Newsletter 22/03/2020
Dear Valued Patients,
The current Coronavirus [COVID 19] pandemic has presented the clinic with a health crisis unlike any we have seen before. We wish to provide you with information on the Coronavirus and important changes to our appointment booking and infection control arrangements. The measures outlined here are designed to keep all patients who present to the clinic as safe as is reasonably possible from coronavirus infection.
What is Coronavirus?
Coronaviruses are a family of viruses that cause respiratory tract infections. Symptoms may include fever, sore throat, runny nose, cough and breathlessness. Severity can vary from a mild cold to life threatening lung infections. This new Coronavirus originated in Hubei province, China and has been named COVID 19.
How is Coronavirus Spread?
Coronavirus is spread via droplet transmission from coughing and sneezing. This can occur when in direct contact with an infected person [infectious from 24 hours prior to the onset of their symptoms]. Touching surfaces that have been contaminated with the virus and then touching your face can also allow spread.
Keys to Reducing the Spread of Coronavirus
The three important strategies that we must all practice to reduce transmission are frequent hand washing, cough etiquette [cough into a tissue and dispose tissue/wash hands] and social distancing [staying 1.5 metres from other people]. The government has put in place public gathering restrictions and 14 days self-isolation requirements for returned travellers, COVID 19 cases and case contacts. People who are well are not advised to wear a facemask to prevent infection.
Who is Most at Risk of Coronavirus?
Whilst most people who develop Coronavirus infection will have mild illness [80%], some will have moderate [15%] and severe [5%] illness. Experience in other countries suggest that factors increasing the risk of severe illness include age [elderly / infants], heart disease, lung disease, high blood pressure, cancer, immunosuppression, pregnancy and indigenous status.
Testing for Coronavirus
The government has provided strict guidelines as to who requires testing. Restraint is required to preserve healthcare resources [test kits / laboratory facilities / personal protective equipment / healthcare workforce]. Patients not meeting the criteria will not be tested.
How is Coronavirus Treated?
There is no specific treatment for Coronavirus. Antibiotics are not effective against viruses. Symptomatic management may include fluids and fever management [paracetamol / ibuprofen]. Patients will need to self-isolate. Severe infection may require admission to hospital for oxygen and ventilatory support.
Coronavirus Vaccination
A vaccine is under development and testing but will likely be 8-12 months away.
Sick Leave and Medical Certificates
As per normal recommendations for other respiratory infections [such as colds and flu], sick patients should self-isolate to reduce the risk of transmission. They should only return to work or school when the symptoms have fully resolved. We encourage employers not to require medical certificates for minor illnesses currently as this represents an unnecessary use of healthcare resources.
The practice will not provide medical certificates in the following circumstances to avoid unnecessary presentations and use of medical resources.
*Clearance certificates for patients having self-isolated for 14 days after overseas travel. If you have no symptoms after this time you are free to return to work.
*Clearance certificates for well people who have had contact with unwell people who have not been formally diagnosed with COVID 19
CHANGES THAT THE PRACTICE HAS ADOPTED TO DEAL WITH THE CORONAVIRUS PANDEMIC
Appointment Booking
In order to protect the health of our vulnerable patients and staff the practice has introduced some screening questions at the time of telephone bookings. These questions will relate to whether the patient has any respiratory tract infection symptoms or satisfies any of the travel / occupational [healthcare worker] or COVID 19 contact criteria that would make them a suspect case. Our online booking platforms [Hot Doc / Appointuit] have clear instructions that patients with any respiratory tract symptoms or fever are not to use the online booking system and are to telephone the practice instead. If patients disregard this policy, we may be forced to disable our online bookings system. Any patients declining to answer the telephone screening questions will not be offered an appointment.
The telephone screening questions will also assist in identifying patients who may be eligible for bulk billed telephone consultations. This may include patients self-isolating on medical advice or patients in high risk categories for severe Coronavirus disease.
Patients Identifying as Having Fever or Respiratory Symptoms
The practice has introduced the following policies regarding the management of patients with any fever or respiratory symptoms [sore throat / runny nose / cough / shortness of breath]
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Patients meeting both the clinical and situational [travel / COVID contact / healthcare worker] criteria for a suspect case will be asked to present to a government fever clinic [Prince Charles / Brighton / Pine Rivers]. Do not present to the practice.
