COVID-19

New Street Medical Centre aims to provide support and up-to-date information for all of our patients during the COVID-19 (novel coronavirus) public health emergency. We are working very hard to keep all of our patients and staff as safe as possible. In order to do this, we will need your assistance and cooperation. We are responding to this rapidly changing environment and as such have made some alterations you may notice at our clinic. At the time of making new appointments our reception staff with be asking a series of questions regarding recent travel, COVID-19 exposure, and any current symptoms so that we can best manage your care. The same will also occur when you arrive for your appointment. We have allocated extra reception and nursing staff to facilitate these changes and appreciate your patience. As part of our nationwide efforts to ‘flatten the curve’ we are promoting social distancing measures. As part of this we are aiming to minimise patients attending the clinic unless medically necessary, and for essential services only at this time.

As more cases of COVID-19 are confirmed around the world and in Australia, it is becoming increasingly clear that we need to take some basic precautions to maintain hygiene levels and ensure that we do all that we can as individuals to help halt the spread of the virus. If we continue in our lives ‘business as usual’ the spread of the virus will be very quick, meaning that a large percentage of our population will all fall sick at once. Our health resources are unfortunately finite; there is a limit to how many patients our health care staff can look after at one time. Once this limit is reached and the hospital beds are full it will be very difficult for us to give adequate care to patients. Our aim as a nation must be to slow down the virus transmission, reduce how many people are sick and needing health resources at one time, and to ‘flatten the curve’.

We are calling on everyone to assist us in this effort – it is indeed everyones responsibility. Please practice social distancing – avoid crowds and smaller gatherings in enclosed spaces, aim to keep a distance of at least 1.5m from others when out in public, postpone any non-essential travel or activities, avoid visiting vulnerable people including our elderly and those with medical issues, and avoid touching or hugging others.

If you are sick please stay home! Australians are a hard-working bunch, and often keep pushing through to attend work while we are unwell. At this time we are urging everyone who is unwell, even if it only seems mild to please stay at home until symptoms resolve. This includes visiting your GP clinic – please call instead for advice.

We understand that this is a stressful time for everyone, so we have included some useful advice below. Please be kind to one another – we can get through this time together.


How does the COVID-19 spread?

Person to person transmission is the most common way for coronavirus to spread. Sneezing and coughing is a common way for the virus to leave the body and find its way to new hosts. Droplets of body fluid, such as saliva, may contain the coronavirus when expressed from an infected carrier. The coronavirus can also spread through contact with contaminated surfaces. Keep in mind, not much is known about the new coronavirus – it is a very different virus to the flu.

How to protect yourself from the COVID-19

Good personal hygiene is key to limiting your risk to the coronavirus. Some tips that can help you avoid an infection include:

  • Wash your hands thoroughly with soap and water for at least 20 seconds, or use an alcohol based hand rub containing at least 60% alcohol. Hand washing should be undertaken regularly throughout the day including before touching your face, before eating, and after contact with other people or surfaces.
  • Cover your cough or sneeze with your elbow or with a tissue. This will help reduce the risk of you infecting those around you.
  • Avoid touching your face
  • Encourage others to stay home when they are unwell. If you manage a team of employees, let them know that they should call in sick if they have symptoms.
  • Avoid contact with anyone who displays symptoms of the coronavirus, including coughing, respiratory irritation, fatigue, shortness of breath, or a fever.

Because COVID-19 is spread between humans so rapidly, the only way to slow the rate of new infections is to reduce human to human contact – this means staying away from other people as much as possible or ‘social distancing’. This is one of the most vital things we can do to protect ourselves and each other.

  • PLEASE STAY HOME when it is at all possible. Talk to your employer about working from home, choose a home-based workout over the gym, order take-away instead of eating in.
  • If you must leave your house STAY 1.5m AWAY FROM OTHERS as much as possible. This of course means no handshakes, no hugging or kissing or high-fives. Wash your hands regularly, and when you return home.

