Some GPs have recently had difficulties in coordinating care for suspected Covid-19 patients. Dr Brian Hughes of the LBH Fever Clinic provides a quick update for the current situation on the North Coast.

Criteria for being seen at the Covid-19 Clinic have changed rapidly over the last two weeks. The criteria as of 8 April 2020 are:

Respiratory infection requiring admission
Overseas travel past 14 days and respiratory symptoms
Contact with case COVID-19 past 14 days
Symptomatic HCW Worker (includes aged care workers and disability workers in residential facilities)
Public health outbreak control (includes aged care facility residents, correctional centre inmates/staff, other institutions, suspect cases in remote Aboriginal communities- 2 or more cases) or as directed by PHU
Essential services workers e.g. Police – symptomatic
Contact with a Backpacker past 14 days -symptomatic
Symptomatic- from or contact with Eastern Suburbs Sydney or Ryde past 14 days (other area defined by PHU – e.g. see below)
Symptomatic from Port Macquarie or Byron Shires
Backpackers symptomatic or asymptomatic
Referrals from GPs (Please call if issues)

To date over 1000 patients have been seen through the clinic. Due to the high volumes it has been difficult to notify negative patients and their GPs of the results. We are continuing to develop a SMS pathway to convey this information for negative patients.

Positive results are notified to the patient and their usual GP (if specified at the time of the Fever Clinic consultation) and to the Public Health Unit.

All positive patients identified through ED or Fever clinic are logged into our post fever clinic Hospital in the Home (HITH) program for monitoring remotely on a daily basis for deterioration. They are also given a fever pack containing gloves, mask and contact details for deterioration as well as a thermometer. We are considering portable O2 saturation monitors as well.

The danger period is days 7 to 11 post onset of symptoms. As a result we are linking in early to make transfer to non-virtual hospital bed safer and easier. (Sea REACH procedure below.)

We are happy to assist with any of your patients, particularly patients with comorbidities and over 65 years old who have symptoms into their second week. If you have concerns or need further information just call LBH ((02) 6624 0200) and ask to be put through to the Fever clinic/HITH or myself.

Dr Brian Hughes MBBS Dip SHM FPC FRACP FACSHP FFAChSHM
General Medicine, Infectious Diseases and Sexual health Physician – Fever Clinic | Lismore Base Hospital