Dr Patrick Dixon on the future of eye health care
In the past week, renowned futurist Dr. Patrick Dixon led a webinar to share his views on the impact of Covid-19 on the eye health industry.
Hosted by Dr. Clare O’Donnell, Head of Optegra Eye Sciences, and sponsored by Doctify, Dr. Dixon explored the nature of this enemy virus, biological impact and implications for opticians.
Dr. Dixon has warned many times of the risks of new virus pandemics, over the past 25 years.
He stated that the real weapon is the genetic code in the centre of the virus, as he drew attention to viewers that only 10 million have been affected out of 7.8 billion people… so we are still in the earliest stage of the pandemic.
He stated that 85% of the 7.4 billion who have never been infected by the virus live in poorest parts of world – e.g. in the slums of Calcutta – and that most of the pandemic is now in emerging nations which will shape pressures on the UK in months to come.
He pointed out that 80% of infected people seem not to get Covid-19 symptoms. A few of these are ‘super spreaders’ who are much more infectious than others. A single super spreader at a conference could easily cause half the participants of a conference to become infected themselves, and such things have happened.
Since most people do not have any symptoms, temperature checks in isolation have limited impact.
Children seem relatively immune, possibly because they have been exposed to other types of coronavirus such as the common cold, and so have immunity – we just do not know yet.
80% of deaths are in those over the age of 80 – and most of those between the ages of 50 and 80 who die with COVID-19 have multiple medical problems or are very overweight.
Germany offered a recent example of the importance of managing the virus locally. A very sophisticated economy, it had a big cluster in a meat packing factory and spread to local town and the R number leapt to 2.7 nationally as a result in just three days.
We need to be aware of the possibility of local spikes which will need to be managed locally rather than nationally from now on. We have already seen this in Leicester.
A further challenge is not knowing how long immunity will last. It may be just a few months or a year or two – this is a big challenge for the scientists working to create a vaccine, which in any case may take over a year to develop.
In the world of optometry, the government is hoping the backlog of patients with serious sight issue can be dealt with as fast as possible, so that those patients can return to work and earn a living or return to their studies. And then to continue with non-urgent treatments as well.
The Government does not know when the next flare ups of infection will come, which may close opticians in a town for another few weeks. So, the aim should be to help as many patients as possible before potentially having to shut down again. That may mean opening earlier, closing later – as many other sectors are doing.
Dr. Dixon said that while we can hope for better vaccine and treatments, in meantime the industry needs to be very agile.
It is a particular challenge for people who are self-shielding of course, making it very hard to receive or deliver eye care. We need to understand multiple levels of risks here, and ways to reduce risks, such as not speaking when doing close-up eye tests.
Many people have asked about patients who present with conjunctivitis, is this a COVID-19 risk? Professional guidance is that while COVID-19 does indeed cause sore eyes in some patients, this is usually only after a cluster of other symptoms have developed, and it would be very unusual for someone therefore who is otherwise completely well to present with conjunctivitis.
Dr Dixon concluded that the guidelines are really about using common sense, taking care at all times, and using initiative to reduce risks wherever possible, without damaging the service that patients need – which is often a fine balance to achieve.