GPs already in action as part of SA’s response to new COVID cluster

Doug Hendrie

16/11/2020 2:30:04 PM

newsGP speaks with South Australia’s Deputy Chief Public Health Officer about the outbreak, which has sparked a rush on testing and potentially reached vulnerable parts of the community.

Adelaide on a map
Adelaide has become a new COVID hotspot as authorities scramble to contain the cluster in the city’s north.

The cluster, which has grown to 17 as of Monday 16 November, is understood to have almost certainly come from a worker at a medi-hotel in Adelaide, where there are also 17 active cases among people returning to Australia.
This response found that the virus had spread among members of the worker’s family, which accounts for 15 of the 17 cases. 
The new cluster has seen the closures of two schools, a fast food outlet, and an aged care facility, and raised concerns about a prison after positive cases were confirmed at each location.
It has also triggered calls for a return to mass testing for everyone with even mild symptoms.

SA Premier Steven Marshall announced a number of new restrictions to take effect from Tuesday. Pubs, clubs and restaurants are capped at 100 people per venue, with a maximum booking of 10 people. Private gatherings at venues are capped at 50. Private residence gatherings are capped at 10 people. Cinemas and theatres are restricted to one person per four square metres.

‘Time is now of the essence and we must act swiftly and decisively,’ he said. ‘We cannot wait to see how bad this gets.’
Contact tracing of thousands of Adelaide residents is under way, according to state authorities, with long lines at COVID testing stations. 
The state’s 30-strong surge workforce of public-health trained GPs has moved into action, notifying patients and undertaking risk assessments of new COVID cases to determine whether they can safely stay at home or need to go to a medi-hotel.
The cluster was discovered when an 81-year-old woman tested positive at the Lyell McEwin Hospital in Adelaide’s northern suburbs, triggering an immediate response that uncovered the broader cluster.
Authorities hope the cluster has been detected early enough to ward off a Victorian-size second wave, with local healthcare professionals expressing confidence in the state’s highly-regarded public health system, which relied heavily on GPs to beat the state’s first wave. 
Melbourne anaesthetist Dr Pieter Peach warned that the Adelaide outbreak is very similar to the beginning of the Victorian second wave.

SA’s Deputy Chief Public Health Officer Dr Emily Kirkpatrick, who is a GP, told newsGP the cluster is a ‘wake-up call’ for the state.
‘We have 17 cases confirmed from the cluster already and we are expecting contacts in the thousands. GPs have already started working as part of the response,’ she said.
Dr Kirkpatrick said genomic analysis is still pending and will be necessary to confirm that a medi-hotel resident is the primary source of the new outbreak.
‘It appears a lot of [this] transmission is within the [family] house, but we will know more soon,’ she said. ‘It’s only been 36 hours. It looks like this is a very rapid onset.
‘We are very grateful people are going out and getting tested. It is very important that people are getting tested with even the mildest symptoms, as we’ve seen low testing rates.’
The cluster imperils Australia’s bid to reopen internally, with some states and territories shutting off travel or requiring South Australians to quarantine.
Adelaide GP Dr Danny Byrne told newsGP the new cluster is concerning, but he has ‘full confidence in our systems’.
‘We did very well the first time around and I’m hoping this has been caught pretty early,’ he said.
‘We learned plenty of lessons from the Victorian situation. We have excellent contact tracing, with a huge team and surge capacity.
‘I don’t think we’re heading to 700 cases a day, Melbourne-style, but this is a risk and it is a wake-up call.’
Dr Byrne warned that Australians returning home from overseas would be more likely to carry the virus, given the alarming surges in infection rates in the northern hemisphere.
‘The virus can really only come from medi-hotels now,’ he said. ‘There’s more COVID in the world and that means more in returned travellers.
‘We want to get all these Australians back home, but it’s a risk we have to manage.
‘This reflects the massive increase in COVID in Europe and America.’

SA’s Deputy Chief Public Health Officer Dr Emily Kirkpatrick called the cluster a ‘wake-up call’ for the state.

Dr Alvin Chua, who is also a GP in Adelaide, told newGP he is not surprised the SA outbreak has occurred. He has immediately moved to institute mask-wearing and early triaging at his practice.
He fears people in SA may have dropped their guard too much after seven essentially virus-free months.
‘We have to be vigilant; our population has become complacent. We have become complacent here in South Australia.,’ he said.
Dr Chua believes the outbreak suggests a more stringent approach to workers in medi-hotels is warranted.
‘In my opinion, medi-hotel workers should do two-week shifts where they’re quarantined as well, and then another week of quarantine without visitors, then back to the community,’ he said. ‘We know this disease is airborne, we know there’s community spread.’
Western Australia, Tasmania and the Northern Territory have closed their borders to SA, requiring a mandatory 14-day quarantine period to enter. Victoria has declared Adelaide a hotspot, and will require interviews and potentially a rapid test for any returnees. By contrast, New South Wales has vowed to remain open to South Australia. 
South Australia’s strong response to the first wave of COVID relied on GPs managing cases in the community, a surge workforce and strong contact-tracing.

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Dr Ian Mark Light   17/11/2020 8:57:42 AM

It is summer so open air examinations under cover from the elements masks with glasses physical distancing and the rapid turn around Covid tests ought help .
Clinics have to be built or renovated to allow for better fresh air ventilation.