Novel coronavirus (COVID-19)
14 Aug 2020
This is our main page for COVID-19 information and is regularly updated. It contains the most recent and most important updates.
New Zealand's Alert Levels are changing at 12 noon on Wednesday 12 August
- Auckland will move to Alert Level 3
- The rest of NZ will move to Alert Level 2.
What does Alert Level 2 mean for general practice?
COVID-19 is a possibility in the community, physical distancing and handwashing is still the mainstay of controlling COVID-19.
We have a duty of care to our communities, in particular the most vulnerable people like the elderly and those living with co-morbidity and in deprivation.
The principles of Alert Level 2 are the same as Alert Level 3.
- Reassure patients general practice is open for business. "The first service to contact for community medical care is your general practice."
- Offer telehealth consultations to patients.
- Ask yourself whether you will add significant value to the patient by an in-person consultation compared to a telehealth consultation.
- In-person visits should be preceded by telehealth triage or assessment.
- Maintain physical distancing procedures within the surgery. In particular, patients with respiratory symptoms need to be separated from non-respiratory within the practice, maintain 2 metre separation in waiting rooms.
- Scrupulous hand hygiene required.
- Use PPE as appropriate (mask for clinician, mask for patient with symptoms - droplet PPE taking a swab).
- Equity is central to care with a focus on M?ori, Pacific and vulnerable populations.
- Investigations should be provided for acute and chronic medical care.
- Proactive care is important for patients with chronic disease.
- Continue to increase the focus on long-term management for those patients with chronic conditions.
- Continue to increase focus on elderly, children, and mental health.
- Core services should be provided - preventive screening, immunisations, contraception services and acute care.
- Medicolegally any deviation from your standard practice as a result of COVID-19 should be documented in the patient's notes.
As a guide in Alert Level 2 we anticipate that around 50 per cent of consultations will be "in-person" and 50 per cent will be through telephone, video or other telehealth means.
What does Alert Level 2 / 3 / 4 look like for practices?
An update from Dr Jo Scott-Jones, Pinnacle MHN medical
The community response levels that we are all now too
familiar with are designed to inform the public and businesses about how to
behave to reduce transmission of the virus. These response levels have an
impact on the way we do business, but they are NOT designed to respond or
direct the way specific HEALTH SERVICES work. You will recall that as the
community response level dropped from Alert Level 4 to Level 3 there was no
significant change in the advice for health service delivery.
This can cause confusion for our general practice teams. In
all alert levels general practice is an essential service and practices will be
open. However, appointments will be conducted online or by phone where
possible. Patients can see a doctor or nurse face-to-face if required.
During the lockdown we know there was a significant drop in
core activity such as immunisation and cancer screening that is likely to have
caused additional morbidity, and mortality. If and when the community response Alert
Levels change we need to learn from the lesson of the past few months and
ensure that we continue to deliver the most important services as safely as
The basic principles
yourself, your staff and your patients safe.
- Telephone first all patients and direct them to
"green / amber / red" streams of care.
- Provide for physical distancing for people using
the waiting room.
- Wear a mask if the patient has respiratory
symptoms, have the patient wear a mask.
- Use droplet PPE if you are taking a respiratory
- If staff cannot maintain social distancing at
work - wear a mask / face covering.
providing core services for as long as you can within principle 1.
- Immunisation, cancer screening, minor surgery
for suspected cancer, contraception services as safely as you can for all
- If you have to reduce access to any service keep
it going for the highest need populations for as long as possible, such as Māori,
Pacific, Deprivation 9-10 and those at highest risk, for example previous
cervical cancer needing follow up.
3. Make contact tracing easy
- Have the Ministry of Health QR code available
for patients and staff. (All businesses must display a NZ COVID Tracer QR code
from 11:59am on Wednesday 19 August, get
your QR poster.)
- Have a system to help contact tracing for people
in your waiting room (CCTV / a written list).
- Ensure staff are keeping records of their close
4. Help identify cases
people according to the criteria - offer swabs to everyone with symptoms,
especially if they meet HIS criteria, don't do asymptomatic swabs unless you
are told to by public health units.
- Gear up and provide swabbing in your clinics if
you aren't already.
- If to meet principle 1 you can't provide swabs
yourself then support the alternative swabbing services (if you bake a cake -
mine's a chocolate one.)
If the prevalence of the disease increases in your community
then you may not be able to differentiate between the "amber" and the "red"
patients - the amber stream may need to be closed down.
If services get overwhelmed you may need to reduce access to
core services - If this happens please let us know and we will support
you to find help for your patients if we can.
I currently am working with the Ministry of Health and the
College on the community health response framework and will keep you up to date with all
Any questions please
do not hesitate to contact me, email@example.com
or by phone 027 475 0488.
Your local Pinnacle contact
Our local leads are available for questions, concerns and advice. Please also contact one of the team if you have any issues with PPE stock - all our leads are working closely with the DHB in their region.
- Waikato - Justin Butcher, phone 021 679
- Taranaki - Tony Mottershead, phone 027 218 6524, firstname.lastname@example.org
- Lakes - Pen Blackmore, phone 021 413 760, email@example.com
- Tairawhiti - Matt Tong, phone 027 616 4817, firstname.lastname@example.org - Please note Matt is unavailable 14-17 August, please contact Justin Butcher (as above) or Jo Scott-Jones, phone 027 475 0488 or email@example.com.
Ministry of Health - useful website links
If you have to close the practice (on advice from Medical Officer of Health) after a confirmed case
- Inform the PHO CEO (phone 021 925 812 / email firstname.lastname@example.org) as soon as you know this is a necessary step.
- Instigate your business continuity plan ( c.f. Foundation Standards).
- inform staff of pending closure and process to follow
- inform patients of impending closure
- notify neighbouring practices / services of impending closure and agree process for practice patients during closure period
- continue to provide virtual services wherever possible
- arrange thorough cleaning of practice
- advise regarding potential length of closure and re-opening protocol.
If you have to close the practice due to workforce issues
- Inform the PHO CEO (phone 021 925 812 / email email@example.com ) as soon as you think this may be necessary.
- Inform staff of pending closure and process to follow.
- Inform patients of impending closure.
- Notify neighbouring practices / services of impending closure and agree process for practice patients during closure period.
- Continue to provide virtual services wherever possible.
Information for patients
There is a dedicated Healthline for COVID-19 - 0800 358 5453 - it is free and available 24 hours a day, 7 days a week. (For international SIMs the number to call is +64 9 358 5453.)
Other COVID-19 information on our website