Northside Health NT.
27 April 2020. EXPANDED TESTING.
An important testing change was announced this week.
From 27 April, ANYONE WITH A FEVER OR RESPIRATORY INFECTION MAY BE TESTED FOR COVID-19.
NB- this is NOT because it is likely that all these respiratory infections are caused by COVID-19. In fact, in the NT, the risk is extremely low. But the decision was made at a national level to begin "sentinel testing" to establish exactly how many people have COVID-19 with low symptoms and no known cause for how they caught it, as a measure of Australia's community transmission rate, and to isolate and treat any unidentified cases.
- "fever (≥38°C) or history of fever (e.g. night sweats, chills) OR acute respiratory infection (e.g. cough, shortness of breath, sore throat), where no other clinical focus of infection or alternate explanation of the patient’s illness is evident".
PLEASE DISCUSS WITH YOUR DOCTOR ANY SYMPTOMS AND THEY WILL DECIDE WITH YOU WHETHER TO PROCEED WITH TESTING.
Testing can occur at Northside or at the dedicated testing centre based at RDH, depending on your symptoms. As a precaution, your testing doctor is required to wear full PPE of mask, gloves, gown and goggles.
Testing procedure: a long cotton bud swab is inserted deeply into your nose and also throat. The swab is sent for processing at RDH lab.
LOCAL UPDATE FROM THE NT CENTRE FOR DISEASE CONTROL,
27 APRIL 2020:
It has now been 3 weeks since the last COVID-19 case was diagnosed in the NT. All NT cases acquired their disease overseas, interstate or from a known close contact and no NT community transmission has been demonstrated to date.
In dealing with a disease for which there is yet no vaccine and no specific medical treatment other than best practice supportive care, the main tactic for reducing and stopping its spread and saving lives has been social distancing (restriction to travel, gatherings, visiting and maintaining 1.5 m personal space), practising good personal hygiene (e.g. covering coughs, frequent hand washing) and importantly early detection of cases for isolation and management. Additionally, timely and thorough contact tracing around all cases to identify close contacts for assessment and quarantine has been and remains a high priority.
Together the people of the NT have achieved an amazing outcome to date in stopping the spread of COVID-19. Now, as the Nation and the Territory looks to move through this pandemic, some of these successful social distancing measures will be reduced. This will occur in a planned, step by step manner. It is essential during this time that there is the capacity to carry out surveillance for the virus to inform those steps and to safely identify and rapidly respond to COVID-19 cases should they occur.
The recent Commonwealth announcement, supported by the NT, promotes testing more widely. This testing beyond the suspect case definition is referred to as ‘Enhanced testing’ and may change over time depending on levels and localities of disease and testing capacity.
WE CONTINUE TO OFFER TELEHEALTH (PHONE OR VIDEO CONSULTS).
Northside doctors, nurses, practitioners and administrative staff are working calmly and proactively to keep you and ourselves as safe and healthy as possible now and for the weeks and months ahead.
WE ARE OFFERING CONSULTS IN PERSON AT THE CLINIC OR VIA PHONE & VIDEO.
During a Telehealth consult, if the GP decides that they need to see you in person, they will ask you to book in for a face-to-face consult on the same day or another day.
All fees for Telehealth consults are the same as our existing fees.
Medicare rebates are exactly the same too.
BULKBILLING HAS BEEN EXPANDED TO COVER: people over 70, ATSI over 50, anyone with a chronic health condition, immune compromised, pregnant, under 16, with a child under 1, with a Health Care Card OR who are under financial strain due to COVID-19.
Bulkbill also for: brief appointments not requiring discussions- eg. repeat prescriptions or extension of medical certificates.
All Care Plans and Mental Health Care Plans can be performed by Telehealth.
Medical certificates will be emailed to you.
Prescriptions, specialist referrals and pathology forms will be sent to your chosen provider.
HOW DOES TELEHEALTH WORK?
You will receive the usual SMS reminder with your appointment time.
