COVID-19 questions and answers for primary health care workers

This page was last updated 29 May 2020.

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 Resources for health professionals.

What is the current strategy to eliminate COVID-19?

The Government’s overall public health strategy for the COVID-19 pandemic in New Zealand is elimination. This means being confident we have eliminated chains of transmission in our community for at least 28 days, and we can effectively contain any future imported cases from overseas.

Our elimination strategy is a sustained approach to keep it out, find it and stamp it out. We do this through:

  • controlling entry at the border
  • disease surveillance
  • physical distancing and hygiene measures
  • testing for and tracing all potential cases
  • isolating cases and their close contacts
  • broader public health controls depending on the alert level we are in.

Healthline

What is Healthline telling patients?

Healthline is using the latest advice from the Ministry of Health to provide information to those who call the COVID-19 dedicated 0800 number.

All callers are asked a series of questions which help determine if they may have COVID-19 and if they require testing.

Callers who fit the definition of a suspected case are requested to self-isolate, and not to present to the GP. Healthline will ring the GP directly if a caller fits the definition of a suspected case, or direct them to a designated testing centre. 

Healthline staff are being kept up to date and are ready to modify their advice as the situation evolves.


Clinical

Who should I swab for COVID-19?

All people who meet the suspect case definition for COVID-19, or where the clinician has a high degree of suspicion, should be tested to confirm or exclude a diagnosis. 

Find more information on the case definition of COVID-19 infection page.

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 (or CBAC, depending on severity), and sent there for swabbing and further management. 

How do we make sure we are using our PPE, testing supplies and laboratory resources wisely?

COVID-19 is likely to be with us for some months and it is important that we ensure the availability of supplies for the coming stages and support laboratory capacity. Practitioners must continue to apply the case definition to determine who is a suspected case and indication to test. 

For the latest advice on PPE use in health care see the Personal protective equipment use in health care page.

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

General practitioners are responsible for informing patients if their COVID-19 test is negative and providing advice. (Note: Public health units will provide follow-up with patients who have positive tests).

The advice to patients with a negative result is:

  • to stay at home while they have symptoms and follow basic hygiene measures
  • they must remain symptom-free for 48 hours before going back to work or doing usual daily activity.

If a patient has been directed to isolate due to recent travel or after close contact with a confirmed or probable case, all pre-existing isolation requirements continue to apply. That means a patient who is in self-isolation/quarantine should complete the full 14-day isolation period, irrespective of the negative test result. If they are still sick with the same illness at the end of the 14-day period, they will need to stay in isolation until they have been symptom-free for 48 hours.

If their current symptoms get worse and they feel more unwell, they should phone Healthline for advice: 0800 358 5453

If they feel fully recovered, but then develop a new illness while in self-isolation, they should call Healthline on 0800 358 5453.

Do patients who test positive for COVID-19 require admission to hospital for inpatient care?

Patients with suspected infection of COVID-19 should be managed medically according to their symptoms and clinical state. They do not need to be hospitalised unless it is clinically indicated.

Does general practice need to provide medical certificates for people who are medically well but are required to self-isolate?

No, Healthline have developed a self-isolation certificate for people who are medically well but are required to self-isolate and have registered with them. Patients can call Healthline for free on 0800 358 5453.


Infection prevention and control

As a health care worker, what is my risk of catching COVID-19?

The risk of catching COVID-19 from a confirmed case largely depends on the patient and how you are caring for them.

Depending on the work you’re doing or the patient you’re caring for, you may need to wear PPE. For guidelines and advice on when PPE should be used and the type of PPE, see the Personal protective equipment use in health care page.
 

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

No. You should stay at home. You should not work in a public setting if you are unwell. In this situation, you should stand down from work, self-isolate, and be assessed as a patient by a medical professional.

It may be appropriate for you to be tested for COVID-19. This will be determined by your health care provider after consideration of the current testing criteria.

There is guidance on the interpretation of results in the Updated Advice For Health Professionals document. 

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

If a person’s COVID-19 status is unknown, there are some risk assessment questions you need to ask ideally ahead of any interaction, or if not possible, while maintaining at least 1 metre physical distancing.

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 the Alert Level 2 risk assessment questions if COVID-19 status is unknown poster guidelines on the PPE for health care workers page.

What are aerosol generating procedures?

Aerosol generating procedures are those that produce droplets that are small enough to be widely dispersed. They pose a higher infection risk for health professionals. Taking a nasopharyngeal or a throat swab in the community to test for COVID-19 is not an aerosol generating procedure.

Aerosol generating procedures should only be done in a hospital setting if COVID-19 infection is suspected.

Read more about aerosol generating procedures on the PPE pages.

What mask do I wear when I take a nasopharyngeal or throat swab?

Taking a nasopharyngeal or throat swab for a patient being treated in the community is not an aerosol-generating procedure. Health practitioners can wear the standard PPE when doing these procedures, which is:

  • gloves
  • surgical face mask
  • long-sleeved impervious gown
  • eye protection.

When do I use an N95 respirator?

N95/P2 respirators are only required when working with a person whose status is COVID-19 suspected, probable or confirmed, to filter small particles produced during aerosol generating procedures (AGP).

AGPs are a set of interventions involving the upper and lower respiratory tract that can generate droplets that contain infectious respiratory secretions.

These are not typically performed in general practice, but may be required in other settings such as community dentistry.

More information about the role of face masks

How do masks affect the transmission of COVID-19?

We have created a document that discusses this in detail – see Transmission of COVID-19 and the role of face masks in health settings.

What if my practice doesn't have a single room to see a suspected case?

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, although this is not best practice. Practices are encouraged to keep a room free for potentially infectious patients, however we appreciate this is not always possible.

How do I clean the room after the patient 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
  • use detergent and water, followed by a hospital grade disinfectant, or use a 2 in 1 product and wipe down/clean hard surfaces and all items the patient has touched (eg, the examination couch)
  • note the dwell time of the product used and follow manufacturers’ instructions for use of any additional PPE
  • 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.
 

Are boots or coverall suits required as routine personal protective equipment (PPE) for the assessment of patients with suspected COVID-19 in primary care?

No – contact and droplet precautions are sufficient. These are:

  • surgical mask
  • gloves
  • long-sleeved impervious gown
  • eye protection.

Hand hygiene is important.

For more advice on PPE, see PPE use in health care.

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 WHO guidance.

How do I properly put on and take off the PPE?

See information about the use of PPE for health care workers.

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

In the first instance, contact your usual supplier to order more PPE stock. If you are unable to purchase new stock, speak with your PHO who will discuss obtaining additional equipment from the local DHB.

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 assess patients who are suspected cases of COVID-19 in a way that keeps them, you, and other people at the practice safe. If that is not possible at your practice at a given time, it is important to have an arrangement in place for patient care. This will involve working with local organisations (other practices, your PHO, or DHB) to establish a pathway to ensure patients can be assessed safely.

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

This information is available in the updated advice for health care professionals document.

Back to top