Coronavirus information for GPs


Coronavirus is an evolving international health concern. This page will be updated with the latest information as it becomes available. 

The information on this page was last updated: Wednesday 19 February 2020, 1.50 pm AEDT

For up-to-the-minute information, visit the Australian Federal Government Department of Health website.  


Coronaviruses are a large family of viruses that cause illness from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

The novel coronavirus (COVID-19) is a new strain that has not been previously identified in humans.

Initial human infections of the novel type of coronaviruses were acquired from exposure to animals at the live animal market in Wuhan, China, however on 20 January 2020 Chinese authorities confirmed the novel coronavirus is spreading person-to-person. How easily the virus spreads from person-to-person remains unknown. 

Symptoms include fever, flu like symptoms such as coughing, sore throat and fatigue and/or shortness of breath.

There is currently no vaccine available for this new virus.


Pathology testing and collection procedures and notification requirements are specific to each jurisdiction. Access local information via the links below:


General practices can reduce the risk or prevent the transmission of infectious diseases by embedding infection control measures in everyday practice. All GPs, clinical staff and non-clinical staff should have a good understanding of infection control principles.

Key for GPs and practice teams is to ensure good triage protocols and avoid having patients suspected of having the virus, in the waiting room with other patients. Practices can utilise the available Patient alert posters to quickly identify, and appropriately manage, patients presenting with symptoms. 

GPs should not treat or carry out testing on suspected coronavirus patients if they do not have the correct PPE equipment. They should seek advice from their local public health unit on where to send the patient for treatment or testing and how to minimise the risk of infection while the patient is being transported.

Patients who notify of symptoms before attending a practice and who have epidemiological evidence, should be asked not to enter the practice until precautions are put in place.

A suspected case is currently defined by the Australian Federal Government Department of Health (DoH) as meeting the below epidemiological AND clinical criteria:

Epidemiological criteria:

  • Travel to (including transit through) mainland China in the 14 days before onset of illness

OR

  • Close* or casual** contact in 14 days before illness onset with a confirmed case of coronavirus.


Clinical criteria:

  • Fever

OR

  • Acute respiratory infection (e.g. shortness of breath or cough) with or without fever.
The DoH are advising that as the full clinical spectrum of illness is not known, clinical and public health judgment should also be used to determine the need for testing in patients who do not meet the epidemiological or clinical criteria above. See the DoH Information for Primary and Community Health Workers fact sheet for definitions of close and casual contacts.

Interim advice to Public Health Units (updated on 15 February 2020) by the Communicable Diseases Network Australia includes the following relating to Persons under investigation:
It is recommended that clinicians should consider testing people with a clinically compatible illness who travelled to any of the following countries in the 14 days before onset of symptoms:
  • Hong Kong
  • Indonesia
  • Japan
  • Singapore
  • Thailand
This list is based on the volume of travel between those countries, Australia and China, and/or the current epidemiology of COVID-19; however, the risk of COVID-19 in these countries is currently thought to be low. Clinical and public health judgement should be applied. The recommendation does not apply to passengers who have only been in transit through an airport in these countries. Note: if a clinician determines that a person under investigation should be tested then that person must be managed as a suspect case.
 

In suspected cases, current advice from the DoH for clinicians is:

  • Place a surgical mask on the patient
  • Place patient in isolated room
  • Contact and follow advice from their local public health unit on the exact specimens required for specialised testing, the approved collection methods and equipment for collecting specimens and the protocols for handling, storage and transport to correct laboratory
  • See DoH fact sheet Information for Primary and Community Health Workers
  • The RACGP also recommends practice staff in contact with any patients suspected of having coronavirus ie at reception, should wear a surgical face mask when dealing with these patients.

The requirements for PPE differ based on the patients respiratory symptoms. Current advice from the DoH is:
  • For most patients with mild or no respiratory symptoms in the community, collection of respiratory specimens is a low risk procedure and can be performed using contact and droplet precautions
  • Patients with severe symptoms suggestive of pneumonia should be managed in hospital. For patients meeting this criteria, the collection of respiratory specimens can be performed using contact and airborne precautions
  • For droplet precautions the room the room does not need to be left empty after sample collection
  • At completion of the consultation, remove PPE and place in a biohazard container, perform hand hygiene, wipe any contacted/contaminated surfaces with detergent/disinfectant
  • See DoH fact sheet Information about the use of personal protective equipment (PPE) during clinical care and the RACGP poster Correct use of Personal Protective Equipment (PPE)
If GPs and practice staff have worn PPE when dealing with a patient who is then confirmed as having the virus this is not considered a close contact so self isolation for 14 days is not required. 


For up-to-the-minute information, visit the Australian Federal Government Department of Health website.  


