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#Covid19ResearchVoices: Research in primary care: It’s a matter of PRINCIPLE

Covid-19 Research Voices: Margaret Ipkoh

Published: 15 May 2020

Dr Margaret Ikpoh, a GP from Hull, describes the impact Covid-19 has had on her practice, the changes to the way they work such as remote consultations and the surge in other practices keen to be involved in research. Part of the Covid-19 Research Voices series

“Brace yourselves!” read the warning I texted on Friday 31 January to possibly the hundreth WhatsApp group I had been added to since the start of the new year. This was my response to the news that two students in York had tested positive to the unfortunately named at the time ‘Wuhan infection’. Little did I know that less than a month later I would be repeating the same words to my puzzled children upon discovering that toilet paper had become the most valuable commodity on a supermarket shelf.

In our pre-Covid days, we were involved in several clinical studies that reflected the breadth and length of conditions presenting to primary care.  I’m aware that not everyone is a fan of, or has undergone a conversion to all things research like myself.  It has however always  baffled me when people query the value of research in primary care, particularly as this is where 90% of patient facing contact occurs.  A few months ago I was asked “what happens when the research dries up?”... but then along came Covid-19.

Overnight, it feels as if general practice has gone from 0- 60 in a heartbeat. The working week now consists of remote consulting, transitioning between hot and cold hubs, ‘Zooming’ in and out of meetings and webinars and ‘coronadosing’ on daily government debriefs.  We have engaged with the RCGP RSC  (Royal College of General Practioner’s Research and Surveillance Centre) flu surveillance scheme for a few years and once it became evident we were dealing with a possible pandemic, we received instruction to start swabbing those who met the case definition. This allowed earlier detection and helped us with workforce planning in the earlier stages of the pandemic.   We anticipated that our care homes would be adversely affected and so a couple of weeks into the pandemic, we trained up care home staff to take swabs from symptomatic residents. Sample serological testing followed, taking an additional blood sample  from patients who present to our phlebotomy clinics to look for ‘game-changing’ antibodies.

We have started recruiting for the PRINCIPLE trial, a study investigating potential treatments for Covid-19 in older patients with symptoms, with the aim of helping them recover more quickly and avoid going to hospital.

Our research team has been remarkably busy, as other diseases have not disappeared and we are still committed to our other non-Covid studies.

This unprecedented event has led to an unprecedented surge in practices keen to be involved in research. We are fortunate that we have always had an engaged patient population who are keen to ensure they are involved in improving patient experiences and care.
This pandemic has also been the catalyst to dramatic changes in the way we work. We have had a boom in remote consulting, digital innovation and even a change in dress code. My ‘scrubbed up’ look is here to stay!

Sadly, some of us have had personal losses along the way. I am now writing more death certificates than I can remember. The studies that explore the psychological impact on us all in the post-Covid era will be just as important as any other priority Covid research.

For now, I am grateful for so many things that I would not even have considered worthy of gratitude on New Year’s Eve,  such as  camaraderie, spending time with family, hugs, freedom of movement  and yes even bizarre and benign inanimate objects such as toilet paper.

Dr Margaret Ikpoh, MuDr FRCGP DRCOG DCH PGDip, GP Partner Holderness Health

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