Further ‘draconian’ coronavirus measures introduced

Matt Woodley

25/03/2020 3:40:00 PM

The restrictions are designed to enhance social-distancing efforts, as medical facilities ration PPE and suspend almost all elective surgery.

Greg Hunt, Scott Morrison, Brendan Murphy
Coronavirus cases in Australia are now doubling every three to four days.

Australians have been told to ‘stay at home’ wherever possible, after Chief Medical Officer Professor Brendan Murphy expressed concern at the ‘very, very steep growth’ in coronavirus cases.

With the total number of cases continuing to double every three to four days, Professor Murphy urged Australians to follow government advice related so social distancing and self-isolation.

‘We have to change the way we interact as human beings in our society for quite a long time,’ he said.
‘These measures are really draconian – we know that – but if we’re going to control community transmission we have to stop the capacity of this virus from spreading from person to person.
‘I have said many times, it is a long haul and that is why we are keen to keep society functioning but keep society safe. The idea that you can put measures in place for four weeks and suddenly stop them and the virus will be gone is not credible.
‘If Australians all do the right thing with these measures and do exactly what the Prime Minister has said and behave completely differently and practice distancing at every point, that will achieve the outcomes that we want.’
The delay on elective surgery, aside from category 1 and urgent category 2 procedures, applies to public and private hospitals and has been brought in to preserve medical resources, including personal protective equipment (PPE), and allow health services to better prepare for a surge in cases.
Doctors are continuing to report dire PPE shortages, with one Brisbane-based GP telling the ABC the situation has become ‘truly scary’.
Dr Maria Boulton, who owns a large medical clinic in Brisbane’s inner north that cares for 15,000 patients, said she only has ‘100 surgical masks in the cupboard’ and that the situation for most GPs is grim.
‘I think the situation in Queensland is getting to the point where you have to assume that everyone has coronavirus,’ Dr Boulton said.
‘We are pivoting to phone consults, but normal medical life still goes on and we’ll still need to do wound dressings and vaccinate babies.
‘What worries us is that you have to treat everyone as if I they are carrying it or incubating it and don’t know it yet, so technically you should be wearing PPE for everyone.
‘Many, many GPs are out because they’ve gone through their stock [and] they can’t get any more.’

GPs have reported severe PPE shortages. 

The Federal Government has agreed to dramatically expand access to telehealth consultations, starting next week, but Queensland Chief Health Officer Dr Jeanette Young said health workers would still have to conserve PPE and ‘only use … when required and consider how it is used’.
‘I am working closely with the Australian Government to increase our stocks of essential supplies, including personal protective equipment,’ Dr Young told health workers in a video address.
‘It is a critical resource in our response and we need to ensure we will have enough for the full duration of the pandemic.
‘New factories are coming online and new supplies will be available. No clinician will ever be asked to treat a patient with COVID-19 unless they have the appropriate PPE.’
Other actions taken by the Federal Government include the implementation of an overseas travel ban with only a few exceptions, restrictions on guest numbers at weddings and funerals, further closures of ‘non-essential’ businesses such as beauty salons and community libraries, and a text message campaign highlighting the importance of social distancing.
Testing criteria are also expected widen in the coming days, with fears community spread could be more prevalent than is currently assumed. Prominent GP Dr Brad McKay told newsGP ‘you can’t see what you don’t measure’ and urged the Government to ramp up testing and source additional kits as soon as possible.
‘The Australian Government has repeatedly told us that the majority of COVID-19-positive cases are from people arriving from overseas, but of course that’s going to be the case if our criteria are biased towards testing people arriving from overseas,’ he said.
‘We currently have no idea of the true extent of community transmission.
‘We’ve already learnt from the HIV pandemic that we need to test, test, test to determine who has the infection, localise where the problem areas are, and prevent further spread. Australia’s dwindling supply of coronavirus test kits is leaving us exposed to this deadly disease.
‘We also need to prioritise testing healthcare workers so we don’t all become predominant vectors of transmission, like we’ve seen occur overseas.’
The Federal Government has reportedly put in mass orders for coronavirus testing kits and PPE, but global supply chain issues have complicated efforts and forced health authorities to search for alternative sources.
The Prime Minister’s office has also announced the Government will take action to help prevent exploitative price gouging and people exporting products that are essential to preventing and controlling the spread of coronavirus.
Despite these efforts, however, Dr Boulton has warned that while testing kits are likely to become available soon, their use may be limited by continued shortages of the PPE doctors are required to wear when collecting samples.
She said her local Primary Health Network had offered her two N95 masks if she agreed to make her practice a respiratory clinic, which under Communicable Diseases Network Australia (CDNA) guidelines may only be sufficient for two patients.
‘There’s chatter that they’re going to expand that [testing] criteria, which is good because I think that there’s a lot of community spread that’s going on without being diagnosed,’ she said.
‘[But] the coronavirus will live on any surface for days – it will live on your hair, your skin and your clothes – so you need a gown for full sleeves, hopefully with a hoodie to cover your hair.
‘You need goggles, you need gloves, and a lot of people overseas are also wearing a face shield on top of all of that, and then you’re technically meant to change it after every patient.
‘Two masks would do two patients, that’s it – they don’t have any stock of gowns, goggles, gloves.’
In its most recent update, the Australian Health Protection Principal Committee (AHPPC) noted weddings and religious services ‘continue to feature in transmission events’ and scope remains for ‘more aggressive’ contact tracing and quarantine enforcement.
It also said ‘additional, materially more disruptive measures’ would be held in reserve until an assessment of the initial social-distancing policies is possible, but that the next likely step will be a ‘carefully considered’ closure of all activity except essential industries and services.
All states and territories are in agreement with the above position, except Victoria, which expressed the desire for even stronger measures.
The RACGP has more information on coronavirus available on its website.
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Dr Matthew James Harvey   26/03/2020 7:02:45 AM

