What’s it like to catch COVID-19?

Linda Greenwall interviews London dentist Richard Prais – one of the earliest confirmed cases of COVID-19 in the UK.

Richard Prais was one of the first dentists in the UK to contract COVID-19. He was between cases 52 and 86 at the time of receiving his test result. Now, more than five weeks on from testing positive, he is listed as having recovered from the illness.

How are you feeling today?

I’m completely better now – although I still have a bit of a cough (I have fully recovered now without any symptoms).

How do you think you contracted COVID-19?

I had been on a skiing holiday to Switzerland at the end of February. I think it was either there, or on the way back, which took me via Milan Linate airport.

How did the disease progress for you?

I was totally fine for a week after returning from Switzerland: I arrived home on 23 February and went back to work on 24 February (a Monday). Then I worked for the week and then started feeling lousy on the weekend. A headache started on Friday morning, which I thought was TMJ-related, so I planned to stay at home that weekend.

I woke up at 3am on Sunday (1 March) with severe diarrhoea (an unusual but classic symptom), fever and stiff, achy limbs. To be honest I thought it was a gastric infection: I had no breathing difficulties or chest pains at that point. I went for testing at the Whittington Hospital later that day.

By Tuesday (3 March), the fever had been present for three days. The hospital called on Wednesday morning, telling us that I had tested positive for COVID-19. My wife was negative. Ironically, by the time I received the positive test result I was fully recovered.

What happened after you found out you were positive?

I called my two sons (aged 26 and 23) to come home so that they could be tested. I then called PHE for advice on what to do in the practice. PHE didn’t advise me to contact my patients – in its opinion at that time, as I was non-febrile at the point of having contact with them, I was not infectious.

My own cough developed a few days later. I had a very mild case; my cough wasn’t painful or annoying, although it got worse about a week later.

How did you approach it with your practice?

The practice has been shut since 4 March.

PHE was certain that I was not infectious, so the practice could remain open. But the advice it was giving changed 10 days later.

But some of the staff were told to go home by 111. To be honest, neither 111 nor PHE were helpful. We were trying to act with responsibility and integrity but the advice differed, depending on who we spoke to.

One of our patients called the local newspaper and suddenly reporters were calling the practice incessantly. The press coverage was mortifying. People were making up stories about me and the practice, and it was heartbreaking to have our integrity questioned. But our patients have mostly been positive: one, a teenage boy, sent me messages of support and those things helped enormously.

Things are tough now, as I think they will be for everyone. Income has dried up and the uncertainty about funding has meant that we have had to put our staff on furlough. We obviously can’t do any face-to-face consultations, but I’m trying to field calls from patients where possible. A lot of them are starting to experience sinusitis and TMJ problems in light of the stress of being in lockdown.

The BDA is lobbying government, and it’s been working really hard to sort these issues out, but it’s still very uncertain.

What’s your advice to other practices?

Cut all costs, simply. Contact certain companies immediately, if you haven’t done so already – finance companies, banks, mortgage providers, suppliers.

Many of our suppliers are being very helpful. Henry Schein is offering interest-free finance on outstanding bills. SOE can put all costs into ‘pause’ mode and has been willing to freeze the cost of extra licences. Both of these companies have been really helpful.

Having these sorts of conversations is sparing a few thousand pounds per month off the business costs, and preserving cashflow.

We put a spreadsheet together documenting all of the ongoing costs of the practice (DPAS can supply one if you don’t already have one), which is helping us pay percentages of what’s coming in.

Not every company has been as understanding, of course. We had a few issues over a new scanner we purchased recently. But after conversations the company backed down and I’m glad to say that we’ve had no further issues.

At this point, we’re chasing the patients who owe money. There were some priorities for that money last month: the staff, the laboratories, who are always good to us. Most people understand that these are unprecedented times, but you still need to be fair to everyone.

What’s next?

I’m blessed that I had a mild case, and that my boys are home and we’re spending time together.

But the worry over the practice and the stress caused by lockdown are taking their toll. I don’t know when things will return to normal, or what sort of procedures we’ll be able to carry out when they do. There is an enormous amount of dental work building up. So organising your appointment book will play a big part in getting back on track financially.

Some of the struggles are going to be harsh, though. Lots of things will change forever thanks to COVID-19, not least of which is how hard it’s going to be to buy FFP3 facemasks in future!

Building up resilience and using this time to organise and prepare for what happens next is probably the best thing to be doing right now – as for the rest, we’ll see!

Published first in Dentistry magazine.