COVID-19: Questions and answers for primary health care workers

Questions and answers on COVID-19 for primary health care workers including general, clinical, and infection prevention and control guidance.

Last updated: 5 July 2022

On this page:


General guidance

How do I know I am using the latest guidelines and advisories?

The Ministry of Health’s COVID-19 webpage is updated regularly with the latest advice and guidelines. Each page should have the date it was last updated.

Specific advice and resources for health care workers, are available at:


Healthline

What is Healthline telling patients?

The COVID-19 Healthline 0800 358 5453 is using the latest advice from the Ministry of Health to provide information to the public. All callers are asked a series of questions which help determine if they may have COVID-19, if they may require testing, and advice on how and where to access care.

Healthline staff are kept up to date with the latest testing guidance and are ready to modify their advice as the situation evolves.


Clinical

What are the precautions for vaccination with the Pfizer COVID-19 vaccine?

The safety and effectiveness of the Pfizer COVID-19 vaccination is well established. We also know having both doses of the vaccine provides the greatest protection from catching the virus and becoming seriously unwell or passing it on to others. 

There are limited medical reasons for not having the COVID-19 vaccine. The Immunisation Advisory Centre (IMAC) confirms the only medical reason for not having a COVID-19 vaccine is having a documented severe allergic reaction (anaphylaxis) to a previous dose of the mRNA-CV vaccine or any component of the vaccine.

Precaution is required, with guidance from specialist and IMAC advice, when there is documented severe allergic reaction (anaphylaxis) or complication (myocarditis, pericarditis) from the first dose of Pfizer COVID-19 vaccine.

Other hypersensitivities and allergic reactions are generally grounds for more precautions to be taken when vaccinating, but are not contraindications in themselves. Options for vaccination in a controlled environment should be considered.

Health professionals can view further advice on your HealthPathways COVID -19 Vaccination pathway.

Who should I swab for COVID-19?

The testing criteria reflect multiple factors and may change frequently.

See the Primary Care Quick Reference Guide and Case Definition and Testing Guidelines.

The Testing guidance for the health sector provides more detailed advice and is updated every six weeks.

Is there anyone I shouldn’t swab in general practice?

Yes. Do not swab:

  • patients with severe illness
  • patients who require hospitalisation or hospital assessment
  • patients with signs/symptoms consistent with pneumonia.

These patients should be discussed with the local hospital and sent there for further assessment and management.

Should I test a patient who is asymptomatic?

There are some instances where testing of asymptomatic people is mandated or advised. The testing criteria reflect multiple factors and may change frequently.

We recommend that you frequently review the guidance on who to test on the case definition and testing guidance page.

What if a patient’s COVID-19 test result is negative?

Many people will be nervous while they wait for their result, while staying at home or in self isolation while the test result is pending. It is important to feed back negative results as soon as possible. (Note: Public health units will provide follow-up with patients who have positive tests.)

The advice to people who were symptomatic but returned a negative result is:

  • if they are still symptomatic, they should continue to stay at home or self-isolate and follow basic hygiene measures until they have been symptom free for 24 hours.
  • if they feel fully recovered, but then develop a new illness or if their current symptoms get worse, they should call their general practice or Healthline on 0800 358 5453.
  • if they are a close contact, or they are under a Required Testing Order or Border Notice, they will be advised by a medical officer of health about the timing of their release from isolation.
  • if a patient meets the HIS criteria they should follow advice from a medical officer of health about when it is safe to return to normal activities. Otherwise they can return to normal activity according to the alert level restrictions they are living under once they have been well for 24 hours.

The advice to people who were asymptomatic and screened for surveillance purposes, returning a negative result:

  • if they are under a Required Testing Order or Border Notice, they will be advised by a medical officer of health.
  • otherwise they can return to normal activity according to the alert level restrictions they are living under.

How do we make sure we are using our Personal Protective Equipment (PPE), testing supplies and laboratory resources wisely?

Practitioners should continue to apply the testing guidance to determine who to swab. See case definition and testing guidance for more information.

For the latest advice on PPE use in health care see Personal protective equipment use in health and disability settings and advice in the Primary Care Quick Reference Guide.

Does general practice need to provide medical certificates for people who are required to self-isolate or stay at home?

