NSW GPs on watch as hospitals placed on red alert

Matt Woodley

20/12/2021 4:46:42 PM

In a possible sign of things to come, a surge in Omicron cases means low-risk patients will undergo ‘self-care’ in the community.

NSW ambulance ramping.
NSW posted record daily case numbers for four consecutive days last week. (Image: AAP)

The change to the state’s COVID clinical care guidance was detailed in a letter sent by NSW Chief Health Officer Dr Kerry Chant on Friday 17 December, which referenced the ‘significant challenge’ posed by Omicron.
The new variant’s increased transmissibility and ability to evade antibodies has stoked fears about its potential impact on the healthcare system, even if it does prove to be milder than previous strains.
Australia’s most populous state posted record daily case numbers for four consecutive days last week, including 2566 on Sunday, and NSW Health Minister Brad Hazzard warned it could be registering 25,000 per day by the end of January.
As a result, Dr Chant wrote that it will become more difficult for the state health unit to contact and manage all positive cases by telephone, and indicated that low risk cases will instead undertake ‘self-care at home’ in the first instance.
‘I would like to acknowledge the enormous contribution that GPs have made during the COVID-19 response and I thank you for your ongoing support of the pandemic response,’ she wrote.
‘We now face a significant challenge with rapidly increasing COVID-19 case numbers related to circulation of the Omicron variant … I would therefore like to take this opportunity to advise you that we are making some changes to the way we manage COVID-19 cases in the community.
‘NSW Health will still screen all COVID-19 cases for certain risk factors and escalate those with known higher risk for increased support.
‘[But] cases that meet the criteria for low-risk will be advised to undertake self-care at home in the first instance.’
Confirmed COVID-19 cases who meet the following criteria are now deemed low-risk:

  • Under 50 years of age
  • Have had two doses of COVID-19 vaccine
  • Do not suffer from any chronic medical conditions
  • Non-Indigenous
Under the system, patients who meet the low-risk criteria on screening will be provided a contact number to seek further medical assistance, as well as a link to a COVID-19 fact sheet, available in a variety of languages. However, any patient with a chronic medical condition, or who is pregnant, should be escalated for additional support.
Chronic medical conditions include:
  • obesity (BMI >30 kg/m2)
  • diabetes
  • severe, chronic or complex medical conditions (including cardiac, respiratory, renal or neurodevelopmental conditions)
  • those who are immunocompromised, including malignancy
  • severe mental illness.
According to Dr Chant, the new approach means it is ‘highly likely’ GPs will receive calls for advice from patients regarding COVID-19 symptoms, as well as issues relating to non-COVID-19 matters during their acute phase of illness.
‘GPs are asked to continue to provide the usual care and support of their patients for non-COVID-19 matters via telehealth,’ she wrote.
‘For any COVID-19 matters, please refer to the RACGP COVID-19 Management in the Community guidelines and your local HealthPathway guidelines.’
RACGP NSW&ACT Chair Associate Professor Charlotte Hespe told newsGP that while GPs are not required to care for COVID-positive patients, they may still be asked by patients for more information on COVID-19 care in the community.
‘If this does occur, GPs just need to refer to the RACGP Home-care guidelines for patients with COVID-19,’ she said.
‘However, if they’re contacted by somebody deemed a “low risk” patient who they know actually has a low or moderate risk of more severe outcomes, then they can contact their NSW Health or Local PHU using the phone number in the letter and given to all patients [1800 960 933].’
Associate Professor Hespe also said it is important for GPs to remember that telehealth remains the safest way to look after patients at this time, unless face-to-face care is clinically required.
‘If GPs would like more information, I’d advise them to please go and look at their local HealthPathways guidance about COVID care in the community, which will provide information about local pathways for all patients and contact numbers,’ she said.
‘We all know how tough this pandemic has been and many GPs are understandably feeling the strain, but it is still vital that we continue providing care for all our patients over the Christmas and New Year period.’
Patients will receive an automated medical clearance notice from NSW Health allowing them to cease isolation 10 days after their positive test date.
Log in below to join the conversation.

community care COVID-19 Omicron self-care

newsGP weekly poll Should after-hours Medicare rebates extend to all-day Saturday?

newsGP weekly poll Should after-hours Medicare rebates extend to all-day Saturday?



Login to comment