Last edited 14 September
Reliable data about the corona crisis (COVID-19) in Dutch general practice has been scarce from the beginning. Since March 2th, the Fame-Net (Radboud University Medical Centre Family Medicine Network) has carefully registered all care contacts related to COVID-19. FaMe-Net registers all doctor-patient consultations within an Episodes of Care structure. This includes diagnoses that may alter during an episode of care, and all encounters within this episode of care. All morbidity is carefully classified in accordance with the International Classification of Primary Care (ICPC).
The interest of this trend data is that it gives insight in the course of the epidemic and the effect of government measures. This will be first visible in a reduction of COVID-19 infection diagnoses in general practice. Reduction in hospital admissions and intensive care unit stays will be visible only days to weeks later. On our website we have been refreshing our data on a daily basis.
The number of COVID-19 cases in general practice initially was steadily increasing, but the curve flattened gradually. Until now, in the Netherlands, only about 10% of the clinically highly suspected cases have been tested with PCR-tests. In the beginning, half of the people with a positive test consisted of healthcare staff who – on the advice of the Public Health Authorities – always passed the results to the practice often without having serious complaints themselves (Chart 1 and 2). In the past months positive cases are mainly tested cases, often not ill at all.
Patients who have a COVID-19 infection report to the GP a variety of complaints (Chart 3). People often report in the first week after the onset of complaints. Less than 15% of patients have complaints for more than a week at first contact. To date, only 6% of patients with suspected COVID-19 infection have been referred to secondary care (Chart 5).
General practice received a striking number of questions about COVID-19 from the beginning of the crisis, but in the course of the months the number of questions related to COVID-19 has dropped considerably. (Chart 4). Compared to encounters for respiratory complaints in the winter of 2019, it was a multiple. About 80% of all requests regarding COVID-19 were handled by phone. In Nijmegen, patients suspected of possible COVID-19 infection (fever and / or respiratory complaints) are still seen as little as possible in day-practice. At the top of the epidemic, a separate GP post for suspected cases was manned 24/7. Home visits have been carried out by own GPs.