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[9 min read] COVID-19 Update for GPs: Prof Michael Kidd, Deputy Chief Medical Officer

Important coronavirus (COVID-19) update for GPs from Professor Michael Kidd, Deputy Chief Medical Officer, Department of Health

Australia now has a daily infection growth rate of less than two per cent, further evidence we are succeeding in “flattening the curve”, however our job is not yet done. Please continue with your great work and urge your patients to maintain good hygiene and to practise appropriate physical distancing. 

While we have made significant progress as a nation, I also take the opportunity to emphasise that any health care worker who has been in close contact with someone with COVID-19, or who is experiencing possible symptoms, no matter how mild, should not be coming into the workplace.  Please reinforce this with all people working alongside you.

Professor Michael Kidd AM
Deputy Chief Medical Officer & Principal Medical Advisor
Department of Health

1. Update on telehealth & GP-led respiratory clinics roll-out

Since March 13 and the rapid expansion of MBS telehealth, more than 3.5 million consultations have been administered to over 2.5 million patients. The latest information on the temporary MBS telehealth services is available here.

Good progress is also being made with establishing GP-led respiratory clinics around the country, with 25 now open. These respiratory clinics will provide dedicated services to people with mild to moderate COVID-19 symptoms.

Thanks to all the GPs who have established clinics so far and all those that are finalising details with the Department. The plan is to have up to 100 operational in metropolitan, regional and rural areas across Australia.

2. Infographic on primary care response for telehealth & GP-led respiratory clinics

This graphic has been designed to help primary care practitioners in a telehealth only setting, and those working in telehealth and GP-led respiratory clinics. It covers:

  • Telehealth only – setting up, connecting and getting started
  • Telehealth & GP-led respiratory clinics:
    • getting the patient’s history
    • conducting the examination
    • considering comorbidities
    • making a decision and taking action.

Download infographic here.

3. Keeping remote communities safe – travel restrictions

The Australian Government is working to minimise the exposure of coronavirus to remote and very remote communities. Access to these communities has been restricted to protect community members from the spread of coronavirus. It’s important that every service provider, Government agency and industry follow the guidelines on entering designated remote areas to help stop the spread of coronavirus.

Download infographic here.

4. Personal Protective Equipment (PPE) update

The Australian Government continues to prioritise securing a long-term supply of PPE including gowns, goggles and both P2 and surgical masks. As PPE is a limited resource, the Australian Government’s highest priority is to ensure access to masks and other PPE for frontline acute health service and primary care staff.

This includes:

  • public hospitals (supporting the states and territories), general practices, community pharmacies, Aboriginal Community Controlled Health Organisations and other settings where people are most likely to be presenting with COVID-19
  • residential aged care facilities in the event of an outbreak.

PPE should be worn when caring for someone with a confirmed or suspected case of COVID-19.

Wear a gown, mask, protective eyewear and gloves. Remove PPE before exiting the room or the person’s home. Wash or sanitise hands immediately after removing PPE.

GPs are being urged to work with their PHNs and use available resources with caution and care.

5. Journal articles and resources of interest

The COVID-19 Clinical Evidence 

The National COVID-19 Clinical Evidence Taskforce is currently reviewing evidence for primary care management of people with mild COVID-19. If you have important questions about clinical care in the general practice setting or suggestions, you can submit them to the Review Team here. Explore the clinical evidence here.

Anxiety among health care professionals

There is no doubt health care professionals are facing incredible challenges, risking exposure, high workloads and in some cases isolation from loved ones – our mental well-being will inevitably be impacted.

The Australian Government is working to establish a dedicated mental well-being platform for health care workers and I will keep you updated on that.

In the meantime, a great place to start is the Government’s Head to Health website – headtohealth.gov.au – you can find a range of resources, some great tips and ways to connect if you feel like you might want to chat to someone.

Beyond Blue has launched its dedicated coronavirus mental wellbeing support service, which includes a range of resources and a dedicated phone counselling service, while Phoenix Australia has released a range of coronavirus resources, for health practitioners, workplaces and members of the community.

The American Medical Association has released a useful table to help understand and address sources of anxiety among health care professionals during this pandemic. View table here.

University of Oxford resources 

The University of Oxford continues its good work publishing online resources. Here are three questions focused on management issues for long term conditions.

Do NSAIDs worsen outcomes in acute respiratory infections? 

Verdict: There is a need for caution when using NSAIDs in the context of acute respiratory infections (ARI). Pre-existing medications and conditions need to be taken account of when deciding to prescribe NSAIDs for symptomatic ARI. The lowest effective dose should be prescribed for the shortest period of time. Parenteral use of NSAIDs during an ARI should be avoided.
NSAIDs do not significantly reduce total symptoms or duration of respiratory infections.

Are inhaled steroids for asthma okay to use or should you discontinue them?

Verdict: There is no evidence of a relationship between the use of inhaled corticosteroids and COVID-19 infection at present. Inhaled corticosteroids are generally considered a safe and frontline treatment for controlling asthma symptoms. Evidence from a 2013 systematic review of seven randomised controlled trials found that discontinuing inhaled corticosteroids in people with stable asthma more than doubled the risk of asthma exacerbation (RR 2.35, 95% CI 1.88 to 2.92, mean follow-up 27 weeks). Inhaled corticosteroids, when taken as prescribed, would reduce the risk of an asthma attack being triggered by a respiratory virus such as COVID-19. There is uncertainty over whether the prescription of higher dose increases the risks of pneumonia.

Should people with chronic respiratory health problems stop taking long term oral immunosuppressants?

Verdict: Evidence of how to manage people with chronic lung conditions on long term oral immunosuppression during the COVID-19 pandemic is very limited. There is no evidence to suggest that long-term immunosuppression should be stopped during the current pandemic.

Original source: https://mailchi.mp/health.gov.au/covid-19-update-for-gps-from-the-chief-medical-officer-xxxxxx-4397451?e=83862cc2c1

See last week’s update from Professor Michael Kidd here.

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