“No clinician will ever be asked to treat a patient with COVID-19 unless they have the appropriate PPE.”

But they’ll ask clinicians to screen potential cases without appropriate PPE.

Dr Ian Mark Light   26/03/2020 1:44:23 PM

There ought to be masks gowns head shields and head cover from the Elective surgery eg cosmetic surgery non urgent screening endoscopy that ought be alloted to at least one in 10 General practices for the URTI LRTI and influenza winter backed by sentinel testing centres which have been in place for influenza for years .

Dr Christopher St John Kear   26/03/2020 3:19:27 PM

It's all too little, too late, and I expect the next turn of events to be heaps of very ill elderly calling for help, with no known infective contact due to us not testing widely enough. At that stage, it'll be game over, period.

Dr Timothy Hugh Begbie   26/03/2020 9:02:20 PM

A patient whom I saw on Monday rang this morning (Thur) to say her husband woke this morning with sore throat, fever and cough. (In an pandemic this is COVID till PROVEN otherwise. I asked if and she said yes, she had contacted the virus hotline. The response A quick checklist said "Does not qualify for testing ? Are you kidding. No wonder in our State they repeatedly tell us that there are NO known cases of community spread. Ostrich behaviour !
She was told to " isolate". I asked if she had this explained to her . NO. Did they tell her the difference between Isolation and Quarantine. NO. Did they give any further guidance NO. I spent 15 minutes (no charge of course) helping her, but what they REALLY need is a test. This is official cover-up. It is a disaster. I am function as a doctor in a special interest group. I am in the high risk age bracket. I have done everything to keep my clinic and patients safe. I have closed my clinic.
I am considered NON - essential.

Dr Maryellen Margaret Yencken   26/03/2020 10:54:55 PM

General practice continues to punch way above its weight and the unpaid hours night and day, extra expense incurred by practice owners is done with good will. However the measly stipend for Tele consults is frankly insulting. We are at the front line, potentially risking our lives and our income has just dropped by a third, because we are instructed we can not privately bill with these item numbers. Shame on you government for your lack of recognition and support of your most front line, cost effective doctors who perform amazingly with next to zero support. So disappointing.

Dr Jaya Pathi   26/03/2020 11:07:42 PM

In addition to all the measures advised for public ( self isolation and distancing and frequent hand washing etc) wearing masks outdoors should be made compulsory to further reduce the risk