RACGP call for national pandemic plan as coronavirus outbreak exposes response flaws
Major flaws have been exposed in Australia’s public health response to the deadly coronavirus outbreak, with GPs calling for a national plan to deal with pandemics as they revealed their anger over having to triage patients for free.
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Exclusive: Major cracks are appearing in Australia’s frontline fight against the coronavirus with general practitioners furious they are not being paid for triaging patients who ring to discuss symptoms.
And the Royal Australian College of General Practitioners said GPs have been given conflicting advice from nine state and federal governments about the right type of masks and testing procedures for patients with coronavirus.
It is high time for a single centralised, national body dispensing information, rather than advice from the state and territory health agencies, RACGP chief Dr Harry Nespolon said.
Initially doctors were told to wear higher grade P2 face masks when treating potential coronavirus patients but now are being advised they only need a cheaper surgical mask, P2 masks are needed only if the patient is symptomatic.
However, one state, South Australia still tells GPs to use a P2 face mask at all times.
More than 1700 medical staff in China have already been infected with coronavirus and it has proved highly contagious on a cruise ship moored off Japan.
“We are also getting different advice from the states and territories on the tests for coronavirus and who should be taking them – should they be done by a GP in a clinic or should they be done in a hospital in a negative pressure room?” RACGP president Dr Harry Nespolon said.
Queensland is telling GPs to “immediately place the patient in a single room (ensuring air does not circulate to other areas) with the door closed” and if the patient has severe symptoms recommends isolating patient in room with negative air pressure.
Other states don’t require this level of infection control.
Queensland also wants specimens to be hand delivered and not be sent in pneumatic tubes.
While NSW says its OK for patients to have the testing carried out by private pathology companies South Australia says “do not refer patients to pathology collection centres – specimens should be collected by the treating doctor or a designated specimen collection staff member/centre”.
Some states ask GPs to test not only patients who’ve been to China recently but also those who’ve been to Thailand, Hong Kong, Japan, Singapore or Indonesia while others don’t.
“It has taken too long for state health agencies to update their advice in line with the federal advice. GPs have faced weeks of confusion trying to figure out which guidelines they should follow. It’s undermining the critical work GPs do in caring for patients and in controlling outbreaks like coronavirus,” Dr Nespolon said.
Doctors are also angry that governments are expecting them to effectively treat coronavirus patients for free.
“For example, some of the states have told people to call their GPs if they suspect they have coronavirus. The problem with that is GPs who are booked out are going to have to stop seeing practice patients and act as a free telephone triage service.
“We are not remunerated for that and it can take up a lot of time. It’s just another instance of why we need a consistent nationwide approach,” Dr Nespolon said.
The RACGP is today urging the government to develop a national plan to deal with potential pandemics after the coronavirus outbreak revealed failures in the public health response.
It echoes calls from the Australian Medical Association and the Australasian Society for Infectious Disease (ASID) which two weeks ago called for a national centre for disease control in Australia.
“The public gets confused and stressed out and they don’t know who to listen to,” said the president of ASID Professor Josh Davies.
The US, China and Europe all have centralised bodies that co-ordinate responses to infectious outbreaks and the World Health Organisation prefers to deal with a single representative body in each nation in a crisis.
Health Minister Greg Hunt said Australia’s readiness to meet the challenges of the novel coronavirus has been proven by the fact there had been no evidence of transmission within this country.
“The Australian Health Protection Principal Committee (AHPPC), which includes the Australian Government Chief Medical Officer and all Chief Health Officers, has provided consistent advice for GPs and health practitioners, which is available on the Health website,” he said.
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“It is a matter for individual jurisdictions if they wish to take additional measures,” he said.
Australian Chief Medical Officer Professor Brendan Murphy conceded there could be different advice at a state level on coronavirus.
The states base their planning based on their own organisational requirements and structures within their healthcare systems, he said.
“The healthcare systems, e.g., governance and management of hospital networks are not uniform across all states and territories,” he said.
Originally published as RACGP call for national pandemic plan as coronavirus outbreak exposes response flaws