Opinion
Why I hang around public toilets watching what you do with your hands
Jenna Price
Columnist and academicI do not miss COVID-19 lockdowns. I could rarely pinch the cheeks of my middle-aged children or go for a walk on the beach. Mind you, I’m kind of locked-down now, glued to the Fox sisters doing it for themselves, their mum … and me. But at least that’s from choice.
Here’s what I do miss – the way people behaved about matters of personal hygiene. Social distancing. We covered our coughs. We turned when sneezing. And, hallelujah, we washed our hands.
Ready, aim, WASH!Credit: Getty Images/iStockphoto
I spent quite some time in the early 2000s hanging around public toilets. I wasn’t interested in picking anyone up, but I was obsessed with what happened when women emerged from their cubicles. We already knew men don’t wash their hands after emptying their bladders, despite actually holding their hoses. But it turns out that women weren’t that much chop in the hand hygiene department either, although women know more about hand hygiene and are less likely to dry their hands on their bums.
Then came 2020, when we discovered a good reason to handwash. Major plus! It lessened our risk of dying. And for a year or two, we remembered those lessons.
I’m reminded of this because, last week, I saw a legendary local GP. She’s a bit of a goddess around our way. Always available (including weekends). Serious about her vocation but comforting and funny in her delivery. The posture and demeanour of someone 20 years younger. For anyone who wants to complain that this is ageist, let me explain that she’s at least 10 years older than me, and I’m constantly exhausted by life.
But she was no energiser bunny when I saw her last. She was hollow-eyed, slightly stooped and uncharacteristically quiet. Turns out, it was the worst winter she could recall, she said sadly. A friend was at that practice on Monday of this week and said the receptionist was constantly on the phone rearranging patient visits because one of the GPs was off sick.
What my legendary local GP described was the influx of patients with flu, colds, RSV, pneumonia and unexplained coughing and sneezing. And that was just in our household alone! I joke (not really, we’ve had everything including walking pneumonia, also known as mycoplasma). Adrian Esterman, professor and chair of biostatistics and epidemiology at the University of South Australia, says even that’s increased. Apparently we are due for an outbreak every three to seven years.
“The last outbreak was 2015, but people were taking protections [handwashing, social distancing, masks] so we didn’t get it,” he told me. “We’ve stopped doing that so we are wide open to catching it.”
Sure, I live with two small children for whom a river of snot emerging from their noses is constant, unyielding, and they are too fast for me to catch and wipe. (Yes, I would wash my hands afterwards.) This has been a diabolical winter and some of that has been our fault. All the lessons of COVID-19 have gone out the window, which we keep firmly closed. No air filters on either. As Esterman says, we’ve stopped taking care.
Individual weeks go up and down but here’s the overall trend. So far this year, the rate of new fever and cough symptoms per 1000 consultations per week has generally remained above the rate observed at the same time in earlier years, according to the Australian Respiratory Surveillance Report (although we hope nothing will be as bad as the winter of 2019 – perhaps the health gods were getting us in practice for COVID-19). We don’t yet have comprehensive data on GP visits over winter, but here’s what we know so far from lived experience.
Graeme Horton practises as a GP in Newcastle. More importantly, he’s the head of general practice and primary care at what I would describe as the most innovative medical school in the nation, the University of Newcastle. Remember, these were the folks who instituted interviews for prospective students so we would actually get GPs who could talk to patients.
Like my beloved local GP, he’s also noticing that the practice he works in has had to cancel patient appointments when doctors are sick. “We are struck with this every day when we have one or more doctors away [because of illness or close contact],” he says.
All this would be fine if we had enough GPs who could work as temps (I think they call them locums). But we don’t have enough GPs either because medical students don’t really want to sign up for what is often reported as hugely long hours and terrible pay. No one writes about the rewards, which are many.
“The federal government needs to take urgent action on Medicare rebate indexation, which has languished since the ’80s,” Horton says. Yep. Horton says his university has seen a slight increase in the number of students wanting to be GPs, but that’s not generalisable across universities.
I’ll tell you what else we could do to stop the mayhem in general practice. Cover your mouth when you cough, wash your hands after bathroom visits. And how about being lovely human beings to medical receptionists. It freaks me out (and should freak you out, too) that a number of GPs now have recorded messages reminding us to be courteous when dealing with staff.
Here’s what you can do. Do all those COVID-19 things. And tell anyone you know interested in studying medicine that it is fine to want to be as rich as an ophthalmologist. Short hours. Great pay. But GPs make our entire nation a better and healthier place.
Jenna Price is a visiting fellow at the Australian National University and a regular columnist for The Sydney Morning Herald.