A total of 40,000 people are waiting for a test for coronavirus in Dublin, according to figures published at the weekend. Odhrán Allen, a 47-year-old asthma sufferer, is one of them. He’s now on his sixth day of waiting.
Last week, he described his frustration at the wait, and lack of communication from the HSE, to the Irish Times.
Allen developed respiratory symptoms, along with a cough, fever of 40 degrees, and what he described as a “raw” feeling in his chest on Sunday, March 15th. On Wednesday, March 18th, his GP referred him for a test for Covid-19. They both felt he was likely to be suffering from a chest infection, but she wanted to rule out Covid-19, because if he had the virus, it would have implications for the treatment of his asthma. “My GP couldn’t give me steroids to help with breathlessness until she knows if I have the virus, as they might suppress my immune system,” he says.
A recent comment piece in The Lancet by Dr Kenneth Baillie advised that, “In our view, steroids should not be used outside of clinical trials for treatment of Covid-19, unless clinically indicated for another reason.” Dr Baillie wrote that “we not advocating that patients, who have already been prescribed steroid for existing conditions, like asthma, stop taking this treatment. Furthermore, we stress that there is not sufficient evidence on steroids and Covid-19 to determine its effects, without clinical trials.”
Comment pieces are commentary by experts in the fields that represent their own views, rather than the view of The Lancet. The HSE’s advice is that people on steroids should continue to take them, unless their doctor tells them otherwise, even if they develop coronavirus.
Over the weekend, Allen’s breathing got worse. By Sunday evening, he was really struggling. “In the end it got to the point where I knew I needed some help,” he says. “My GP had advised that if my breathing deteriorated I should call an ambulance. I was reluctant to do that because I was afraid to go to hospital, in case I contracted the virus there.”
But at about 8pm, with his breathing increasingly laboured, he called an ambulance. He was warned that he was number 22 on the list, and there would be a wait. It took two-and-a-half hours for the ambulance to arrive. “There’s an infection control protocol in place,” he says. “Between every call out they have to disinfect the ambulance.”
Allen was taken to the specialised unit at Beaumont where suspect Covid-19 patients are treated. Triage was carried out there by medics in full protective gear, and he was assessed as being low-risk for the virus. “They did the routine assessment that I would normally get. They felt my oxygen saturation was okay, so they weren’t concerned about that. I had taken Solpadeine when I was waiting for the ambulance, and my temperature was normal. They listened to my chest and said it was very wheezy, so they felt it was most likely asthma.”
In the past, Allen has been treated by nebuliser, but it was felt that if he did have Covid-19, the virus could be spread through the nebuliser mist. He was prescribed oral steroids and advised to continue self-isolating, and taking the antibiotics prescribed by his GP at home.
“I got to Beaumont at around 11.15pm and I was discharged from the emergency department just before midnight. It was the quickest visit I’ve ever had,” he says.
But the question of how he was going to get home presented another, unexpected difficulty. Neither he nor his partner has a car. The usual option of a taxi was ruled out, because he couldn’t risk infecting someone else. So he had to call his brother – even though he had been isolating himself from family members. “The hospital provided me with a mask to wear in the car, and I used a lot of sanitiser gel, but I’m really worried about the possibility of having infected him, even if there is a small chance I do have the virus,” he says.
Back at home, he is feeling slightly better. “The steroids have definitely helped. The symptoms of asthma have abated. My chest is less congested, and the wheeze and breathlessness are gone. I still have soreness and a rawness in my chest. And I still have a slight temperature of 38.3.”
But he’s still waiting to hear from the HSE about when he will get tested. “I’m on day six of waiting. It’s day eight since I first got sick. I understand there is a backlog and there are higher-priority people than me, like frontline healthcare staff, and people who are immune-compromised.
“But what I have a real problem with is the lack of communication from the HSE. I don’t even know if they have received the referral. They need to consider the impact of the delay in testing on patients like me, where normal treatment options are affected by a possible diagnosis of Covid-19,” he says.
“I’m really conscious that this is an unprecedented situation, and everyone is trying their best, and that the officials are learning as they go. But in my case, the delay in testing led to me having an asthma attack. Nobody intended that to happen. It’s a consequence of me not having the test.”
This article was edited on Tuesday March 24th to clarify details from the Lancet's article on steroids and Covid-19.
