Interim Guidance last updated 17 February 2020
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- Elective surgery
- Outpatient clinics
The people who meet the following criteria are required to self-isolate because of the low risk that people who have been in China may be infected with novel coronavirus 2019 (COVID-19), and the very low risk that some people with COVID-19 infection may be infectious prior to symptom onset.
- People who have been in, or transited through, mainland China (excluding Hong Kong, Macau and Taiwan) in the last 14 days must self-isolate for 14 days after departing China.
- People who have been in close contact with a person with confirmed COVID-19 infection while infectious must self-isolate for 14 days following last contact.
Onset of COVID-19 illness during recovery from an operation is likely to complicate recovery and prolong the hospital stay, as well as expose health care workers who would then have to be excluded from healthcare work. Please note, this does not apply to unplanned surgery.
For planned surgery only, staff are required to:
- Ask patients at the time of booking confirmation whether they have been in, or transited through mainland China, or been in close contact with a person with confirmed COVID-19 while infectious, during the 14 days before their scheduled surgery.
- For patients who meet the criteria for isolation:
- postpone surgery until 14 days after the patient departed from mainland China, or came in contact with a person with confirmed COVID-19 while infectious, if it will not significantly impact patient outcomes – this decision will require discussion with the clinical team
- ensure the surgery is re-scheduled as soon as practicable after the 14 day exclusion period has lapsed
- please note, if the patient is unwell they are requested to seek health advice (from their GP or by calling healthdirect on 1800 022 222) to exclude COVID-19 as well as to resolve any other health issues.
Before attendance at outpatients
- Develop a system, prior to attendance (e.g. phone call, SMS), to ask patients whether they’ve been in or transited through mainland China, or have had close contact with a person with confirmed COVID-19 while infectious, in the 14 days before the scheduled outpatient appointment.
- If the patient meets the above criteria:
- consider alternate of methods of conducting the appointment if appropriate (e.g. telephone or tele-medicine)
- if it is not possible to conduct the appointment in an alternate way, reschedule their appointment unless it is medically necessary
- reschedule the appointment for as soon as possible after the 14 day exclusion
- remind them they are to self-isolate at home for 14 days after they departed mainland China, or had close contact with a person with confirmed COVID-19 while infectious
- remind them if they develop respiratory symptoms or fever to call healthdirect on 1800 022 222 or call their GP
- Note, facilities will need to develop a system to implement the above steps, including appointing an appropriate person to assess whether or not it’s safe to defer the outpatient appointment.
During outpatient attendance
- Consider options to identify patients in the outpatient clinic waiting room, e.g.
- waiting room signage
- asking patients at reception whether they have been to or transited through mainland China, or have had close contact with a person with confirmed COVID-19 while infectious, in the previous 14 days.
- For patients who meet the above criteria:
- ask the patient to wear a surgical mask
- ask the patient if they have any respiratory symptoms or fever.
- For patients who meet the above criteria within 14 days of their appointment and who do not report any respiratory symptoms or fever:
- the attending doctor should make a clinical assessment about the presence of respiratory symptoms
- if no symptoms/signs continue the outpatient consultation as normal, with the patient wearing a surgical mask
- remind the patient that they should self-isolate themselves at home for 14 days after they departed China, or their last contact with a person with confirmed COVID-19 while infectious.
- For patients who meet the above criteria and who report symptoms manage the patient in conjunction with the emergency department as per the clinician guidance.
- Other guidance: ensure availability of surgical masks and hand hygiene facilities.