GP push to spread clear COVID messaging

On 5 August last year, Victorian Premier Daniel Andrews announced that the state would be going into its sixth lockdown.
 
The number of new COVID-19 infections reported that day? Just six cases.
 
Fast forward less than six months and the pandemic is playing out very differently. More than nine in 10 people aged over 16 has now been fully vaccinated, compared to just over one in five back then.
 
Daily case numbers also have several more noughts. And the change in messaging as suppression shifted to ‘living with COVID’ has been dramatic.
 
Many resources aimed at guiding general practices and the public on managing COVID-19 at home have also been released, including the RACGP’s.  
 
But, as GPs face huge call volumes and pressure on hospital networks grows – a statewide Code Brown emergency was declared in Victoria on Tuesday – the key question remains: is the advice getting through to patients?
 
For many GPs, the answer is clear: not nearly well enough.
 
That is certainly the case for Dr Magdalena Simonis, a member of the RACGP Expert Committee – Quality Care (REC–QC), who recently wrote an advice piece for Nine Newspapers on how to manage COVID-19 at home.
 
‘Our phone lines are being overwhelmed by requests for advice,’ Dr Simonis told newsGP.
 
‘One of the reasons … I wrote the article was because I was repeating myself many times a day [to patients] over the phone.’
 
Dr Simonis says people are dealing with a lot of insecurity and, in her view, that has not been adequately addressed by government messaging.
 
‘They’ve said “go see your GP if you’ve got concerns” but they didn’t ask us what we would need in case there was a swarm of anxious patients,’ she said.
 
‘So we are trying now to patch those gaps.
 
‘There’s a lot of concern out there about how to manage this at home, and people are being told to manage this at home and to stay at home. But they’re not being empowered to make decisions about their families.’
 
Dr Simonis believes there needs to be a ‘multi-pronged’ approach, to communication including TV, radio, social media and newspapers.
 
A key part, she says, is ensuring appropriate messages reach Culturally and Linguistically Diverse (CALD) communities.
 
‘It needs to be delivered ideally through representatives of their community in the language that they understand, and through people that they trust,’ Dr Simonis said.
 
It is one of the reasons Dr Simonis also wrote about managing COVID in the home for the Greek community newspaper Neos Kosmos – and she encourages other GPs with CALD backgrounds to do something similar for their respective communities if possible.
 
Werribee GP Dr Joe Garra describes Dr Simonis’s Nine Newspapers article as ‘wonderful’ but expresses similar views about how effectively the health advice is spreading.
 
‘People don’t know what to do,’ Dr Garra told newsGP. ‘A lot of our phone calls are basic education.’
 
With more widespread and clearly understood messaging, he says the strain felt by many general practices could start to ease.
 
Dr Simonis agrees.
 
‘It should relieve the current pressure on our front office staff and the aggression that some of them are experiencing from patients who are frustrated,’ she said.
 
‘This is a way of being very proactive in delivering health information, which is really what we need to be doing more.’
 
Dr Garra particularly worries about misuse of rapid antigen tests (RATs) being used by ‘the worried well’, with more vulnerable patients potentially missing out – and believes there should be more prominent messaging both on how to conduct the tests and when they are appropriate.
 
Vulnerable patients also need to be targeted more effectively, he believes – particularly if they are to gain access to life-saving treatments such as sotrovimab, which is most effective if used early in the course of a COVID-19 infection.
 
‘If you’re elderly or you have got multiple illnesses, the government should be saying “let your GP know you’re COVID positive – don’t just wait and ring when you’re sick”,’ he said.  
 
Inner-west Sydney GP Dr Michael Bonning, who is also a member of RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), highlights the impact of a system being swamped by patients who might not need help.
 
‘We still need to use our hospital systems and our general practices to take care of non-COVID care, patients who have other ailments that need to be sorted out,’ he told newsGP.
 
‘The more time we spend inappropriately using our services, especially emergency, the less time someone who’s having chest pain for a different reason gets access to that service.’
 
Dr Bonning does not blame the public, but says coherent, easy-to-find messaging is key to addressing the issue.
 
‘Trusted healthcare leaders are the best people to put up there so that people in the community get information that is accessible to them in their own language and in [a] format they trust,’ he said.
 
‘The Government says something, and then every person, rightly or wrongly but generally because they have limited information, runs to their GP and says, “What does this all mean? What do I need to do?”
 
‘And the GP says, “Well, I learned about it on the in the press conference the same way you did.”
 
‘The ability to push out that information at the same time so that the community is better informed now that we’re living with COVID is a really important requirement of government.’
 
Dr Garra, in the meantime, highlighted the fundamental change in pandemic management that has evolved since that sixth Victorian lockdown and says ensuring greater clarity for the general public should now be a top priority.
 
‘It was a massive shift from being instructed what to do, to now being told “oh, you have got to work it out” but without giving people the basics to work it out,’ he said.
 
‘If we’re expecting the population to self-manage and not let the system out of control, that’s got to be the number one message.’
 
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