The best approach to battle coronavirus? Pick up the phone

Tumut Hospital Staff say they are well prepared to care for people who may be diagnosed with COVID-19. [L-R] Acting NUM Julie Brewis, Senior RN Lorraine Sullivan, Clinical Nurse Educator Kellie Oddy and Transition to Professional Practice Nurse Chloe Bussa

Isolation rooms have been set up at local medical clinics and hospitals, but so far, only one Tumut clinic has reported testing a patient for COVID-19, the new strain of the coronavirus which is causing an international pandemic. That test returned a negative result.

The first step for anyone who has symptoms of COVID-19 is to pick up the phone. That’s the advice from local clinics, the Tumut Hospital and the Murrumbidgee Local Health District.

Dr Tran at the Connection Medical Centre in Tumut has her staff directing all concerned patients to call the Murrumbidgee COVID-19 Hotline to be screened. Even if a patient comes to the clinic, they are directed to a phone dedicated for that purpose. The Hotline then triages patients and helps them book a testing appointment, if required.

Jennie Fischer, Practice Manager for the Tumut Family Medical Centre, said they are asking their patients to start with the hotline and call the clinic as a second step. They are the only clinic in Tumut so far to confirm that they’ve tested someone who suspected they might have the disease. That test was conducted two and a half weeks ago, sent to Sydney, and returned no sign of the disease.

With testing kits in short supply, the government is limiting the types of cases which can be tested, encouraging others to self-quarantine and practice good hygiene.

“The latest advice is to have the swab done there needs to be fairly clear evidence that you’ve travelled [internationally] or been in contact with someone that’s a confirmed case [within the last 14 days],” Jennie said.

“We can still swab people for the general flu, like we would during the regular flu season anyway. The actual COVID testing at this stage is being reserved for people who meet the case definition.”

That makes it difficult for health professionals to know how many people might have the virus but haven’t been tested. The Murrumbidgee Local Health District is still reporting that there haven’t been any confirmed cases in the Riverina and spoke strongly against “misinformation” being spread through the rumour mill.

“We have heard rumours of unverified reported cases. Spreading misinformation about COVID-19 is dangerous and only the facts should be told,” said Kerry Lindeman, Cluster Manager, Tumut, Batlow and Tumbarumba Health Services.

“To date, there have been no confirmed cases (positive tests) of Coronavirus (COVID-19) in our area.”

Kerry stressed that the Tumut Hospital is “well prepared to care for people who may be diagnosed with COVID-19.” She said people with mild to moderate symptoms can be managed at home with the support of their GP and Murrumbidgee Local Health District’s virtual health services.

“Those who are more unwell may be admitted to an appropriate local hospital,” said Kerry.

The hospital said it has “plans in place for the treatment and care of any one who may have contracted the virus and needs to be admitted,” with an isolation area established with support form a team of infection control personnel.

 “District speciality infection control nurses are out and about in our hospitals providing support to front-line staff to maximise the safety of our healthcare workers and the community,” said Kerry.

At Tumut Family Medical Centre, Jennie Fischer said they haven’t seen many patients who fit the criteria to be tested, even though there are a number of people coming in with cold and flu symptoms.

“We’ve probably only had a few people who have been specifically worried about the fact that they’ve had contact with someone or have travelled overseas,” said Jennie.

“Unfortunately it is that time of the year, the change of season, you often get an increase in hay fever often, plus you get an increase in gastro bugs and sniffles and colds and flus.”

To help slow the spread of COVID-19, and other diseases, many local clinics, including the Tumut Family Medical Centre, have been setting up separate rooms for anyone who appears to be contagious and asking people with coronavirus symptoms to call ahead and discuss their situation with a nurse over the phone or in the carpark.

Margaret Reynolds is the Practice Manager for both the Adelong Medical Centre and Fitzroy Medical Centre in Tumut. At both clinics, there are isolation rooms and signs in the parking lot asking people not to come inside if they think they might have COVID-19.  

“From our point of view, we don’t want

[people who are likely to have COVID-19]

coming in the surgery, that’s why we’ve got the signs up,” she said.

“We’ve removed all the toys and the magazines from the surgery. We’re trying to clean the surgeries through the day as well, so the less stuff that’s on that front counter, the better.

“We’ve just got the TV in the kids room. We’ve moved a lot of stuff from the front counter which has got pamphlets and stuff like that, just so it’s easier for us to clean.”

Margaret said that since there haven’t been any confirmed cases of the virus in the Riverina, it would be difficult to tell if the virus was already present in the community. That’s why social distancing is important, along with self-isolation if people strongly feel that they have symptoms, but haven’t traveled or come into contact with a confirmed case. 

“The testing is so strict at the moment, you really wouldn’t know if people had it or they didn’t,” she said. The Adelong and Fitzroy clinics aren’t currently testing for the disease, but are triaging patients and referring them for testing appointments.

“If someone is [suspected of having COVID-19], we give them the form, tell them to call Douglass Hanly Moir [in Wagga], go home and self-isolate and make the appointment with DHM.”

Douglass Hanly Moir has notified medical practices that testing has increased at their Docker Medical collection centre, with collections taking place between 7:30am and 3:30pm, with patients seen every 15 minutes.

Staff stress that the collection point is not a drop-in centre and “anyone who turns up without an appointment will be sent away.”

DHM says it is essential that patients phone ahead and wear a face mask when they enter the Docker Medical facility.

In the meantime, local medical clinic managers are joining the chorus of health and government professional who recommend good hygiene and social distancing.

Margaret said they’re working to keep up with the changing criteria for fighting the spread of coronavirus, watching daily seminars and taking online classes to brush up on basic hygiene and handwashing techniques. She recommends the general public does the same.

“It is hard because you think, this week we’re doing this, but next week, we might change,” she said. “They have brought in new [phone] numbers through Medicare, where doctors can do a consult on the phone with someone they think may have it and can’t come into the surgery.”

Margaret said there also appears to be a flu going around Sydney and Melbourne, with a number of people coming into the Adelong clinic with sore throats and heads after returning from the cities. Those patients are being separated into the isolation room while they wait to be seen.

Jennie Fischer at the Tumut Family Medical Centre, said the best decision for anyone with symptoms is to start by calling the Health Direct triage line, even though “we have heard from a number of people that line is super busy and it’s difficult to get through.”

She said the next option to call a local GP and discuss symptoms over the phone.

“The most important thing is hand hygiene, cough and sneeze into your elbow, and look out for the older people as well,” said Jennie.

“Try and keep away from older people and people with other existing conditions like diabetes or lung disease or heart disease, because they’re going to be a little bit more vulnerable.”

And if you’re healthy?

“If you’re healthy, continue on as normal and try not to hoard toilet paper.”

Dr Tran at the Connection Medical Centre, agreed, saying she is running desperately short of toilet paper and tissues and isn’t sure she can keep the clinic open without those supplies. She said she has “begged the supermarket,” but there’s little they can do.