 


Current advice from the Australian Federal Government Department of Health (DoH) regarding face masks is that:

  • face masks are not currently recommended for use by healthy members of the public for the prevention of infections like coronavirus
  • persons with a suspected or confirmed case of coronavirus should wear a surgical face mask when in contact with others
  • GPs and practice staff should wear a surgical face mask when providing routine care to potential coronavirus cases with mild or no respiratory symptoms
  • a P2/N95 mask must be worn for aerosol generating procedures in patients with severe symptoms. Patients with severe symptoms suggestive of pneumonia should be managed in hospital.
The Federal Health Minister has announced that surgical face masks will be made available to general practices from the national stockpile as needed, to be distributed by local Primary Health Networks (PHNs). Some but not all states are also releasing P2/N95 face masks from their stockpiles for general practices. Contact your local PHN regarding stock.

See the DoH fact sheet Information about the use of personal protective equipment (PPE) during clinical care factsheet.


You may consider displaying the below posters at the entrance to your practice and making hand hygiene products and face masks available to patients who meet the criteria on the posters. 

Patient alert poster – Coronavirus – English version - A3 (Updated 18 Feb 2020)
Patient alert poster – Coronavirus – Chinese version - A3 (Updated 18 Feb 2020)
Patient alert poster – Coronavirus – English version – A4 (Updated 18 Feb 2020)
Patient alert poster – Coronavirus – Chinese version – A4 (Updated 18 Feb 2020)


Persons who have travelled from or transited through, mainland China on or after 1 February 2020, must isolate themselves in their home (or other appropriate location) for 14 days after leaving mainland China. This means they should not attend public places, in particular work, school, childcare or university.

  • Information for travellers arriving in Australia from mainland China is available here.
  • Information on home isolation is available here.


If you have patients who are considering travelling to any destination with detected cases of the novel coronavirus, information is available via the Smart Traveller website.


Practices should plan and prepare for open, realistic and continuing communication with the public during events such as the current novel coronavirus event. Patients need to know that their general practice is a reliable source of accurate, clear, concise, balanced and up-to-date information.

Calm, clear responses providing the most recent information will assist in reducing any alarm. The communication should be consistent with the Australian Federal Government Department of Health and state/territory health departments.

To ensure that all practice staff feel confident in their knowledge and in delivering information to patients and responding to queries, practices could consider instituting morning debriefs on the current situation.

Practices should clearly communicate to patients:
  • what is known
  • what is unknown
  • what is being done
  • where they can access further information

Methods of communication will vary depending on the practice and patient groups. By selecting a range of different communication methods during events such as this, patient reach will be maximised and the load on more direct methods of communication such as phone and email will be lessened. Examples of different communication methods include:
  • posters and signs at the entrance to the practice and in the waiting room (see Patient alert posters)
  • fact sheets and brochures (see Advice from State/Territory Departments of Health)
  • on-hold telephone call waiting messages
  • phone answering machine message
  • information on practice website
  • information in practice newsletters
  • internal building signage such as a notice board dedicated to current events
  • waiting room videos (provided by some PHNs and State/Territory health Departments)
  • credible websites with relevant information
  • social media

Communication topics may include:
  • who is at risk
  • how is it spread
  • signs and symptoms and how these vary from normal flu
  • infection control measures (what is and is not effective)
  • when to call for an appointment
  • when to go, and not to go, to the emergency department
  • self-isolation for suspected and confirmed cases
  • frequently asked questions including travel advice
  • practice policies including what to expect if you are suspected of having 2019-nCov

Ensure all communication with your patients take into consideration:
  • native language (you may need to consider using an interpreter)
  • vision and hearing deficits
  • literacy and comprehension.
 

The World Health Organization Emergency Committee are meeting regularly as the novel coronavirus (COVID-19) health concern evolves.

The COVID-19 outbreak currently meets the criteria for a Public Health Emergency of International Concern (PHEIC) requiring a global coordinated effort. 

Updates are available via the WHO website.

The WHO website now includes a Myth Busters section which may assist in addressing misinformation amongst patients.


During events such as the current coronavirus situation, additional pressure may be placed on GPs and practice staff as frontline workers through increased patient attendance to the practice, responding to fear and anxiety amidst the community and staying up to date as the situation evolves.

It is important during such times that GPs and practice staff take time to care for themselves and take the opportunity to debrief with colleagues.

If you require additional support, services are available, specifically developed for doctors.

RACGP GP Support Program


Should you need support, don't hesitate to contact the RACGP GP Support Program. This is a free and confidential psychological support service available to all members, delivered by LifeWorks by Morneau Shepell. Access the service by calling 1300 361 008 (24 hours/7 days).

DRS4DRS

You can also access support via the DRS4DRS website and state/territory based helplines.

DRS4DRS is an independent program providing confidential support and resources to doctors and medical students across Australia, by doctors.

Confidential phone advice is available 24/7 for any doctor or medical student in Australia via each state/territory helpline and referral service.

 
Australian Capital Territory 02 9437 6552
New South Wales 02 9437 6552
Northern Territory 08 8366 0250
Queensland 07 3833 4352
South Australia 08 8366 0250
Tasmania 1800 991 997
Victoria 03 9280 8712
Western Australia 08 9321 3098

Further services and resources can be found in the RACGP fact sheet Self-care and mental health resources for general practitioners 
 

Patient alert posters - Updated 18 February 2020