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Coronavirus criteria expand again

Matt Woodley 17/02/2020 3:49:03 PM UPDATED: GPs should now consider testing symptomatic patients who have a recent travel history in a number of different countries.

Patients with symptoms who have recently travelled to Hong Kong, Indonesia, Japan, Singapore, Thailand, Iran, South Korea, Italy or Cambodia are considered to be ‘person under investigation’.

The latest advice, published in updated interim guidelines produced by the Communicable Diseases Network Australia (CDNA), recommends clinicians consider testing people with ‘a clinically compatible illness’ who have previously travelled to Hong Kong, Indonesia, Japan, Singapore, Thailand, Iran, South Korea, Italy or Cambodia within 14 days of symptom onset.



Passengers who have only been in transit through an airport in these countries should not be considered as a ‘person under investigation’.



The original update came more than two weeks after a Sydney GP, who helped identify one of the first confirmed cases in Australia, called for expanded testing criteria after they had multiple requests for coronavirus testing denied on the basis of travel history.



‘My fear is that the number of cases in Australia is getting much, much higher. But, unfortunately, we have set an artificial barrier for confirming the actual number,’ the GP said at the time.



‘The policy needs to be changed.’



The new list is based on the volume of travel between the listed countries, Australia and China, and the current epidemiology of COVID-19 (coronavirus). At the time of publication on Friday 28 February, South Korea had the highest number of confirmed cases outside of China (1766), followed by Italy (655), Iran (245) and Japan (207). Singapore, Hong Kong and Thailand all had fewer than 100.



Japan has temporarily closed schools and urged people to avoid crowds and ‘non-essential gatherings’, after Health Minister Katsunobu Kato warned the outbreak had entered ‘a new phase’. The island nation confirmed its first death due to the virus earlier this month, and people with no travel history or direct connections to China have also been infected.



Indonesia and Cambodia have not had any confirmed cases; however, there are doubts as to whether this is an accurate representation of the situation, given Indonesian authorities have only tested 134 people and there are reports of a confirmed case travelling within Bali while possibly contagious.



Meanwhile, Cambodia allowed hundreds of passengers to disembark from a cruise ship that had recently been to Hong Kong and Singapore, despite numerous other countries previously barring the ship from docking over coronavirus fears.



The number of new cases in China appears to have slowed somewhat and its government recently ordered all people returning to Beijing from extended Lunar New Year holidays to undergo a self-imposed two-week quarantine to help curb the spread of the virus. However, question regarding its shifting methods for documenting news cases, combined with a slight recent uptick in cases, means the situation remains ‘complex and serious’, its National Health Commission said.



According to the ABC, around 500 million people in China have been affected by policies put in place to restrict movement in an effort to contain the outbreak.



At the time of publication, there had been nearly 83,000 confirmed cases and more than 2800 deaths.



The RACGP has more information on coronavirus available on its website.



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