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GPs urged to be vigilant as coronavirus cases multiply


Matt Woodley


26/01/2020 8:38:33 PM

With several cases confirmed in Australia, Chinese authorities have said the virus is becoming more infectious.

Brendan Murphy
Australian Chief Medical Officer Brendan Murphy said it is important that people who have recently arrived to Australia from Wuhan, and those in close contact with them, watch for signs of the virus.

‘According to recent clinical information, the virus's ability to spread seems to be getting somewhat stronger,’  China's National Health Commission Minister Ma Xiaowei told reporters.

He said the incubation period for the virus could range from one to 14 days.

It has been suggested the coronavirus is infectious during its incubation period, even when people are not displaying symptoms; however, Australia's Chief Medical Officer Professor Brendan Murphy disputed such claims.

‘The expert panels that met today were not convinced of that,’ he told reporters on Monday. ‘It would be very unusual because this virus is similar to the SARS and MERS viruses and they were not infectious before symptoms.’

All five of Australia’s confirmed cases – four in NSW and one in Victoria – have recently returned from Wuhan or had direct contact with infected people in China. Local health officials do not believe there has been any local human-to-human transmission. 

Professor Murphy said there is no evidence of sustained human-to-human transmission outside of China’s Hubei province, the epicentre of the virus.

All flights from China into Australia will now be met by border security officers to ensure unwell passengers are identified and receive health warnings.

Professor Murphy said it is important that people who have recently arrived to Australia from Wuhan, and those in close contact with them, watch for signs of novel coronavirus 2019 (2019-nCoV).
 
‘We don’t know exactly how long symptoms take to show after a person has been infected, but there is an incubation period and some patients will have very mild symptoms,’ Professor Murphy said.
 
‘Symptoms include fever, cough, sore throat, vomiting and difficulty breathing. Difficulty breathing is a sign of possible pneumonia and requires immediate medical attention.
 
‘People who arrive in Australia from an international flight with these symptoms should alert their airline, or a biosecurity officer if they have disembarked.’
 
Victorian Health Minister Jenny Mikakos said the Victorian patient and his family ‘did everything right’ upon suspecting he may be infected.
 
‘He exhibited no symptoms on the flight and when he did experience some symptoms of illness they contacted the GP on Thursday, they called ahead and he was double-masked when he presented to the GP clinic,’ she said.
 
‘He was not confirmed to have coronavirus by the GP. The family contacted the Monash Medical Centre on Friday, they called ahead of time and again he was masked before he turned up at [emergency] and [was] immediately put into isolation.’
 
None of the patients showed signs of having the virus upon arrival, but a man who returned on 20 January via China Eastern Flight MU749 developed symptoms that night. NSW Chief Medical Officer Dr Kerry Chant said authorities are attempting to track down anyone who was on that flight to urge them to be tested for the virus.
 
Authorities have also conducted extensive interviews with many people who have come into contact with the infected men, but conceded the patients may have come in contact with hundreds of people since arriving in the country.
 
Dr Chant she said there is significant potential for more cases in NSW, while the Queensland Government has established an emergency coordination centre to manage potential cases.
 
The Victorian Department of Health and Human Services has asked health professionals to watch out for signs and symptoms of 2019-nCoV infection in patients who may have travelled to areas affected by an emerging outbreak, and issued resources for GPs, including guidelines and Chinese language posters.
 
Victoria’s Deputy Chief Health Officer Dr Angie Bone said she is concerned the infected man in that state had visited a GP the day before presenting in hospital, but the doctor did not suspect 2019-nCoV despite him being a Chinese national and resident of Wuhan.
 
Dr Chant also said some cases could have been caught sooner by GPs, and urged doctors treating those with coronavirus-like symptoms to contact health authorities.
 
Federal Health Minister Minister Hunt said containment process have been activated.
 
‘Australia has world-class health systems with processes for the identification and treatment of cases, including isolation facilities in each state and territory,’ he said.
 
‘Our laboratories have developed testing processes for this novel coronavirus that can provide a level of certainty within a day.’
 
New cases have also been reported in Canada, Nepal and Malaysia, bringing the number of affected countries to 11. The number of confirmed cases is approaching 3000 and there had been 80 confirmed deaths at the time of publication.
 
However, unconfirmed reports and videos on social media from inside Wuhan claim these figures are vastly underestimated.
 
More than 56 million people are currently in lockdown in mainland China, while Hong Kong has also declared a state of emergency.
 
Chinese President Xi Jinping has said the country is facing a ‘grave situation’ and is ramping up efforts to control the outbreak, including by building two brand new hospitals in Wuhan within weeks specifically to deal with 2019-nCoV cases.
 
Despite these efforts, scientists at the MRC Centre for Global Infectious Disease Analysis in the UK have warned self-sustaining human-to-human transmission of 2019-nCoV is the ‘only plausible explanation’ for the scale of the epidemic, and suggested transmission of the virus needs to be cut by 60% in order to curtail the outbreak.
 
Such an effort would require finding and isolating patients even with only mild symptoms that could easily be confused with other diseases.
 
A team from Lancaster University has estimated only 5% of cases have been identified so far, and that the number of infected people is actually closer to 11,000. The same team believes 190,000 people will be infected by 4 February.
 
The World Health Organization’s assessment of the situation remains ‘unchanged’; very high in China, high at a regional level, and moderate at a global level.
 
The RACGP has more information on coronavirus available on its website.
 
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Dr Peter James Strickland   28/01/2020 11:57:01 AM

This debacle within Australia appears to me to be directly related to the fact that the Australian health authorities have allowed this to happen. Putting the responsibility onto GPs is a direct transference of the poor measures instituted to date to prevent entry of this infection into Australia in the first place. Now they are talking about the "plight' of 120 children trapped in Wuhan Provence, and bringing them back to Australia. No!! --- the potential for any one of those children and families bringing the virus into Australia is high, and thus causing morbidity and possible mortality in Australia itself in those who have not travelled. It is a no-brainer --no entry at present from ANY areas affected by the virus. Isolation is the key, not mixing those possibly infected with those non-infected.