether or not you have Coronavirus symptoms, it’s essential to dial 999 if you have symptoms that could be a heart attack or stroke, or if your heart symptoms get worse. We are hearing that fewer people are being seen in hospital with heart attacks in recent weeks, which suggests that people are not seeking help when they should do. Don’t delay because you think hospitals are too busy – the NHS still has systems in place to treat people for heart attacks. If you delay, you are more likely to suffer serious heart damage and more likely to need intensive care and to spend longer in hospital.

You should always dial 999 immediately if your chest pain is sudden, spreads to your arms, back, neck or jaw, and feels heavy or tight, or if you become short of breath or start to feel sick.

You should also dial 999 if you have signs of a stroke, such as your face drooping on one side, can’t hold both arms up, difficulty speaking. You should also dial 999 if you are having severe difficulty breathing (such as gasping for breath, choking, lips turning blue, or not being able to get words out.)

Am I in the “extremely vulnerable” group who need to stay at home for 12 weeks?

Some heart patients are considered at extremely high risk of severe illness from coronavirus. You are classed as extremely vulnerable (at highest risk) if:

  • you have had a transplant at any time, including a heart transplant
  • you are pregnant and have significant heart disease – defined by experts as any of the following: coronary heart disease (if you have symptoms), hypertrophic cardiomyopathy (if it affects your heart function), thickening of the heart muscle (left ventricular hypertrophy) caused by high blood pressure, pulmonary arterial hypertension, a narrowed or leaking heart valve if this is moderate or severe, heart failure that affects your left ventricular function, significant congenital heart disease

If you are in one of these groups, you should protect yourself by staying at home, and minimising contact with people you live with, for the next 12 weeks. This is called shielding. If this applies to you, you will be contacted directly by the NHS with further advice. If you think you fall into one of these categories but have not received a letter, email or text by now, you should discuss your concerns with our doctor.

I don’t fall into one of those groups: am I still at high risk from Coronavirus?

Even if you are not at highest risk, you may still be at particularly high risk because of your heart condition if:

  • You have heart disease and you’re over 70
  • You have heart disease and lung disease or chronic kidney disease
  • You have angina that restricts your daily life or means you have to use your GTN frequently
  • Heart failure, especially if it restricts your daily life or you’ve been admitted to hospital to treat your heart failure in the past year
  • Heart valve disease that is severe and associated with symptoms (such as if you regularly feel breathless, or you have symptoms from your heart valve problem despite medication, or if you are waiting for valve surgery). A heart murmur that does not cause you symptoms doesn’t put you at high risk
  • You’re recovering from recent open-heart surgery in the last three months (including heart bypass surgery)
    Cardiomyopathy (any type) if you have symptoms such as breathlessness, or it limits your daily life, or you’ve been told you have problems with your heart function
  • Congenital heart disease (any type) if you also have any of the following: lung disease, pulmonary hypertension, heart failure, you’re over 70, you are pregnant, or if you have complex congenital heart disease (such as Fontan, single ventricle or cyanosis)

Read our information about Coronavirus if you have congenital heart disease.

If you are in one of these groups, the advice is the same as for everyone in the UK (except for the extremely vulnerable, who have to be even more careful to protect themselves): stay at home apart from essential needs.

If you don’t fall into one of the groups above, having a heart condition or any of these issues means you are at high risk – again, you should stay at home, apart from essential needs:

  • Coronary heart disease, such as a past heart attack, stent, or bypass surgery (at any time)
  • Over 70 years old
  • High blood pressure (hypertension)
  • Pregnancy
  • Diabetes
  • Lung disease, including asthma
  • Chronic kidney disease
  • Stroke
  • Vascular dementia or small vessel disease in the brain
  • Body mass index of 40 or over (severely obese)
  • Smoking – because the act of smoking (putting your hand to your mouth) increases your risk of catching it, and because it damages your lung health. If you smoke, stop today

What information do you have for people with Brugada syndrome or Long QT syndrome?

If you have Brugada syndrome or Long QT syndrome and get coronavirus symptoms (especially a high temperature), you should call our doctor and tell them about your heart condition, and ideally let your cardiology team know. This is because you might need extra ECGs to monitor your heart, and your heart condition may affect what treatment for COVID-19 is right for you. It is important to try to bring your temperature down quickly by taking paracetamol, to avoid a very high temperature triggering a heart rhythm disturbance.

I have atrial fibrillation – am I at risk from coronavirus?

If you have atrial fibrillation, there isn’t enough information at the moment to tell whether it or other abnormal heart rhythm problems put you at higher risk from coronavirus. It seems likely if you have well-controlled atrial fibrillation, that your risk is lower than for the groups mentioned above.

I have a pacemaker – am I at risk from coronavirus?

If you have a pacemaker, whether or not this raises your risk from complications will depend on the reason why your pacemaker was implanted. There is no evidence that the virus itself infects pacemakers or ICDs, or that it causes endocarditis.

COVID-19 coronavirus is a new disease and we don’t know everything about who is most at risk of complications. Other heart patients may still be at particularly high risk or high risk. This list is based on the best information available from relevant experts. It’s possible that other conditions could put you at risk that we don’t know about yet, so it’s important that everyone works hard not to catch or spread coronavirus.

 

Credit: British Heart Foundation