The Ministry encourages workplaces to accept the Ministry of Health text services 2328 or 2648 as sufficient evidence for sick leave purposes, and not to request further medical certificates due to the extra pressure this places on primary health care.

For more information on leave entitlements and COVID-19, visit Employment New Zealand.

Do I need to provide a medical certificate for someone seeking an exemption to wear a mask?

No. People who cannot wear a face mask for legitimate reasons can apply for a face mask exemption pass.

More information on applying for a face mask exemption

When can someone who is a confirmed or a probable case of COVID-19 be released from isolation?

This is determined by the medical officer of Health/public health official.


Health worker infection prevention and control

Should I go to work if I have respiratory or influenza-like symptoms?

No. You should stay at home. You should not leave home if you are unwell. In this situation, you should stand down from going to work, and arrange to be tested for COVID-19.

You will need to stay at home until  the result is negative and your have been free from symptoms for 24 hours. 

What should I do if the patient’s COVID-19 status is unknown?

No matter what someone’s COVID-19 status is, you should always follow routine infection prevention and control precautions (standard as well as any transmission-based) for all care.

See ‘COVID-19 Status unknown’ on the Personal protective equipment use in health and disability care settings page and in the Primary Care Quick Reference Guide.

What are aerosol generating procedures?

Aerosol generating procedures are interventions that can promote the generation of fine airborne particles (< 5 microns). These fine particles remain suspended in the air for longer periods than larger particles and can be inhaled resulting in a risk of airborne transmission. Aerosol generating procedures are not common in the community. They are most typically performed settings such as community dentistry. Taking a nasopharyngeal or a throat swab in the community to test for COVID-19 is not an aerosol generating procedure.

Read more about aerosol generating procedures.

When do I use an N95/P2 particulate respirator?

N95/P2 particulate respirators are only required when working with a person who is at increased risk of carrying or shedding SARS COV2 virus. This respirator filters extremely small particles.

See Personal protective equipment use in health and disability settings for role of face masks and advice according to alert level and clinical care setting.

How do masks affect the transmission of COVID-19?

See information in Personal protective equipment use in health and disability settings.

What if my practice doesn't have a single room to see a patient with symptoms consistent with COVID-19?

Each practice will have a system for treating infectious patients (such as influenza or measles) that suits their clinic and setting. Sometimes this can mean assessing the patient in a car or in a sheltered place outside. Practices are encouraged to have a red stream system for potentially infectious patients, cohorting staff to red or green stream, and dedicated physical spaces when seeing red stream.

How do I clean the room after a patient with symptoms consistent with COVID-19 has left?

The best way to prevent any potential transmission of infections in primary care is to clean the room between patients. 

After the patient has left:

  • wash your hands and put on gloves for cleaning
  • wipe down/clean hard surfaces and all items the patient has touched (eg, the examination couch) by either using:
  • detergent and water, followed by a hospital grade disinfectant, noting the dwell time of the product used and follow manufacturers’ instructions for use of any additional PPE or;
  • a 2 in 1 cleaning and disinfectant wipe that is effective against SARS-CoV-2.
  • dispose of PPE safely and appropriately in a closed clinical waste bin, followed by hand hygiene practices.

 Stand down of the room is not necessary.

 Also see: COVID-19: General cleaning and disinfection advice

How is the Ministry of Health making decisions around PPE?

The Ministry is working with a Technical Advisory Group, which includes national infection control experts, public health experts and clinicians. The decisions are made on scientific evidence, international experience and current World Health Organization guidance.

How do I properly put on and take off PPE?

See Personal protective equipment use in health and disability settings.

What do we do if our primary care practice runs out of PPE?

PPE for New Zealand’s publicly-funded health workers is ordered and distributed through a nationally  coordinated approach managed by the Ministry (see COVID-19: Personal Protective Equipment Central Supply). This approach enables availability of PPE where and when it is needed during the COVID-19 response.

If you have any queries about PPE supply and distribution, email [email protected]. If there is an immediate need for the PPE, the general practice should contact their District Health Board in the first instance and alert the Ministry of Health COVID Health Supply chain team. 

What do we do if we are unable to assess or swab a suspected case, because of a lack of a single room, insufficient PPE, or we don’t have enough staff?

It is important to have an arrangement in place for patient care. This will involve working with local organisations (other practices, your PHO, or Te Whatu Ora district) to coordinate with an agreed pathway to ensure patients can be assessed safely.

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