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General practitioners are pleading with the Victorian health department to let them take a more active role in contact tracing.
The call – which includes the Australian Medical Association in Victoria, the Royal Australian College of General Practitioners, as well as local GPs and epidemiologists – comes as state health authorities overhauled the system around five suburban tracing hubs.
Some local doctors concerned about days of backlogs are already making their own calls to close contacts of patients within hours of a diagnosis.
Tapping into the local knowledge of GPs about popular gathering spots and transmission risks, they argue, would benefit Victoria’s contact tracing regime.
On Friday, a Victorian delegation, as well as chief scientist Alan Finkel, met with New South Wales premier Gladys Berejiklian and her contact tracers in Sydney, as they aim to emulate a system that relies on local health district expertise.
Dr Ines Rio, AMA Victoria’s chair of general practice, said she knew of GPs making calls to contacts of cases themselves, and said Victoria’s tracing system should be decentralised to make this more common.
“Most general practices are quiet at the moment,” she said, adding that the timeframes for telling close contacts to self-isolate could reduce from “more than a week to under an hour”.
“Once we know a patient has it, rather than call the DHHS [Department of Health and Human Services] hotline [for reporting a case] for two hours, we can ask them about their living situation and have the rest of their family tested that day and isolating.”
Rio said local GPs also had knowledge about local multicultural communities and associated transmission risks, including common gathering locations.
She also believes that if someone tests positive at a hospital or screening centre, their case information should be passed onto a GP, if contact tracers are backlogged.
Rio said that while many Victorians do not answer the ‘no caller ID’ that contact tracers appear as on phones, GPs called from familiar numbers and are easier to contact after a missed call.
The amount of time it currently takes contact tracers to tell all close contacts to self isolate, which is a matter of days, is enough time to allow them to become infectious and spread Covid-19 further, she explained.
“It’s going to be more timely, more effective, and GPs are crying out for it,” Rio said.
Dr Vishy Goonewardene, a GP at Bundoora in Melbourne’s north, has been testing patients for Covid-19 in his clinic.
He is frustrated that when a patient of his tests positive, he is only able to inform the DHHS about the patient’s result, and not let contact tracers know details of who they interacted with.
Goonewardene said that hours after a recent patient tested positive, he contacted five close contacts – family members and acquaintances they said they had interacted with in recent days – and urged them to get tested and self-isolate.
He said each of the close contacts was only contacted by the DHHS eight days later and told to self-isolate.
“As a GP, if I have someone who has the virus, I would like to hand over their information, who they’ve interacted with, so the contact tracers can begin immediately telling everyone to isolate,” Goonewardene said.
“There should be an online portal for this, and if they can’t integrate primary care physicians into this, then the most basic thing is to let the clinicians do their job and start calling themselves.
“We are all in this together.”
Cameron Loy, Royal Australian College of General Practitioners Victoria chair, told Guardian Australia that while GPs should not be expected to conduct long phone interviews with all patients, the DHHS shouldn’t replicate requests for information that GPs already knew.
“If contact tracers in Victoria can’t get the information they need, or if GPs can get that information faster, then the contact tracers should be using GPs help,” Loy said.
Prof Raina MacIntyre, an epidemiologist at the University of New South Wales, said Victorian contact traces should utilise GPs.
“Given there’s greater telehealth now, and because a lot of consultations have dropped off, it’s an option to be looked at,” she said, noting GPs were overqualified to be making calls themselves.
She also encouraged greater use of technology, including fixing bugs in the Covidsafe app, and using credit card, public transport card, and mobile phone data to trace movements.
“There should be a concerted effort to use this time to be scaling up how many talented people are involved,” MacIntyre said.
A DHHS spokesman said contact tracers call every positive case within 24 hours and their close contacts within 48 hours. He also said all positive cases are asked for their Covidsafe app data.
Source: The Guardian
Keyword: Victorian GPs push for a more active role in Covid contact tracing | Coronavirus outbreak