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Episode 1

COVID-19: State of the nation

Show notes

Welcome to Generally Speaking, the conversation for all GPs, sponsored by CommBank.

Join GPs Dr Gill Singleton and Dr Billy Stoupas as they discuss some of the most pressing topics and challenges in healthcare for Australian GPs to stay informed, connected and inspired.

This episode, our hosts Gill and Billy open the conversation with Professor Michael Kidd about the state of the nation in a fluently changing environment. As the Deputy Chief Medical Officer and Principal Advisor to the Department of Health, Michael is also a GP, former President of the RACGP, and a globally recognised leader in primary health.

There’s no question this topic is vital with the global COVID-19 pandemic, following the disastrous summer that many communities in Australia experienced as a result of the bushfires and floods. Without any doubt, the breakout of COVID-19 created a major imbalance in every aspect of life globally. 

22 April 2020 - 02:47 PM | 27 min 2 sec

(0:22) Billy shares that in this globally dire situation of the COVID-19 pandemic, GPs are in the centre to offer support, advice, medical assistance and troubleshooting with extensive medical knowledge and experiences. Gill and Billy discuss the impacts to their practices and patients, and what innovations other GPs are adopting in light of telehealth and social distancing.

(1:01) How is your practice getting on with telehealth?

Billy finds the concept of telehealth services to be intriguing and very adaptive for the healthcare sector in supporting the current pandemic. He is also relieved to be in such close contact with his concerned patients through various communication tools.

The current situation and Government policy coinciding with that requires people to stay home on a strict basis, however, there are patients who are in need of periodic sessions with their healthcare consultants but at the same time they also dwell on the fear of infection while visiting GPs. So in this case, the communication tools are offering them a chance to have a face-to-face conversation with their respective consultants without having to leave their homes.

Gill runs an asylum seeker and refugee health clinic that sees a large proportion of patients who are on a low-income bracket and can also be worried about the situations of their home countries.

(3:27) Are you seeing any new patients? How frequently are new patients dropping by to seek assistance from the GPs?

Gill’s fellow GPs are observing a decrease in the number of their patients, however the clinic has been rather steady with its patients as many of them are now incapable of working in this situation, so they’re in need of pharmaceutical supplies and other healthcare benefits.

(4.08) How many hours are you working at the clinic?

Gill is offering a reasonable amount of work hours at the clinic as the physical appearance does boost the morale of the clinic staff. In addition to that, there are patients admitted with chronic disease who require a regular check-up from their consultants. At the same time they seek emotional support in the current isolated situation, so not all patients can be handled through communication tools.

Introduction of Dr Michael Kidd

(5:55) In recent days, many of the states expanded testing of COVID-19. What are your thoughts on this course of action and what does it contribute to the future?

Australia has one of the highest testing rates for coronavirus. As a result, the country has been very proactive in identifying, isolating and treating the COVID-19 patients. Michael has observed an increase in the testing capacity due to the supply of sufficient testing kits and other required objects followed by the announcement from the Prime Minister that the restrictions will be in action for four more weeks. During these four weeks Michael expects to see more increase in the testing capacity and more proficiency in contact tracing of existing COVID-19 patients in order to find out the potential carrier of the disease and, after tracing the outbreak areas, quickly isolate those areas and provide the infected people with proper medical care.

(7:45) Being a little far back from China but moderately ahead of Germany, England and Italy in dealing with the COVID-19 pandemic, Australia has a comparatively favourable position than other countries of the world. What are your thoughts on that?

Michael draws the attention to the positive phenomena that took place in the last few weeks. Australia took a very swift action in preventing cross-border travelling by reducing the amount of international travel, also creating a very bold national response that resulted in restricting inter-country travel, for which the Government is to thank for.

In addition, the Government was also successful in providing proper medical care to those people experiencing acute disease, overcoming the shortage of COVID-19 testing equipment, providing potential influenza patients with vaccination facilities, and providing other healthcare benefits such as consultations through telehealth. In addition, the GP community played a vital role by adapting themselves to telehealth, through which the RACGP was instrumental in advising members in the short time frame.

