Conflicting advice, a lack of testing kits and delays on hotlines are testing the health system
Doctors and patients have criticised the “confusing” and haphazard process for accessing tests for the coronavirus, even as health authorities vowed to improve communication in the face of an ever-increasing number of confirmed cases in Australia.
Federal health minister Greg Hunt ramped up the government’s rhetoric on Sunday, telling people they should get tested for the virus if they had flu-like symptoms.
But doctors say that message has threatened to inundate a health system grappling with equipment shortages while it comes to grips with an escalating public health emergency, while some patients say the process for accessing tests remains confusing.
One doctor from Sydney’s eastern suburbs said that the “widespread view” among his colleagues was that the response to the virus was “a shambles” with “multiple layers of conflicting advice”.Federal health minister Greg Hunt ramped up the government’s rhetoric on Sunday, telling people they should get tested for the virus if they had flu-like symptoms.
But doctors say that message has threatened to inundate a health system grappling with equipment shortages while it comes to grips with an escalating public health emergency, while some patients say the process for accessing tests remains confusing.
The doctor, who wished to remain anonymous, said Hunt’s comments had come in a context where GPs were grappling with shortages of basic equipment such as hand sanitiser, while some pathology labs in the city were running low on testing kits.
“They were not sick enough to go to the hospital and we don’t want to overload the hospital system, but we still need to know whether these people were OK. That was about 10am. By 10.20am we got a call to say the first lab was no longer doing the tests as they’d run out the kits. The second one wasn’t even answering the phone and the third was the same.”
Other medical agencies have been overrun by demand; on Tuesday the Victorian ambulance service said its dedicated coronavirus hotline had been “experiencing system issues due to extraordinary call volumes”, while videos on social media showed long lines around the block at the Royal Melbourne Hospital.
Lines of patients lining up for COVID-19 testing now extending half a block at @TheRMH.
One woman who tried to get tested after coming down with flu-like symptoms on Sunday said that after being turned away by her local GP clinic she tried to contact the New South Wales public health unit but that the call went to voicemail.
“I decided to wait until Monday morning and try again after 9am. My next attempt went to another recorded message indicating that there were too many calls coming through and to try again later,” she told Guardian Australia.
After spending more than 20 minutes on hold she tried her GP again, who suggested she visit RPA, but said when she arrived at the testing clinic the queue was “spilling out the door”.
“Most people were wearing masks, but the variety of shapes and sizes suggested they had brought their own,” she said.
“I asked the man at the back of the queue if the clinic gave him his mask. It hadn’t – and I didn’t have one. I was starting to wonder if this was the best place to be considering I might only have a cold.”
In a statement, a spokeswoman from the NSW health department blamed delays on Monday on the opening of a larger testing clinic to cope with increasing demand, saying there had been “a short transition period where people were queuing while staff were opening the new space”.
She said that while treatment times on Monday had been two to three hours, the previous clinic had been less than an hour.
“So we expect today’s times will reduce as the processes get bedded down,” she said.
She said that people were required to use hand sanitiser and were given a face mask.
“They then fill in a registration form and are asked to take a seat in a designated area outside the clinic. All chairs within the clinic and in the designated waiting area outside the clinic are spaced a metre apart, to reduce the risk of transmission,” the spokeswoman said.
"Ideally you want to treat suspected cases with a high degree of caution"
“When seen by a clinician inside the clinic, the patient has observations taken, such as temperature checks etc, and is then swabbed, if required. Patients who have been swabbed are then given packs of masks and sanitiser and are required to self-isolate at home pending the results.”
On Tuesday Hunt acknowledged the commonwealth advice line had faced “additional pressure” over the weekend due to an influx of calls, while Australia’s chief medical officer Brendan Murphy sought to clarify questions around who should or should not present for testing for the virus.
“Our focus at the moment is testing people who are returned travellers who have acute respiratory symptoms, cough sore throat and the like, and contacts of confirmed cases,” Murphy said.
“At the moment we are not recommending that general members of the community with acute respiratory symptoms – colds, flu, and the like – be tested.”
But GPs have also expressed fears about a lack of preparedness in the medical system to deal with the increasing number of people seeking to be tested and the financial impost the virus is placing on smaller practices.
Brisbane GP Jared Dart said that while doctors were able to assess patients, the highly contagious nature of the virus meant the process of evaluating patients was time and resource intensive. Dart said has spent about $7,000 more than average on supplies in February.
“Ideally you want to treat suspected cases with a high degree of caution. A separate consulting room, separate waiting room, appropriate PPE [personal protective equipment] for staff and masks for patients. That makes the workflow for clinics very hard,” he said.
Dart said that in order to conduct consultations with patients, he’d had to ask some of the allied health services at his clinic to vacate, as well as conducting tele-health consults which are not covered by the medicare rebate.
“In Queensland we’re lucky that the private pathology companies are doing the tests, which isn’t the same everywhere,” he said.
Murphy has promised to improve communication with doctors, but GPs have reacted angrily to the Victorian health minister’s criticism of a Melbourne doctor who treated patients while unknowingly having the virus.
“We’re being asked to take in undifferentiated, potentially risky cases to assess and if anything happens our confidentiality is not protected and potentially our clinic shuts for two weeks,” Dart said.
“If the clinic closes I won’t be getting an income as a GP and I won’t be getting one as a business owner but I still have to pay rent and my staff. We’re in a very, very difficult position being asked to do the important public health work which we definitely want to do for our community and our patients but it doesn’t feel as though we’re being supported to do that.”
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