Please use this as a guide- your GP may not call at exactly this time.
KEEP YOUR PHONE WITH YOU AND BE READY.
Prepare a clear list of what you want to achieve in the consult.
You will have your consult via phone with your GP.
We may use other video platforms to contact you on your phone. These do not require any special Apps, just your phone camera. Just click on the link we send you in an SMS.
If your doctor decides they need to see you in person, you will be asked to attend the practice that day or book for another day. Some examples of this might be a skin lesion of concern or a Cervical Screen Test.
Medical certificates will be emailed to you.
Prescriptions and pathology forms will be sent to your chosen provider.
Naturopath and psychologist consults will occur via Zoom video link. Please install the Zoom App on your device before your first consult.
OUR WAITING ROOM AND WHAT TO DO IF YOU HAVE A COLD:
We are implementing various strategies in the waiting room to lower infection risk, such as removing reading material and placing Perspex screens at reception.
Please remember that everything we are doing is designed to protect you, and very vulnerable people who may be in the waiting room, and the practice staff who need to remain well to keep providing essential care in the next critical several months. We all need to be understanding and considerate towards each other at this time.
Anyone with any respiratory symptom is no longer able to wait in the waiting room. Please use your car as a private waiting room.
This includes: cough, cold, flu, sore throat, fever, runny nose, sneezes, sore ears, sore eyes, sinusitis, conjunctivitis or red eyes and anything else to do with your airways.
MILD COLDS: You will also need to discuss possible COVID-19 testing with your GP.
All mild respiratory illnesses (colds) should stay at home until fully recovered. It is important to stop spreading ALL colds and infections to other people at the moment, to keep them stronger in case they also get COVID-19 or to prevent a health worker having to stay home due to a cold.
STAY AT HOME IF YOU HAVE A COLD.
Wear a MASK if you have to go out. Homemade cloth masks are useful in reducing droplet spread.
MODERATE COLD SYMPTOMS: If your cold is more than mild, please book a GP appointment to discuss treatment you might need for such things as painful ears, tonsils, sinuses or severe cough, or if you are at risk of problems such as an asthma flare-up, you need to be assessed in person by a GP. This will occur initially by telephone then the GP may assess you in your car/ in the carpark. You may be asked to wear a mask. The GP will wear protective gear such as a mask, gown and goggles. You will also need to discuss possible COVID-19 testing with your GP.
SEVERE COLD OR FLU: It is very important that you take action immediately however, if your mild flu or cold becomes more severe. Call us. Any sign of pneumonia such as difficulty breathing or shortness of breath, particularly with fever, requires an urgent visit to RDH ED, no matter what time of day or night. Pneumonia qualifies immediately for COVID-19 testing.
What if I am coming to the clinic for something else and I happen to have cold symptoms?
PLEASE DO NOT ENTER THE WAITING ROOM. Call reception. The consult can occur by telephone, to you in your car in the carpark, and scripts or paperwork brought out to you.
HOW TO MANAGE A MILD COLD OR FLU AT HOME.
Sleep and rest are very important. Implement the basics- healthy food, plenty of water, minimise sugar, caffeine and junk food.
Immune support: use vitamin C and herbs at hand such as ArmaForce, olive leaf or echinacea. Vitamin C can be taken 1g every 1-2 hours (for adults); stop before the point it causes diarrhoea (eg 10g a day).
STOP taking all these immune supports after the first 4 days as they may worsen the cytokine storm that causes COVID-19 to become severe for some people at Day 7 and beyond.
Symptom relief as required: decongestant nose sprays, cough lozenges and paracetamol. At this time, it appears best not to use ibuprofen as it appears to worsen COVID-19 symptoms.
If required, a medical certificate can be issued to you by one of our GPs using a Telehealth consult.
FLU VACCINES- AVAILABLE NOW, BUT VARIABLE SUPPLY.
We remind all people who are eligible for free flu vaccines to book for vaccination NOW (over 65 years old, ATSI, pregnant women, or with a chronic health condition).
