Morrison government funds ‘pop up’ testing clinics and tele-consultations in $2.4 billion COVID-19 health package

Michelle Grattan, University of Canberra

The government will unveil on Wednesday a package of coronavirus health measures, including a network of respiratory clinics, a new Medicare item for tele-consultations, and a communications campaign.

The package, which comes as the number of Australian cases reached 100, will cost A$2.4 billion, which includes $500 million announced last week to help states with their costs on a matching 50-50 basis.

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The health measures precede the government’s multi-billion stimulus to address the hit the virus will deliver to the economy, which threatens to push Australia into recession.

Up to 100 “pop up” fever clinics will be established across the country, in a program costing $205 million.

These “one stop shops” will test people worried they may have the virus. They will supplement the work of GPs and state respiratory clinics.

As people become increasingly fearful about the virus, many are seeking tests, even though they fall outside the guidelines recommended for testing.

In Melbourne on Tuesday people queued outside the Royal Melbourne Hospital. In Perth there was a queue even before a new clinic opened at the Royal Perth Hospital’s Ainslie House, despite the clinic supposedly being for those at higher risk. In South Australia a “drive through” clinic has opened.

Commonwealth Chief Medical Officer Brendan Murphy said that in the last few days there had been a “significant surge” in the number of people requesting testing.

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Partly this had been sparked by some misinformation in the media suggesting everyone who had flu-like symptoms should be tested, he said. “We’re not saying that at the moment.”

Murphy said those who should be tested are returned travellers who develop acute respiratory symptoms or people who have been in contact with confirmed cases who develop acute respiratory symptoms.

The aim of the pop up clinics in the federal package is to deal with people with milder symptoms, taking the load off hospitals’ emergency departments and GPs, so that hospitals are only presented with the more serious cases.

Each clinic, staffed by doctors and nurses, would be able to see up to 75 patients a day over six months. They could operate as dedicated medical centres.

Health authorities and medical bodies will identify practices in regional, rural and urban areas. Some 31 Primary Health Networks will receive $300,000 to assist in identifying and setting up the “pop up” clinic sites and distributing protective equipment.

Up to an initial $150,000 will be given to help clinics start and offset losses from normal business.

The new Medicare item for telehealth will enable those who are isolated due to the virus to access medical services from home by audio or video. This will reduce risks of transmission from people going to doctors’ surgeries (and the inconvenience of consultations in car parks as doctors keep them out of surgeries).

The telehealth service, starting on Friday, will be bulk billed and available for medical, nursing and mental health medical staff to deliver services over the phone or through a video conference (including FaceTime, Skype, WhatsApp). The new item will cost $100 million and run for six months, when it will be reviewed.

The telehealth services will be available to

  • people isolating at home on medical advice

  • those aged over 70

  • Aboriginal and Torres Strait Islanders aged over 50

  • people with chronic health conditions or who have compromised immune systems

  • parents with new babies and pregnant women.

The telehealth arrangements will also mean health practitioners who are themselves in isolation will be able to continue to provide services, so long as they are fit enough to do so.

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‘Fever clinics’ are opening in Australia for people who think they’re infected with the coronavirus. Why?

The planned national communications campaign about COVID-19, including information on how to guard against the virus and what to do if you get it, will start within days and cost $30 million.

A wide range of platforms will be employed, and particular audiences targeted. It will use television, radio, print, digital, social media and displays on public transport and at shopping centres, as well as putting material in doctors waiting rooms. Market research and tracking will be used to refine the campaign.

Scott Morrison said Australia is “as well prepared as any country in the world” to deal with the virus, and the health package “is about preventing and treating coronavirus in the coming weeks.”The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

‘Fever clinics’ are opening in Australia for people who think they’re infected with the coronavirus. Why?


Gerard Fitzgerald, Queensland University of Technology

The Western Australian health minister has announced “fever clinics” are to open this week for people who think they have coronavirus symptoms.

And in NSW, the chief health officer has advised hospitals set up “respiratory clinics” to deal with a potential spike in COVID-19 cases.

Other states are set to open their own versions, particularly if transmission of the virus from person to person becomes more established in the community.

So what are these clinics? And why are people being advised to use them rather than seeing their GP or going straight to the emergency department?

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What are ‘fever clinics’?

Fever clinics are dedicated facilities to assess, test, treat and reassure people, and where necessary, to triage them through the healthcare system.

In the absence of substantial community transmission of the virus in Australia, it’s expected most people who’ll use these clinics will be:

  • people worried they’re sick but aren’t showing symptoms (the “worried well”)

  • people who think they may have been in contact with an infected person

  • people with other illnesses who want reassurance.

The idea is to divert people concerned they may be infected away from emergency departments and general practices.

Not only does this reduce demand for these traditional services, it potentially limits the spread of disease among vulnerable populations, such as the sick and elderly.

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General practices have open waiting rooms and while they can ramp up their infection control measures, not all practices can do this effectively.

Similarly, emergency departments are not well structured to isolate large numbers of potentially infectious patients.

By contrast, fever clinics can assess and treat potentially large numbers of people with appropriate levels of infection control. They’re also staffed by people dedicated to this one task. So expertise is concentrated in one location.

Fever clinics are part of a broader emergency health response to the coronavirus. And different states give them different names. For instance, in NSW their official name is “pandemic assessment centres”.

Where are these clinics?

Fever clinics may be set up in new facilities or by repurposing existing ones, such as community health centres or dedicated general practices.

They need to be somewhere with good public access (and parking), preferably away from existing crowded major health facilities to avoid congestion.

They may be possible in heavily populated areas but less so in rural areas as they require enough patient numbers (to make them viable) and access to enough staff.

Existing healthcare staff will work in these new fever clinics, stretching regular services.

Staff – such as doctors, nurses and laboratory staff – will generally come from the existing health service, potentially leaving these services short. And staffing may be an issue in rural and remote areas that are already under-resourced.

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People who attend these fever clinics, who require higher levels of care, will need to be referred to specific health facilities. So arrangements for referral and safe transfer are needed.

Fever clinics are also only part of a broader health system response and can never replace other sources of care.

Severely ill patients will still call for an ambulance and need to be in hospital. Many patients will choose to see their regular GP.

So the broader health system needs to be supported if we are to mount an effective health response against the coronavirus.

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Do fever clinics work?

There is surprisingly little published research about people’s experience with fever clinics. Few outbreaks have had enough patient numbers to justify setting them up.

During the swine flu pandemic of 2009, Australians were keen to use one clinic when it was located within an emergency department. More than 1,000 people with flu-like symptoms attended in one month.

However, it is difficult to find any evaluation of how well fever clinics work across health systems, either in improving health outcomes or reducing costs.

What’s the take-home message?

People have a right to be concerned, but not unduly alarmed, about the outbreak of COVID-19.

Recent data suggest the disease is highly infectious although 80% of people have a mild-to-moderate disease, 20% a severe/critical illness and 2-3% die.

People who are at greater risk are those who are older or have other illnesses.

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The best thing people can do is to take reasonable precautions: avoid crowded places, wash your hands regularly and avoid touching your eyes and mouth.

Fever clinics may well have a role in providing a single source of assessment, advice and treatment. However, we still need enhanced infection control procedures across the healthcare system and to access other sources of medical care.The Conversation

Gerard Fitzgerald, Emeritus Professor, School of Public Health, Queensland University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.