COVID-19 Symptoms

We are still learning about the coronavirus, but it affects people in a range of ways. Common symptoms include:

  • cough – usually dry
  • fever (temp >37.5 deg)
  • Shortness of breath
  • sore throat
  • muscle aches

These symptoms range from mild to very severe, with around 5% requiring intensive care in a hospital ICU. Some people may have no signs at all, but still be able to spread the virus. The symptoms can also be very difficult to distinguish from a regular cold or flu. Because of this, it is important even if you only have mild symptoms to stay at home – this is the only way to avoid spreading the disease. And if you are well you should practice social distancing measures – this will help prevent the spread from people with no symptoms, as well as helping to prevent you from becoming unwell.

COVID-19 Diagnosis

COVID-19 can only be diagnosed via taking an oral / nasal swab. Doing these tests requires swabs, reagent to run the test, as well as Personal Protective Equipment for the health care worked taking the swab. The supply of all of these things is often low. That is why currently we can only test people meeting strict criteria which are being updated regularly. New Street Medical Centre is not able to test for COVID-19. If you believe that you may require screening please contact one of the dedicated COVID-19 testing clinics based at major hospitals including MMC Clayton, Royal Melbourne and Alfred Hospital (call pre arrival – 9076 2000). Alternatively call the national hotline on 1800 020 080 or the Victoria Health Department on 1800 675 398.

COVID-19 Treatment

COVID-19 is a viral infection – this means that antibiotics will not work (they are only effective for bacterial infections). More severe cases may need hospital treatment, but the majority of cases are milder and are able to be managed at home.

Treatment is aimed at easing symptoms while the body fights the infection. Ways to help manage at home include:

  • stay hydrated – aim to drink at least 2L of water or fluids a day
  • rest – you may need to sleep more than usual
  • paracetamol (Panadol) may be suitable to help with muscle aches, fevers etc.
  • It is currently suggested that people with COVID-19 DO NOT use ibuprofen (Neurofen).
  • Eating fresh fruit and veggies
  • frequent hand hygiene
  • staying away from others while unwell.

If you feel very unwell or become short of breath you should call your nearest hospital or 000 for medical assistance.

COVID – 19 Self Assessment

Are you concerned that you may have coronavirus? – The Austin Hospital have established a simple online form which will assess your situation and symptoms and advise you on what actions you need to take.

Simply fill it out, hit submit and you will receive an immediate response about what you need to do next. You can click on the form here: https://c19.austin.org.au/user

What’s the difference between self-isolation and quarantine?

Let’s go through them.

Quarantine

  • You are at risk of having the COVID-19 infection (eg recent overseas travel, or recent contact with someone diagnosed with COVID 19) but not actually known to be infected and are currently well. You may or may not end up with it
  • You are asked to wait it out in isolation until 14 days have passed if you remain well. This reduces the chances of the infection spreading and applies if you have come back from the growing list of countries with a lot of infection or if you have had contact with someone who is positive
  • If you become unwell during the 14 days, testing is done and if positive you move into isolation phase (or into hospital if very unwell)
  • If unwell but testing is negative, we still want you to stay in quarantine until the 14 days are up, as the infection may take that long to show
  • If well at the end of the 14 days, you may resume normal contact (keeping in mind social distancing of course), providing you stay well

Self-Isolation

  • You have tested positive for COVID-19
  • You are well enough to be looked after at home
  • At time of initial publication (9 March 2020), in Australia, you can come out of self-isolation if all of the following apply
    • more than seven days since you became unwell
    • at least two days with no fever
    • at least one day of feeling better/having no symptoms
    • two tests 24 hours apart that are both negative

Please take care. It seems unlikely that you can be reinfected, but we don’t want you getting another infection so soon after having COVID-19.

What about the new two weeks’ quarantine for people arriving from overseas?

What does that mean?