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Patients with fever or respiratory symptoms but without the situational criteria will be offered an appointment in our dedicated infectious symptom review facility in the vacant shopping centre tenancy next door to the practice. These patients are not to enter the main surgery premises. We have provided five dedicated parking spaces outside the front entrance for patients to park on arrival. All patients are asked to weak a facemask [if they have access to one] and to telephone reception on arrival. Patients will be seen one by one by a doctor wearing appropriate personal protective equipment. Waiting patients will remain in their car. It may not be possible for the patient to be seen by their usual doctor. All patients seen for infectious symptoms in this facility will be bulk billed. The doctor will not be able to see the patient for any issues unrelated to their respiratory illness due to lack of resources. These issues will need to be addressed later when the patient’s infectious symptoms have resolved. The practice recognises the cooperation of ISPT, the shopping centre operator for their generous assistance during this difficult time.
Patients Without Fever or Respiratory Symptoms
Patients requiring face to face consultations or ineligible for bulk- billed telephone consultations will be offered a normal appointment within the main surgery. Patients are encouraged to present to the surgery alone unless a care giver is necessary.
Patients eligible for bulk billed telephone consultations will be booked for a telephone [telehealth] consultation. We will need to confirm your contact telephone number at booking. The time given for the call will be approximate and may be affected by emergencies. The call from the doctor will be from an “Unknown Number” when it appears on your telephone. If the patient fails to answer after two telephone contact attempts this will be considered as a missed appointment and the patient will need to rebook. Even if eligible for telehealth, the patient may need to be seen in person [if not self-isolating], if a physical examination is required for diagnosis and management.
OTHER INFECTION CONTROL MEASURES INTRODUCED BY THE PRACTICE
*The waiting room seating has been rearranged to increase social distancing.
*Practice entrance door to remain open to reduce door handle contact
*Magazines, brochures and children’s toys have been removed from the waiting room. If you require any device to entertain you whilst you wait you should bring it from home.
*Discontinuation of nebuliser use to reduce risk of aerosolization of the virus.
*Discontinuation of care planning for allied health referrals until further notice.
*Provision of alcohol-based hand disinfectant for patients and staff
*Community education re infection control measures
*Appropriate Influenza vaccination utilising off peak times where possible. Private influenza vaccine is now available and is $18. Patients who qualify for government funded influenza vaccination are encouraged to wait for the release of the government stock as most qualifying patients require the higher antigenic potency vaccine that the government supplies.
*Deferring non urgent preventative care activities where appropriate
*Increase in cleaning and disinfection practices
ONGOING COMMUNICATION
*The practice will endeavour to update our patients on further changes as the pandemic progresses. We are closely following the advice of the Chief Medical Officer and relevant authorities.
*It is a difficult balancing act between caring for patients with infectious symptoms and protecting our most vulnerable patient groups and staff from COVID 19.
*We will post updates on our website, practice signage and via SMS. If you have previously declined to receive SMS contact, then you will have to notify reception to consent to this service if you now wish to receive SMS updates. As always, we encourage you all to update your contact details with our reception staff.
*We would like to thank you all for your understanding and cooperation at this challenging time. It is likely that the measures outlined will need to continue for some months until the pandemic is controlled. Further changes to the way that we operate may be necessary and these will be communicated to you. The best outcome will require us all to work together during this unprecedented event in our lives.
Practice Hours
Monday
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6.00am – 8.30pm
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Tuesday
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6.00am – 8.30pm
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Wednesday
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6.00am – 8.30pm
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Thursday
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6.00am – 8.30pm
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Friday
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6.00am – 7.30pm
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Saturday
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8.00am – 3.00pm
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Sunday
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Closed
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Our opening times may vary in the future if staff absences occur due to illness. We will keep you informed of any changes.
Best Wishes
Dr Lachlan Steffen
Dr Mike Pokarier
Dr Peter Hackney
Elizabeth Sullivan [Practice Manager]