There are significant supply problems all around Australia. If vaccines have run out at the time you call, we will put you on a wait list for the next lot that arrives.
Avoiding the flu will keep your immune system stronger if you do catch COVID-19.
Private flu vaccines for all other people are also available now.
Pneumococcal vaccine is also free and recommended for the same groups.
WHAT DOES COVID-19 CAUSE?
European studies indicate that 50% of those infected are asymptomatic. The exact numbers are not known.
Studies indicate including different rates of frequency for symptoms but they generally include:
fatigue or muscle ache
loss of taste and smell
Around 80% are considered mild
Around 15% are severe and 5% are critical.
The disease usually becomes severe at Day 7 or 8, not earlier.
PLEASE REMEMBER THAT IF YOU DO CONTRACT COVID-19, EIGHT OUT OF TEN PEOPLE WILL ONLY HAVE A MORE MILD FLU-LIKE ILLNESS. (Flu can still feel terrible).
So self-isolation at home for any cold/flu at the moment is the most sensible approach to take. If it is COVID-19, the odds are that it will affect you mildly and the most useful action you can take is not spreading it to others.
It is very important that you take action immediately however, if your mild flu or cold becomes more severe. Any sign of your lungs being affected such as difficulty breathing, shortness of breath and chest pain, particularly with fever, requires an urgent visit to RDH ED, no matter what time of day or night.
Testing for people with fever or respiratory symptoms but no known contact with COVID-19, can be done at Northside.
Testing for suspect cases needs to be notified to CDC (Centre for Disease Control). These tests will occur at the dedicated testing centre at RDH.
If you fulfil the criteria, you need to first book the COVID-19 test by calling CDC on 89228044 or 1800 008 002. If you are very unwell, call the hotline and proceed immediately to RDH ED.
CRITERIA FOR "A SUSPECT CASE" FOR TESTING FOR COVID-19:
You develop respiratory illness with or without fever (above 38 degrees) and fall into any of the following categories:
You have returned from overseas or interstate in the past 14 days
You have been in close contact (see below) with a confirmed coronavirus (COVID-19) case in the past 14 days
You are a healthcare worker with direct patient contact, pharmacist, or frontline worker (police, emergency services, correctional officers, educators, childcare, aged care & disability workers, pharmacists & pharmacists)
Any patient in hospital
Any person in the following settings: a. aged care and residential (including disabled and mental) care facilities b. in military group residential settings c. boarding schools d. correctional or detention facilities for those detained in previous 14 days e. Aboriginal rural and remote communities at particular risk of covert transmission. Currently this includes only those communities with a degree of interaction with the Kimberley region of WA.
Close contact with a positive case = more than 15 minutes face-to-face contact in any setting with a positive case from any time 24 hours before they show symptoms onwards; OR more than 2 hours in a closed space together, from 24 hours before they show symptoms onwards. Living in the same household would fulfil the definition of close contact and would require testing. On airplanes, only the people in the two rows around the positive case need to be tested.
89 228 044 (8am-4.21pm): to book testing in Darwin.
They ONLY want calls about symptoms which fulfil testing criteria.
1800 008 002: NT-wide COVID-19 phone line.
1800 020 080: The national COVID-19 hotline for general advice.
Perhaps the silver lining at this stressful time is how much creativity and kindness is being shown.
Check out “The Kindness Pandemic” Facebook group, with over 400,000 members sharing positive stories about hope and kindness occurring all over the world. A little bit of kindness goes a long way at this very challenging time; and remember, we are here to do our best for you.
COVID-19 Current Situation and Case Numbers (Australian Government Department of Health): detailed graphs, charts and up-to-date Australian data.
“Home Schooling due to Virus and School Closures in Australia” (Facebook group): resources and ideas for families at home.
The Coronavirus Sanity Guide: free meditations, podcasts, blogs and talks.
COVID-19 Support: mental health supports and ideas.