  • Remember the above definitions. Quarantine means you are at higher risk; you don’t necessarily have the infection and you may or may not get it. You are not in isolation.
  • This is an important distinction – quarantine and isolation are being confused by too many commentators
  • This means your close contacts do not need to be quarantined with you, unless they qualify for quarantine because they were also traveling.
  • If you become unwell and upon testing are found to be positive for Covid-19, you are now in isolation and those who have been in close contact with you will have to go into quarantine.
  • If you have been in strict quarantine and they have not had 15 minutes’ face-to-face contact or two hours in a room with you in the 24 hours before you became unwell, they do not need to be quarantined.
  • If they have been in close contact, and if we assume you are only infectious for the 24 hours before you became unwell and you had testing as soon you knew you were unwell, the community is buffered by the incubation period which is, on average, five days.
  • Your close contacts will, however, have to be quarantined as soon as your test becomes positive.
  • So if your test is back in one day, it should be at least three days (assuming they are infectious before they are unwell) before they become infectious; two days’ buffer if it takes two days; one day’s buffer if it takes three days, and if the test takes four days or more we have a potential problem.
  • These are assumptions, they are not always right, but they will have to do for now.

Rules for living in isolation

If you live alone, the situation is relatively straightforward:

  • No visitors
  • No trips to the shops, school, university, work, park, library, movies, church/place of worship, GP, chemist, etc
  • No family gatherings
  • Stay at home

If you are sharing a room or home with your partner or family, there are a few more things to consider in addition to the above:

  • If you are able, isolate yourself from others. Ideally, stay in your room and have your partner sleep in another room
  • If you can isolate yourself from others within your home, do so – for 14 days. Sorry, that will be a long two weeks
  • If you cannot isolate yourself within your home, cover your mouth when you cough, wash your hands frequently, wipe touched surfaces or wear disposable or clean gloves if you need access to communal areas (ie kitchen) and wear a face mask when others are around (further advice below)

Keep in mind that most of your family will be in quarantine, as they are likely to have been in close contact with you.

We still want you isolated in that situation in order to reduce the risk they get it (we don’t want them to get sick because that will reset everyone’s 14 day self-isolation time). This will change if/when the infection becomes more widespread.

Why 14 days?

This seems to be the longest time in which this virus can be incubating before people become sick. If you are not sick 14 days after exposure then, as far as we know, you have not got this infection.

Keep your distance

Stay 1.5 m from others.

Imagine a bubble. Stand up, arm above your head and out to the side, then spin around. That’s your bubble.

If you’re unwell, try to keep your bubble intact. If you’re well, don’t pop the bubble of sick people.

What are we trying to achieve with isolation?

We are trying to slow down the spread of the infection.

This is important because the health system will find it much harder to manage if everyone gets sick at the same time. People are at a higher risk of getting sick with COVID-19 if they have close contact with someone who already has it.

Close contact is defined as having the following contact with someone who has COVID-19 (this includes contact in the 24 hours before they became sick):

  • Fifteen minutes or more of face-to-face and/or
  • More than two hours in the same room

This is particularly important for people at higher risk of complications from COVID-19. If you have, or think you could have, COVID-19, it is vital you stay away from people who:

  • are older (highest risk in people over 80, but the risk starts to seriously climb from 50)
  • have heart problems
  • have diabetes
  • who have lung troubles (eg asthma, emphysema, chronic bronchitis, bronchiectasis, cystic fibrosis, etc)
  • have high blood pressure
  • have cancer.

We are also concerned about people whose immune systems are low, including because of medication that they take, and Aboriginal and Torres Strait Islander people.

The Washington Post has made a corona simulator https://www.washingtonpost.com/graphics/2020/world/corona-simulator/ to help us understand the difference social distancing can make in dealing with the virus.

Ideas on what to do while in isolation

If you are unwell, you will need to manage your symptoms. For most of us, this will be like managing a cold:

  • Eat well (fruit and vegetables, not those tempting chips and lollies)
  • Keep your fluids up, use paracetamol or ibuprofen for pain or high fevers
  • Get some sleep
  • Low-grade fever in someone who is otherwise feeling okay does not have to be treated; it is part of the body’s immune response and we get better quicker if we let it be
  • Let us know if you are getting worse, especially your coughing is worsening and/or if you are having trouble breathing (phone your GP or emergency department for advice, or state or national help lines or 000 in an emergency)

You will need to eat

Think about what you have in the pantry/fridge/freezer.

If you need more supplies, can someone drop fresh food over? It can be home delivery from family or friends, or deliveries from the supermarket or restaurants.

