Home-care guidelines for patients with COVID-19

Escalating care

Patients, other household members and caregivers should be advised to contact the patient’s GP or hospital-led service via telephone for advice if symptoms worsen or there are any red flag symptoms (refer to Box 3). It would be helpful to give patients written information about symptoms to watch out for. If the GP is not immediately available, they must call emergency services on 000 and clearly communicate the patient’s COVID-19 status to the phone operator. The ambulance crew must be aware of the patient’s COVID-19 status and will relay this to the receiving emergency department.

Transfer to hospital is recommended if the patient develops symptoms or signs suggestive of moderate or severe COVID-19, such as:

  • SpO2 less than or equal to 92%, even if feeling well
  • worsening shortness of breath or difficulty breathing
  • blue lips or face
  • pain or pressure in the chest
  • cold and clammy, or pale and mottled skin
  • confusion or fainting
  • becoming difficult to rouse
  • little or no urine output
  • coughing up blood.5

If a patient with minimal or mild symptoms shows signs of deterioration, particularly breathlessness, without the above signs:

  • ensure they have an action plan in case of rapid deterioration
  • increase the frequency of surveillance
  • consider referral to a hospital-led COVID-19 service.

When patients are being cared for in the community by GPs, GPs, the patient and the patient’s family/supports can escalate care to ambulance or hospital if they have any concerns, regardless of whether they meet the criteria outlined above.

  1. Communicable Diseases Network Australia. Coronavirus Disease 2019 (COVID-19): CDNA National guidelines for public health units. Version 6.7. Canberra: Department of Health, 2022 Content/cdna-song-novel-coronavirus.htm [Accessed 13 May 2022].
  2. Australian Technical Advisory Group on Immunisation. Clinical guidance for COVID-19 vaccine providers. Canberra; ATAGI, 2022 [Accessed 13 May 2022].
  3. Department of Health. How COVID-19 vaccines work. Canberra, 2022 vaccines/how-they-work [Accessed 19 may 2022].
  4. Rees S, Fisher J. COVID-19 and the mental health of people from refugee backgrounds. Int J Health Serv 2021;50(4):415–17. doi: 10.1177/0020731420942475.
  5. National COVID-19 Clinical Evidence Taskforce. Management of adults with mild COVID-19 (version 42.1). Melbourne, 2022 [Accessed 19May 2022].
  6. Community Health Pathways – NSW Collaboration. COVID-19 Active Case Management, 2022.
  7. National COVID-19 Clinical Evidence Taskforce. Pathways to care for adults with COVID-19 (version 4.2). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  8. Agency for Clinical Innovation. Caring for adults and children in the community with COVID-19. Sydney: NSW Health, 2022 [Accessed 19 May 2022].
  9. National COVID-19 Clinical Evidence Taskforce. Pathways to care for children and adolescents with COVID-19 (version 2.1). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  10. National COVID-19 Clinical Evidence Taskforce. Steroids for people with asthma or COPD and COVID-19. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  11. National COVID-19 Clinical Evidence Taskforce. ACEIs/ARBs in patients with COVID-19. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  12. National COVID-19 Clinical Evidence Taskforce. Oestrogen-containing therapies. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 10 June 2022].
  13. Cagnacci A, Bonaccorsi G, Gambacciani M, Board of the Italian Menopause Society Collaborators. Reflections and recommendations on the COVID-19 pandemic: Should hormone therapy be discontinued? Maturitas, 2020;138:76–77. doi: 10.1016/j.maturitas.2020.05.022.
  14. Australian Government Department of Health. Lagevrio (molnupiravir) PBS Factsheet. Canberra: DoH, 2022 [Accessed 15 June 2022]
  15. Australian Government Department of Health. Paxlovid® (nirmatrelvir and ritonavir) Pharmaceutical Benefits Scheme Factsheet. Canberra: DoH, 2022 [Accessed 15 June 2022]
  16. National COVID-19 Clinical Evidence Taskforce. Corticosteriods (systemic) for adults. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  17. Australian Government Department of Health. Guidance on the use of personal protective equipment (PPE) for health care workers in the context of COVID-19. Canberra: DoH, 2021 [Accessed 19 May 2022].
  18. Infection Control Expert Group. Information about cleaning and disinfection for health and residential care facilities. Canberra: Australian Government, 2020 coronavirus-covid-19-environmental-cleaning-and-disinfection-principles-for- health-and-residential-care-facilities-coronavirus-covid-19-environmental- cleaning-and-disinfection-principles-for-health-and-residential-care-fac.pdf [Accessed 19 May 2022].
  19. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Melbourne: RACGP, 2021. A message for pregnant women and their families information-for-pregnant-women [Accessed 19 May 2022]
  20. National COVID-19 Clinical Evidence Taskforce. Pregnancy and Perinatal care. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  21. The Royal Children’s Hospital Melbourne. Clinical Practice Guidelines – COVID-19. Melbourne: The Royal Children’s Hospital Melbourne, 2021 [Accessed 19 May 2022].
  22. National COVID-19 Clinical Evidence Taskforce. Management of people with COVD-19 who are older and living with frailty and/or cognitive impairment (version 5.0). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2021 [Accessed 18 May 2022].

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