According to the latest case definition, which was updated on Tuesday, if a patient requires hospital admission and they have either clinical or radiological evidence of pneumonia, acute respiratory distress syndrome or an influenza-like illness, they should be treated as a possible case of coronavirus, regardless of epidemiological links.
Other patients need to meet both epidemiological and clinical case criteria in order to be considered a possible case of COVID-19, the guidance says. This includes travel to specific countries or contact with a confirmed case of the coronavirus, plus shortness of breath, or cough, or fever alone.
If GPs suspect a patient in the surgery has COVID-19 they should leave the room and ask the patient to call NHS 111, according to current PHE guidance for primary care. Practices should have an isolation area available for patients suspected of having the virus. In emergencies, practices are expected to call an ambulance, informing the call handler that the patient could have coronavirus.
Travellers returning from Italy
PHE also updated its guidance on specified countries and areas relating to coronavirus today. The whole of Italy has been made a 'category 1' country, meaning that any travellers returning to the UK from anywhere in Italy are now being advised to self isolate for two weeks, regardless of whether or not they experience symptoms. Previously this only applied to people who had been in the areas of northern Italy that have been hardest hit by COVID-19.
The move comes as GPs warned that practices were not ready to cope with a coronavirus outbreak. In a GPonline poll of 401 GPs, 67% said they did not feel their practice was adequately prepared to deal with the emerging outbreak.
More than half of GPs (53%) said practices had not received adequate guidance and information about COVID-19 - and just one in five (21%) said their practice had the equipment needed to manage an outbreak, including supplies of personal protective equipment (PPE).
Earlier today RCGP chair Professor Martin Marshall said that the government was ‘insufficiently focused’ on general practice, with ministers prioritising hospitals and NHS 111. He said that COVID-19 could become ‘the biggest issue the NHS has ever seen’, warning that GPs would start to feel the pressure ‘in quite a significant way’.
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