If outbreak worsens, response plan to include dedicated ‘fever clinics’ to free up emergency hospital beds for the most ill

With the first two cases of community transmission of coronavirus confirmed in Australia, doctors will be briefed in coming days about what to do if patients start presenting to clinics and emergency departments with symptoms.

Both cases of transmission occurred in New South Wales. One of the cases, a 41-year-old woman, could be traced to her 43-year-old brother with the virus who had recently returned from Iran.

However, the second case, in a 53-year-old health worker, was most concerning given the man had not recently travelled to an affected country and had not knowingly been in contact with an infected person. Health authorities are now tracing all of those known to have been in close contact with the man, including elderly patients.

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The Royal Australian College of General Practitioners president, Dr Harry Nespolon, said he had asked the government “to be very clear about role of GPs” should community transmission become widespread.

“I’ve been told the government will put out a plan in the next week or two about the role of GPs and how to resource them, whether that’s protective suits, goggles, whatever the case may be,” he said.

“We have also asked the government to provide us with an item number to bill Telehealth, because taking phone calls to triage people will be inevitable and we need to be compensated to do that, to tell people whether they should come into the clinic or go to a hospital.”

If widespread community transmission occurred, people with symptoms should call ahead to their GP clinic so that staff could prepare, Nespolon said.

“I think the prime minister wants this sorted as quickly as possible so that we can give clear advice to our doctors about what to do before this virus hits,” he said. “General practice will be a central part of the response.”

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The government has already activated an emergency response plan for coronavirus and has been consulting with state and territory health departments and health ministers to prepare. As part of the plan there are different levels of response, depending on whether community transmission is low, moderate or severe, which can be hard to predict ahead of time.

Stakeholder briefings are being held throughout the week with peak bodies, including the aged-care sector, to identify their needs.

Guardian Australia has been told that as well as Telehealth, part of the response will include establishing dedicated coronavirus clinics so that emergency hospital beds can be reserved for the most sick patients. Because the virus lives on surfaces, hospital isolation rooms will need to be disinfected thoroughly before a new patient can be given a bed, a process that can take a few hours.

States and territories will coordinate which community GP clinics will become specialised “fever clinics” to free-up hospital beds.

However, unless someone has travelled to an affected country in the past 14 days or been in close contact with an infected person, there is currently no need for concern that experiencing any cold or flu-like symptoms might be coronavirus. Anyone who is unsure can call the national coronavirus health information line.

A federal health department spokesman said calls were initially handled by contact-centre operators. “There are processes in place to transfer callers with health symptoms to the Healthdirect helpline for clinical assessment where required.”

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He said the department was working through a range of likely scenarios as part of its preparations, including determining which events would trigger a change in response.

“States and territories will work closely with the Commonwealth to ensure there are clear avenues for what people should do if they become unwell,” the spokesman said. “This may include using home care to manage patients who only have mild illness and do not require hospitalisation. Our planning work will develop a range of safeguards to manage and protect people’s health.”

In Australia, the people most at risk of getting the virus remain those who have recently been in mainland China or Iran, or been in close contact with someone who is a confirmed case of coronavirus. Those people must isolate themselves for 14 days in their hotel or home. If mild symptoms develop, at-risk people should call a doctor or hospital and tell them their recent travel or close-contact history. If serious symptoms such as difficulty breathing develop, at-risk people should call 000 and notify the officers of recent travel or close-contact history.

A close contact is someone who has been face to face for at least 15 minutes with someone who has tested positive for the virus, or been in the same closed space for at least two hours without protective gear with the person while infectious.

The current advice for doctors treating travellers with symptoms, or treating those who have had close contact with someone with symptoms, is to place a surgical mask on the patient, put them in an isolation room and contact their local public health unit about specialised testing.

To date 30 people have been identified with coronavirus in Australia and of those, 15 people have recovered and one person has died, with the rest in a stable condition.