To our Dear Patients,

We appreciate the stress and disruption that the Coronavirus epidemic is causing.

The situation is changing rapidly and there is  a lot of confusion.

Please be assured that the doctors and staff at Eltham and Monty Clinics are working very hard to guide you through this time.

Here we address a few of the current issues:

Information

We would encourage you to get the official information that is relevant from the Victorian Department of Health website:

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

This site is updated daily. It answers many of the common questions.

This is the advice that everyone should be following in Victoria. We really do have excellent medical experts in Australia.

We note there is a lot of misinformation, rumour mongering and second guessing in both the mainstream media and social media. This is most unhelpful.

A planned  and co-ordinated response will be the best for minimising the impact of this disease on the community.

Please check the Department of Health site and our website before calling the clinic as our phone lines are extremely busy at present.

Protocols for the clinic

Basically we are keeping people with respiratory symptoms out of our clinic buildings during the epidemic.

So, if you have ANY respiratory symptoms (fever, runny nose, sore throat, cough, shortness of breath) please ring the clinic first. Do not just turn up.

When you arrive for an appointment, ring the clinic to check in.

You will be asked to wait in the car.

The doctor will phone you when they are ready to see you.

Much of the consultation will happen over the phone.

The doctor will advise where and how to conduct your examination.

Consultations for anything that is not a respiratory illness will continue as normal.

Testing for Coronavirus

Testing is only available for people who are sick and meet the Victorian Department of Health criteria for a “suspected case.”

The current criteria are:

Have travelled overseas in the last 14 days AND have respiratory symptoms or close contact with a confirmed case.

OR a healthcare worker or aged care worker (direct patient contact) with respiratory symptoms and fever.

There is a national shortage of testing kits.

There is no point testing if you are not sick. The chance of getting a positive result is very low.

It also clogs up the pathology labs with unnecessary tests. Having a test “just to make sure” is of no value because a negative test today does not stop you getting sick tomorrow.

“Telehealth” consultations and Medicare 

We are going to increase the use of phone consultations during this epidemic to reduce potential exposures to the virus for patients and staff.

The government have also sensibly enabled some Medicare rebates for patients without physically seeing the doctor. These item numbers are available temporarily for the next six months.

These consultations will be primarily conducted by phone call but may also involve a video call e.g. Skype.

They are not suited for all conditions but will be useful during this epidemic.

• If you are a non-concession patient, the consultation fee will be $83 and there is no Medicare rebate.
• If you are a concession patient,  AND you meet the Medicare criteria for a “Telehealth Medicare rebate,” then you will be bulk-billed.
• If you are a concession patient but you do not meet the Medicare criteria for a “Telehealth Medicare rebate” then the fee will be $53. There is no Medicare rebate.

Feel free to request a Telehealth consultation.

You will be booked a nominal time. The doctor will call you.

Please have your phone line free!

Clearance certificates

There is no such thing as an official “Clearance Certificate” (and there never has been).

You receive a certificate of sickness from your doctor.

If you are not certified sick, then you are presumed to be well.

Many employers get this wrong. If your employer is asking you to get a clearance certificate, or asking you to stay away from work even though you are not sick and not in home isolation, then refer them to their business advisor or Fairwork Australia.

Epidemiology

There are three major phases to this epidemic:

1. Trying to keep it out of the country (“Containment”) . We are now past this point.
2. Deliberately trying to slow the spread of the infection through the population (“Control”).  This is our current phase.
   This is important to try to ensure that there are not too many people sick at any one time, such that it will exhaust our capacity to treat them.
   For Coronavirus this really means having enough hospital beds and ventilation machines to help those who get really sick.
   The current term being frequently quoted:  “flattening the curve” refers to deliberately slowly the spread of the virus. The epidemic will last longer, but there will be less people sick at any given time.  This creates a flatter curve if you graph the  “number of cases” plotted against” time.”
3. Accepting that the virus has spread throughout the population and just treat people who are sick (“Mitigation”).
   At that point there is no point in testing people or quarantining them. The epidemic will end when enough people become immune or a vaccination is widely distributed.

This epidemic will last many months. There is no certainty as to how long and the epidemiologists are doing modelling to help estimate this better.

We are here to help and support you.

Feel free to contact the clinic with any questions or concerns.

Please be kind to our reception staff. They are working flat out to get problems sorted out for everyone.

Thank-you for your understanding.

Ian, Richard and Cameron