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New risk assessment Covid-19 algorithms for GPs

By Dermot - 05th Mar 2020

The telephone risk assessment and testing pathway for mildly symptomatic patients who phone general practice regarding Covid-19 have been published by the Health Protection Surveillance Centre (HPSC).

In a communication to members on 5 March, the ICGP said the algorithm was the “single most important clinical tool” and is being updated as new information becomes available.

The algorithms relate to performing risk assessment for mildly symptomatic patients over the phone and for patients who present in GP surgeries.

Five new videos are available on the HPSC website outlining different clinical scenarios, including room decontamination, to assist GPs in containing spread of the virus in cases where a patient presents to a surgery.

The ICGP also advised its members that community/home testing was now being provided by the ambulance service and confirmed that GPs would not be engaging in home testing.

“Public health doctors are the only ones permitted to request tests and test results will be communicated by public health,” the letter outlined.

GPs are experiencing difficulties obtaining alcohol gel and surgical masks due to a worldwide shortage of these products.

The ICGP noted that the HSE was aware of this situation and confirmed that “HSE stocks will be distributed to GPs”. The “logistics” were being “worked out”.

The ICGP’s “clinical hub” is being updated daily as the situation evolves and members have been asked to access the information to note any changes.

Speaking to the Medical Independent (MI), Dr Nuala O’Connor, ICGP GP Lead with the HSE antimicrobial resistance and infection control team, said GPs nationwide were receiving three types of calls to surgeries.

The first related to large volumes of calls from the public on whether to undertake overseas travel. Dr O’Connor said all such calls should be redirected to the Department of Foreign Affairs website, as GPs cannot give travel advice.

The second grouping of calls are from the “worried well” who have no symptoms of Covid-19 and no travel history to an affected region. These callers, Dr O’Connor advised, should be redirected to the HSE website.

Finally, GPs are handling calls from people who have recently returned from an affected region; who have developed symptoms; and who have had close contact with a case of Covid-19. These calls are being assessed by GPs in conjunction with public health.

“Each practice has to decide what is the most appropriate way for them to manage callers,” Dr O’Connor advised.

The ICGP communication outlines: “The only patients you should receive calls from are from those who have been in infected areas, or indeed those that may be immunosuppressant or have a number of chronic diseases and thus have health concerns.

“All other patients should be directed to www.hse.ie. Travel advice should be taken from Department of Foreign Affairs website.”

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