General practice - Pandemic phases Australia 3 to Australia 5

Page contents: Practices | Clinical | Public Health: 'stamp it out | Checklist for phases Australia 3 to Australia 5 | Worksheet: for phases Australia 3 to Australia 5

Practices

Update your staff

GPs need to know who to refer suspected cases to as new referral pathways for suspected cases will be set up to send patients with suspected flu to designated hospitals.

Home visits

GPs will need to consider if they are willing to do home visits. Practices need to have a plan for how this will work during a pandemic, that is, is a duty doctor system needed?

Make sure that the home visit kit has personal protective equipment as well as infectious waste bags.

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Clinical

GPs will start to see increasing numbers of potential cases, contacts and worried people.

GPs need to ask every unwell patient about recent (in the last 10 days) travel to at risk areas and think ‘Could it be flu?’. Watch out for health alerts from DHS updating GPs on the situation as well as regular updates on the treatment of cases:

• symptomatic cases will be treated with antivirals for five days — DHS will advise and supply
• see Interim national pandemic influenza clinical guidelines (June 2006) available a the Department of Health and Ageing website.
• contact your designated regional hospital for admission.

Designated hospitals have negative pressure rooms and infectious diseases specialists. A list of these hospitals is available from DHS.

Public health: ‘stamp it out’

Public health responses to infection within Australia are likely to include:

• containment measures
  • designated hospitals/assessment clinics
  • stringent infection control
  • intensive contact tracing
  • targeted antiviral prophylaxis (supplied by DHS)
• strengthening surveillance
  • new case definition
  • laboratory testing of all suspected cases
• increased communication to and from DHS
  • look out for new health alerts from DHS.

Staff risk of infection, fear and practice survival

Pandemic flu:

• is likely to cause infection in all age groups
• may have a very high mortality in different age groups
• medical staff may have a higher infection rate than the general population
• infections in staff may also lead to further infections in their close contacts.

Staff working with patients with pandemic influenza need to be conscious of this risk. Give them the opportunity to understand the possible risks and how they can protect themselves.

Allow them to make informed choices about working in a potentially dangerous environment with plenty of notice to consider their responses. When the first outbreak of a potential pandemic flu arrives, it will be too late to respond rationally and staff may react out of fear or ignorance. Staff may want to opt out of work in this area or may want to volunteer for flu work in hospitals.

Concerns and anxieties about infection in both patients and staff are likely to occur at the same time as public health measures, such as social distancing, are implemented. Absenteeism of staff may put huge pressure on rosters, practice management and finances. Some practices may consider collaborating or decide to share resources with neighbouring GPs to survive.

Think about:

• what functions are critical for your practice survival?
• who provides these functions?
• who can replace them? (think laterally, that is, casual staff, volunteers, community organisations).

Use the practice survival planning tool at the end of this section to help plan. It will also be repeated in the pandemic phase. Further information on general business continuity can be downloaded from the Australian Government Department of Industry, Tourism and Resource website.

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‘Stamping it out’: avoiding spread of infection in the practice

Avoid contact between suspected cases and other patients:

• implement new triage plan
• see people at home if possible
• if seen at clinic, options include asking suspected case to:
  • wait in separate area or in their car
  • come at a different time to other patients
  • wear a mask and sit at least one metre from other patients
  • wait in a consulting or treatment room.

During the consultation wear personal protective equipment and ask the patient to wear a mask. Avoid patient breathing directly onto you at close proximity during examination if possible, that is, ask patient to turn head away from you.

Isolation and care of contacts

DHS will provide contact tracing and advice on isolation and antivirals.

For more information, see Appendix 4.2 of the Victorian influenza pandemic plan at the Infectious Diseases, Epidemiology and Surveillance website.

Ways to minimise infection for yourself and others:

• wash your hands and do not touch your face
• wear gloves
• check your temperature twice daily and self monitor for respiratory symptoms
• if you develop a fever or respiratory symptoms, immediately stop work, be assessed and notify your practice.

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Worksheet: for phases Australia 3 to Australia 5

Worksheet: for phases Australia 3 to Australia 5 (33kb, pdf)

Template: Contingency arrangements for unavailability of staff (29kb, pdf)

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