Drive-thru coronavirus testing ‘needs to be explored’: Victorian health chief

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Adjunct Clinical Professor Brett Sutton told newsGP the technique now being used in South Korea and the UK ‘absolutely needs to be explored’.
 
He said Australia should explore any techniques that could ‘help facilitate testing at scale in a way that makes it safe for staff and convenient for community, while diverting from busy emergency departments and GPs’.
 
Any trial would have to be tested with one of Victoria’s tertiary hospitals first, he said.
 
South Korean health authorities have opened rapid-testing drive-thru clinics in the most-coronavirus-affected city, Daegu, as well as Seoul and several other cities, allowing drivers to be tested within 10 minutes and receive the results later.
 
The new approach is intended to ease pressure on clinics and hospitals while affording healthcare workers better protection from the virus.  
 
‘Here we can test many people within a short period of time in a less crowded manner, and there are lower risks of infection because it’s done inside the car,’ Chief of the Goyang Community Health Centre Kim An-hyun said, according to a Reuters report.
 
The UK has swiftly followed suit, with a similar service opening outside an Edinburgh hospital and another in central London.
 
Monash University Professor of General Practice Danielle Mazza backed the ‘excellent suggestion’ should virus achieve sustained community transmission, as many experts are now predicting.
 
‘It took staff in my clinic an hour to process a [single] patient requesting testing yesterday, [which was] enormously disruptive to other patients and the whole clinic,’ Professor Mazza said on Twitter.
 
Associate Professor Mark Morgan, Chair of the RACGP Expert Committee – Quality Care (REC–QC), told newsGP the concept is an interesting one. 
 
He said GPs will need to innovate to be able to cope with the potential community spread of COVID-19 (coronavirus), especially as every person with cold and flu symptoms may be suspected of having the virus.
 
In 2009, Associate Professor Morgan led a simulated response of a large general practice to the avian flu to investigate how a general practice would cope with the early stages of community spread of pandemic influenza.
 
He and his team developed two techniques that helped with social distancing.
 
The first was a ticket system so patients with flu-like symptoms could wait in their cars in the clinic car park. The second was to seek an arrangement with a local fast food restaurant to use their drive-thru facilities to quickly administer vaccinations.
 
But Associate Professor Morgan suggests the most significant benefit for general practice might be to make telehealth consultations Medicare-funded, enabling advice and triage over the phone.
 
The calls come as GPs grapple with how to best respond in the event the highly transmissible virus becomes widespread in Australia. There are concerns over how to best isolate suspected cases while healthcare workers maintain their own safety, at a time when personal protective equipment may be in short supply.
 
The Australian Government’s recently publicised coronavirus emergency response plan states that GPs and other health providers ‘manage the bulk of people with respiratory illnesses’ in the community, while hospitals will support more severely affected patients.
 
The plan also envisages networks of ‘fever clinics’ set up in or adjacent to hospitals.
 
‘New models of care may be instituted to manage novel coronavirus patients, [such as] fever clinics staffed predominantly by nurses via management protocols, with onsite or telephone medical support,’ the plan states.
 
The worst-case scenario foreseen by the plan, however, could overwhelm existing medical infrastructure – and prompt calls for faster, safer testing.
 
In that worst-case scenario – which includes widespread transmission and high clinical severity – the plan states a level of impact could be similar to the 1918 Spanish flu and ‘challenge the capacity’ of the health sector.
 
NSW Chief Medical Officer Dr Kerry Chant has said the country’s health system ‘will be stretched’ if Australia sees a similar outbreak to those currently taking place overseas.
 
Biosecurity expert Professor Raina MacIntyre has estimated the country could need 1.8 million beds if the virus affects a majority of Australians. She estimates a pandemic could lead to 25–70% of the population being affected.
 
While mild in most people, the virus is most threatening to older people or those with comorbidities.

A new Chinese epidemiological study of more than 44,000 confirmed cases detected as of 11 February found the death rate was highest for people aged over 80 – at 14.8% of those infected – while posing very little risk to children, with no fatalities recorded for children aged nine and under.
 
An Australian Department of Health spokesperson said it is up to state and territory governments to choose their models of care.
 
‘As part of preparedness planning, different models of healthcare delivery are being considered. This includes models such as the establishment of fever clinics,’ the spokesperson said.
 
The RACGP has more information on coronavirus available on its website.
 
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