Abbreviations can be tricky things. If my patient has PID, is that a prolapsed intervertebral disc, or pelvic inflammatory disease? And when I document ABH in the notes, am I raising a concern about bowel cancer due to altered bowel habit, or documenting a brush with the law and a conviction for actual bodily harm?
I thought I’d learnt all the medical abbreviations that I’d ever need, but there is a new kid on the block. ‘Normal LFT’ no longer automatically signifies that the liver function is normal but might mean that my patient has done a lateral flow test (LFT) that has come back negative for COVID-19.
I’m sure that, like many people, I have dozens of lateral flow test kits hanging around at home. My secondary school-age child gets them sent home from school and I take them regularly for work. Friends who walk past testing stations on their way to work report that they have to avoid eye contact for fear of having another pack of test kits thrust into their hands.
But, despite how many of them there are, LFTs are still not always being used in the right way, so is it pleasing to hear that pharmacies are going to be able to distribute these test kits under the Pharmacy Collect service. Tests will be given out by pharmacies, to be done at home, and those collecting the kits will need to answer three questions: have you used these before; why do you need them; and what is the age of the person using the kits?
These questions are really important. Public understanding of COVID-19 is, in my opinion, pretty poor. The pandemic has seen the development of “Schrodinger’s cough” – a cough that is so bad that the coughing person rings their GP to ask for antibiotics, but is simultaneously definitely not bad enough for them to feel they need to self-isolate or take a test.
If I had a pound for every febrile coughing person who has rung me in the last year (and here I really need a facepalm emoji), I’d be retiring to a Caribbean island as soon as restrictions allow. Similarly, many patients have told me that they don’t need to take a test because they have a cough but no fever, or that “it’s definitely not a COVID cough, doctor”.
The latest frustration is those who ring up and say that they have a cough or fever, but that it’s fine because they’ve done a lateral flow test and it is negative – completely failing to understand that lateral flow tests are only for asymptomatic carriers. They are not sensitive enough to be used for people who have symptoms of COVID-19.
This message is clearly not getting out there with the distribution of test kits as it is at the moment, and so the involvement of healthcare professionals such as pharmacists in giving out the test kits will hopefully help to remedy this. I hope that those who get kits from pharmacies will read the advice sheet, which clearly states that kits are for those who don’t have symptoms, and that if the advice appears unclear to them then the pharmacist will be able to explain the three key messages:
- These are for asymptomatic people
- A positive result needs to be confirmed with a polymerase chain reaction (PCR) test
- A negative test doesn’t affect the need to follow whatever social distancing rules are in place at the time, because the test isn’t 100% accurate.
I am looking forward to the next relaxation of lockdown restrictions and undoubtedly LFTs are a key part of this return to normality. Pharmacists and other healthcare professionals have an important role to play in making sure that the public understands when they should and shouldn’t be used. Hopefully Pharmacy Collect can contribute to a greater public understanding.
Toni Hazell is a GP based in a practice in London