Strange and scary times: my thoughts on the current COVID-19 situation by Dr Jane Dickson Vice President of FSRH

Jane Dickson, FSRH’s Vice President (Strategy) of the Faculty of Sexual and Reproductive Healthcare (FSRH), shares her thoughts on the current COVID-19 pandemic and how it is affecting SRH services.

These are strange and scary times. I work as an SRH Consultant in South East Wales. We have more COVID-19 cases in Gwent than the rest of Wales combined and the escalation of cases in our area has been likened to the situation in Italy. Yesterday our Director of Public Health published a stark video message that we do not have enough critical care beds and ventilators to manage our patients locally.

Last week the FSRH published our COVID-19 statement outlining which SRH services are essential and should be maintained through the crisis . Very helpfully our FSRH Clinical Effectiveness Unit also published guidelines for extended use of LARC, enabling us to provide firm reassurance to our patients that their LARCs would not instantly run out, and in the case of implants and intrauterine contraception have at least one year’s extra effectiveness.

We also stated that initiation of LARC was not ‘essential’ at this time. This does not mean that LARC is not essential - indeed it’s easy to argue that while socially isolated sexual activity is likely to be significant, so contraception is more essential than ever. It is fundamental that vulnerable women can still access LARC and we must ensure emergency IUD fitting and management of LARC problems are maintained.

However in producing the statement we were being realistic that many staff will be sick, isolating or shielded - at last count yesterday there were 16 members of staff off in my service. And very quickly we will see many staff redeployed to help with COVID19. If services and practices have the ability and capacity to fit and to change LARC that is great but I suspect it will not be for long. And of course women themselves are being advised to stay at home so alternative forms of contraception may be better all round.

The other issue concerning me greatly is the recent fiasco with regard to abortion legislation. Earlier this week a statement was produced allowing mifepristone to be prescribed remotely and used in a patient’s home. This was overwhelming common sense when women are being told to stay at home, maybe ill or self-isolating and most likely looking after children who are no longer at school.

However within a matter of hours it was announced that this was a ‘mistake’. We now have an emergency situation where only one doctor is needed to sign a cremation form, only one doctor is required to section a patient, yet still two doctors are needed to ‘allow’ an abortion. Never has legislation seemed so cruel in what is often a woman’s greatest time of need.

The only ray of light for me is at least abortion has been identified as an ‘essential’ service, so for the time being I am being allowed to carry on doing the job which I love and where I feel secure. For many of my colleagues this is not the case and I have been absolutely awe-inspired by colleagues from my service who have already volunteered to go to the front line.

As I said, these are strange and scary times and I look forward to seeing you on the other side.

The FSRH have collated a range of useful resources that you can access on their COVID-19 webpage – you can take a look here. 

Jane Dickson
Vice President, FSRH