One of the founders of a group of GPs working in some of the country's most disadvantaged areas has warned that some people are "in denial" about having Covid-19 among a cohort she called the "unworried unwell".
Dr Edel McGinnity is involved in the nationwide Deep End Ireland GP grouping and also works at a large practice in NW Dublin.
She said she was concerned that some people - often already unwell with existing conditions - are reluctant to engage with doctors, while she diagnosed to people this week with Covid-19 symptoms but who will not now be tested under changes to the testing regime announced on Wednesday.
"I have referred 200 people for testing since it started on March 16," Dr McGinnity said. "Obviously some of those have been tested but a significant number have not been tested. Only three or four phoned us to find out what was the story."
The Deep End model comes from Scotland and in Ireland as many as 100 GPs have an involvement. Dr McGinnity said there were people - "the unworried unwell" - who are already preoccupied with family and social problems and who may be reluctant to report symptoms, or late in doing so.
"There is an enormous amount of denial out there," she said.
"There are a lot of people who don't want to think about having this virus.
She said in disadvantaged areas there is already more demand for healthcare, with more people getting chronic illnesses at a younger age.
Just last Tuesday Dr McGinnity said she spoke with two patients at their homes to check on them, and both showed signs of Covid-19.
"The problem is there are people coming in and out of those houses all the time," she said.
Other issues include transport difficulties for those in these areas with symptoms, and higher rates of mental health problems in poorer areas.
She said it was not uncommon for three generations of one family to be living in one property and that leads to worries for anyone who has to self-isolate.
Dr McGinnity referred to one call she made to one patient this week with an underlying illness.
"We are used to supporting, helping, reassuring, but I left her more upset than I found her," she said.
"The 'stay at home message' can sometimes go a bit far with people thinking they shouldn’t go to hospital no matter what is wrong.
"And thinking GPs are closed because we have cancelled routine appointments.
"It's really important that people who are sick should know that they can still contact their GP who will still look after them, we just need to do things a bit differently - over the phone mainly, or special visit times and waiting in the car until called etc.
"I'm worried that people are getting very sick at home," she added.
Dr McGinnity said Deep End Ireland's aim is to lobby for appropriate resourcing for all services in these areas – along the lines of the Deis schools model in education, and said the group is hoping that Slaintecare might address some of these issues.