Communication to GPs from HSE re. updated case definition, priority groups and resources:

FAQs:

What do GPs advise people who were referred for test prior to COB Tues 23d March?

All test appointments for Friday 27 March and after are now cancelled; the tests for Healthcare workers will still be processed.

People who do not meet the WHO case definition, will not now be tested but will be required to self-isolate at home.

Low risk group:

Good news is that you are in a low risk category we expect you will have a relatively mild form. The test is not an intervention or treatment. What we are trying to do is to prevent anyone with COVID infection even mild from spreading it to others in their own home or close circle.

Priority Group:

People in a priority group and waiting for a test are being asked to re-engage with their GP for assessment, to determine if they meet the WHO case definition, in which case they need to be tested.

If patient’s symptoms deteriorate it is important that they contact their GP as soon as possible.

If you have an appointment for a test on 26 March?

Anyone who has an appointment for a coronavirus test scheduled for Thursday 26 March will still be tested. Go to your appointment as planned.

If you had an appointment scheduled for 27 March or after?

All test appointments for Friday 27 March and after are now cancelled. If you have a fever and a cough or fever and shortness of breath and you are in a priority group you should call your GP to arrange a new test.

If you have any symptoms, such as sore throat, runny nose, blocked nose, cough or wheezing, you should behave as if you have the virus. Self-isolate to help stop the spread of this disease. The people in your household will need to restrict their movements.

What do GPs advise patients who (i) do not meet WHO case definition & (ii) not in a priority group?

This cohort should self-isolate at home for at least 14 days from the start of their symptoms and have no fever for the last 5 days.

What do I advise patients who are waiting test results?

Advise patients that they will receive their results by text if they are negative and by phone if they are positive from a public health doctor. Your GP is not able to check when your test results will be available. You will be the first person to know your results.

While it is more usual that a GP who orders a test for a patient gives them a result in this instance the HSE has decided that it is more important for the Public Health Doctor to communicate the result to you so they can start the process of contact tracing. We would ask that you be patient and wait for the text or phone call from public health doctors.

Remember the advice is the same until you know the results of the test Continue self-isolation at home for 14 day. People in the household will also need to restrict their movements for 14 days only going to shops or pharmacy as necessary.

What are the Priority groups for testing?

With increasing numbers of people being referred for testing, our health service must now focus on testing those at greater likelihood of having COVID-19 infection, those who will benefit most from public health management, those most at risk of severe infection and essential healthcare workers.

This is to make sure we protect the most vulnerable people in our community and achieve the greatest good. Therefore priority will be given to people with symptoms of COVID-19 in the following groups:

Symptomatic, as per COVID19 case definition –

1. a) Close contacts of a confirmed case
2. b) HCW who are front facing/ have regular patient contact
3. c) Groups most at risk of severe infection such as persons with diabetes, immunosuppressed, chronic lung disease, chronic heart disease, cerebrovascular disease, chronic renal disease, chronic liver disease and smokers.
4. d) Household contacts of at-risk groups above
5. e) Staff and residents of nursing homes and other residential care settings and those in direct provision, homeless, ROMA and travelling community settings where symptom management is difficult
6. f) Prison staff and inmates where it may be difficult to implement self-isolation advice
7. g) Pregnant women to ensure they can be managed safely in hospital, minimising the risk of spread in the maternity hospital.

How can I send referrals for patients during ‘out of hours’ service?

It is the patient’s responsibility to ensure they follow up with their GP to organise a referral if this is recommended by a doctor on duty for Out Of Hours service.

Many patients don’t have thermometer what do we advise patients?

If the patients feel they have ‘chills/fever/sweats’ this is an acceptable proxy for ‘temperature’

What is the testing capacity?

We are working to expand capacity testing; our goal is to cater for at least 15,000 tests per day by the end of April 2020.

A range of resources are available and listed below to support you and your patients.

Further advice will be available later this week on how to manage the patient at home with COVID-19 and the role of the GP in community hubs.