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General practice is prepared to tackle coronavirus – but we cannot do it alone
RACGP President Dr Harry Nespolon outlines what GPs need to know amid the current outbreak.
RACGP President Dr Harry Nespolon believes GPs need to be ‘vigilant in order to detect and isolate any cases that may present over the coming days and weeks’.
When faced with any public health emergency, including an infectious disease outbreak, the community will inevitably turn to general practice.
GPs are vital for both disease control and the essential health services for which patients rely on us every day. Our position as trusted authority figures means we must offer informed reassurance, guidance and comfort to concerned patients and community members.
Alert, but not alarmed.
It is important to remember that our experience dealing with more common contagious viral infections, such as measles and influenza, means we are well placed to fulfil our role in the wider healthcare response to the ongoing coronavirus outbreak.
At this stage, we know human-to-human transmission can occur, and some of the early cases have been severe. But, we do not yet know how transmissible this infection is, nor how many people get mild infection.
In a letter to Australian health practitioners, Chief Medical Officer Professor Brendan Murphy stressed the critical nature of early detection ‘to enable diagnosis, isolation and appropriate contact tracing’ in order to ensure there is no human-to-human transmission in Australia.
He’s right.
This means we must take a cautious approach and be vigilant in order to detect and isolate any cases that may present over the coming days and weeks.
Clinically, nearly all cases have had fever, associated with other respiratory symptoms including cough and shortness of breath. It is estimated that about 25% of cases so far have severe symptoms with significant pulmonary involvement.
While the virus’ exact incubation period is yet to be determined, all reports suggest an average of around seven days, with an upper limit of 14 days.
Combining an awareness of these factors with any potential travel history a patient or a contact may have should help in our goal of dramatically reducing any exposure the Australian population has to this virus.
Should a wider outbreak occur, every accredited general practice has an infection control plan, which includes pandemics. As such, I have the utmost faith Australia’s GPs will be ready to protect the community from this threat, along with any other potential harms that might afflict our patients.
But in order to ensure best practice is employed in surgeries and clinics across the country, we must be given the appropriate information, tools and support from public health authorities.
To this end, I have sought assurances from Professor Murphy. He has confirmed GPs and practice staff should wear face masks when consulting potential coronavirus cases, and that clinics with supply issues can access the national stockpile via their local Primary Health Network.
While it is not recommended people in the community wear face masks, we have been advised that patients suspected of having coronavirus should be isolated and managed in contact/droplet precautions:
- Place a single-use surgical mask on the patient
- Isolate the patient in a single room with door closed
- Any person entering the room should use appropriate droplet and contact precautions personal protective equipment (PPE), ie single-use surgical face mask, eye protection, gown and gloves
Practices should already have around a month’s supply of PPE should a pandemic event occur, so they will be able to cope in the short term. However, if coronavirus spreads – as many fear it will – we could be looking at a prolonged period where these measures need to be applied.
In this case, the Australian Government must consider how it manages the nation’s emergency reserves and how it will distribute PPE across the country.
Federal Health Minister Greg Hunt has already announced the national medical stockpile of 12 million masks will be made available as needed, while other PPE such as gloves, gowns, and protective eye wear will also need to be sourced and made ready.
Aside from physical equipment, effective public health messaging is needed to inform patients of their responsibilities with regard to infection control – in particular, calling ahead of time, informing reception staff of relevant prior travel, and wearing appropriate PPE such as a face mask.
Communication is key in situations such as these. So long as we have the most up-to-date information in a timely fashion and are able to work hand-in-glove with other emergency services and healthcare sectors, I see no reason why we will not be able to meet this challenge as we have others before.
The Government has promised it will do all it can to have the right information, support structures and preparations in place.
The rest is up to us.
The RACGP has more information on coronavirus available on its website.
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