It is important to note, however, that anyone who does drop anything to your house should avoid direct contact with you by dropping the food at the doorstep and leaving.

You will need to clean

This is more important if others are sharing the space with you, but at some stage the house will need to be cleaned.
Based on what is known about previous outbreaks (SARS and MERS), coronaviruses can live on surfaces for an average of 4–5 days. But some have survived at room temperature for up to nine days. ( https://www.healthline.com/health-news/how-deadly-is-the-coronavirus-compared-to-past-outbreaks )

For cleaning surfaces, the Center for Disease Control and Prevention (CDC) recommends you wear disposable gloves. If you are using reusable glove, do not use them for any other purpose.

This may be difficult for most, but do what you can with what you have. Either way, wash your hands after cleaning.
Use a detergent first. For suitable surfaces, follow with diluted bleach, such as White King Bleach (sodium hypochlorite 4% chlorine) at a ratio of one-part bleach, seven parts water.

A combined commercial spray is fine to use instead of the above two-step process. Most household disinfectants are based on benzalkonium chloride, with 0.05% the concentration recommended.

Alcohol wipes or sprays are suitable alternatives, for example, for phones, where Apple does not recommend bleach.

Wipe benches and frequently-touched surfaces such as tables, doorknobs, doorbell if getting deliveries, light switches, cupboard and drawer handles, desks, toilets, taps and sinks twice a day.
Once finished cleaning, dispose of/remove the gloves and, again, wash your hands!

Other cleaning essentials

After using the toilet, close the lid, flush and wash your hands. The virus can be detected in faeces and closing the lid before flushing reduces the risk of the virus becoming airborne and spreading the infection further.
If there is only one toilet in the household, clean (as above) the toilet seat, flusher, tap, sink, door handles (ie any surface that may have been touched) each time it has been used by the person who is sick.

If you have two toilets, the sick person gets one and everyone else uses the other one. This is the same for shower/bath.
Change sheets and towels regularly, keep the towel of the sick person separate from other towels, e.g. in their room, and have a separate towel for on which they can wipe their hands after washing.

Wash the floors once a day. This is especially important if you have young children.

Regularly clean down hand-held devices such as gaming controls, mobile phones, tablets, keyboards (with alcohol spray or alcohol wipes).

The sick person should be excused from setting the table, cooking, washing up and unpacking the dishwasher. They should also eat away from others who are well, preferably in their own room. (It is also important they wear their face mask when in the same room as people who are not sick.)

There should be absolutely no sharing of food or drink that has been in contact with the sick person – into the bin with their leftovers.

You can wash clothes the usual way. You don’t need to separate out the clothes or towels from the sick person, but make sure you wash your hands after putting the washing into the machine.

But please don’t shake the clothes out before washing – this increases the risk of viral particles becoming airborne. Dry clothes well before putting them away. Use a disposable or washable clothes bin liner.

The sick person should have their own rubbish with a disposable liner. It is good practice to wear gloves when emptying the bin, and wash hands well after taking the rubbish out.

If you have an unwell young child , try to have one person providing their care. That person should be very careful about how they interact with others who are well.

In the event of a sick child, now is the time to consider extending their electronic time (just for now). Most kids will be excited about this and it helps by keeping them occupied and distracted.

You will need to keep occupied

In the event you are quarantined, see if you can work or study from home.

Maintain connection with friends, family, neighbours, others in your community – consider setting up regular phone calls to check in with and check on others. There are many options.

It is important to keep active. Consider ways to do this from home, such as spring cleaning or organising the house, downloading an exercise app, checking out YouTube exercise or dance classes. Movement matters!

Mental health considerations

Keep your mind occupied with meaningful and creative pursuits.

It is okay to not be okay, but try not to panic. Panic will not help.

Head to Health has some great online mental health resources. There are also lots of great free/low-cost apps or websites, including a number you can work through with your children:

  • This Way Up ($55 – you will need a referral from your doctor)
  • Smiling Mind (free, for children and adults)
  • Mood Gym (free, for adolescents and adults)
  • The Brave Program (free, for children aged 7–17)

For more information please review the following links:

https://www.dhhs.vic.gov.au/victorian-public-coronavirus-disease-covid-19