Novel Coronavirus ( 2019-nCoV): Advice for Primary Care: 28.1.2020

Please note that the advice for primary care may change at any time.

It is crucially important to obtain a travel history from any patient with respiratory infection to determine history of travel to Wuhan, Hubei Province, China in the 14 days prior to symptom onset.​

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All patients with respiratory infection and recent travel history as above should be provided with a surgical mask upon entry to the facility. For potential cases of novel coronavirus infection, include contact and droplet precautions, such as personal protective equipment (PPE).
Please ensure all reception staff are obtaining travel history over the phone.
Consider putting a poster up on your front door asking patients to immediately inform reception if they are unwell with a flu-like illness and fever  and recent history of travel to Wuhan, China.
Undertake an assessment in a private room with the door closed.
Assess the patients need for hospitalisation.
If a case of 2019-nCoV infection is suspected, requests for laboratory testing in Primary Health Care should be done in consultation with the local medical officer of health.
Red flags requiring hospitalisation are;

• Pneumonia
• Severe cough and fever
• Shortness of breath and hypoxia requiring oxygen.
• Dehydration and unable to drink fluids
• Septic shock, including dizziness and confusion.
• Kidney failure

Patients not requiring hospitalisation:

Where community care is safe and appropriate no diagnostic testing is required,  patients should stay at home avoiding contact with others until one day after the symptoms settle. To reduce risk of transmission in the community avoiding close contact with people suffering from acute respiratory infections and frequent hand-washing, especially after direct contact with ill people or their environment is important. People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands) and stay home if unwell.
Aerosol-generating procedures should be avoided in Primary Health Care.
The patient should contact their doctor or call HealthLine if they deteriorate.
Patient not requiring hospitalisation BUT with a history of close contact with a symptomatic confirmed case in the 14 days prior to symptom onset (irrespective of the travel history)

• The patient should be advised to self-isolate at home or in their accommodation.
• The local medical officer of health should be immediately informed (07 838 2569)
• Laboratory testing should be organised by the GP in consultation with the local medical officer of health, starting with the common respiratory infections (please refer to Annex 2)
• Usual respiratory precautions for viral respiratory infections (as per the local pathways or protocols) should apply.

Patients requiring hospitalisation:

• The patient will be investigated once hospitalised.
• The local medical officer of health should be immediately informed (07 838 2569)
• Your local hospital should be contacted first before the patient is sent for assessment.
• Usual respiratory precautions for viral respiratory infections (as per the local pathways or protocols) should apply before and during patient’s transfer to hospital.

Thank you, further advice will be issued when necessary.
Damian Tomic
Clinical Director Strategy, Funding and Primary Care
Waikato DHB
Level 1 | Waiora CBD | 87 Alexandra St | Hamilton 3240
Phone: (07) 834 3600 ext: 97600 | Mob: 027 590 1242 | Email: Damian.Tomic@waikatodhb.health.nz

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