(10:43) After having adapted to telehealth, the most obvious question raised among GPs is ‘How long do telehealth item numbers last?’

Michael points out that the new item numbers have been granted a six-month extended period from the MBS. Also during this period, a modified form of telehealth might be introduced. It will also be observed how the project is actually contributing to the pandemic situation, and whether any adjustments need to be made if the changing situations require. Whether the project should be extended even after the pandemic situation has been lifted is the other focus. Michael adds that the role of GPs in residential healthcare facilities in this pandemic situation is absolutely essential worldwide, and telehealth would reduce their work load a bit and make their efforts more effective.

(12:38)  Over the last month we haven’t really known how much COVID-19 has been spread in our community, but that is changing in a number of states due to the increase in the number of tests being performed. However, there are a lot of questions amongst our colleagues about serology testing and how sensitive polymerase chain reaction (PCR) testing is. What are your thoughts on that?

Michael observes that testing has not been done on a large population scale, rather patients have been isolated and treated according to their symptoms. This coincides with the depicted guidelines regarding the contamination; however the span of testing must be expanded as much as possible and as quickly as possible as the country has the capability of doing so.

Moreover, it has been observed the community transmission in Australia is comparatively lower than many other countries, however this could be more established if more testing is performed in those regions where infected people have been found and more people should be reached for testing through proper contact tracing. The next stage of testing is PCR testing which provides very satisfactory and reliable results. In addition, serology testing is proving to be vital for research worldwide since the results might indicate the chances of a person to get infected by COVID-19 immediately after recovering from it.

(16:17) What is your opinion on using masks to prevent the spread of disease and would your opinion change if we had an endless supply of masks?

Michael explains that clearly we need masks to prevent the spread of disease. Despite of a lot of debate on the topic, wearing masks can prevent you from touching your mouth and nose which reduces the chance of the COVID-19 virus getting into your system. Michael adds that there was a significant shortage in the supply of masks in Australia a while back, however the country is expecting to receive new masks from external suppliers and the local manufacturers are also stepping in to produce masks domestically and maintain the production quality, with respect to the ones that are being used in the United States and other countries.

(18:54) Do you think the practice of using masks will be useful for us in the flu season?

Michael says the most effective measure against the flu season would be to immunise ourselves, he also adds that various types of influenzas are very contagious and can easily be spread through human-to-human transmission. Wearing masks allow an infected person to prevent the infection from transmitting to another person through face-to-face conversations or coughing and sneezing, so it is definitely going to come in handy.

(20:32) In the early stage of the pandemic there was a confusion among the population and also among GPs, particularly around testing and who were eligible for testing. How would you like to comment on that?

It is crucial that we have proper guidelines from certified bodies, especially for the healthcare workers on how to handle this situation effectively. In the case of Australia, national efforts to manage the crisis have been extraordinary as well as cooperation from the RACGP and other medical colleges that have been very helpful in the manner of providing proper guidelines and testing. At the same time the nation has been very responsive in abiding by the guidelines and maintaining proper hygiene and social distancing which are vital for preventing this disease.  

 (25:19) The importance of general practice has been recognised by the nation and also their efforts have been widely recognised by both the Government and the nation in keeping this pandemic at the bay.

  • Testing is increasing more as we speak and it is the most important function to perform in prevention and cure of COVID-19.
  • ‚ÄčAustralia is in a comparatively favourable position regarding the pandemic due to the relentless effort of the Government and the health and medical professional community.
  • Polymerase chain reaction (PCR) testing has proven to be very reliable, and serology testing determines the condition of a person’s immune system.
  • Masks play a very important role in preventing human-to-human transmission for COVID-19 and other contagious diseases.

‘I look back at my career and think about the time when HIV first appeared, and it took us three years before we could actually isolate the virus’ – Dr Michael Kidd.

Generally Speaking is an RACGP podcast, sponsored by CommBank and hosted by GPs.

Resources referred to in the podcast and on the webpage are not necessarily endorsed by RACGP and views of the presenters are their own.

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