Dear Member / clinic owner,

Meeting, MoH / Clinic owners / RNZCUC

  • Teleconference today
  • MoH is actively looking at a UCC support package, and could be close to announcing something by next week.
  • Aim to enable clinics to continue operating.
  • MoH accepted need to include UC in its communications and to receive UC feedback; we’ve made some specific suggestions to achieve this.

Clinic opening hours

RNZCUC will be lenient with clinics that are closing early because of low consult numbers, in terms of Urgent Care Standard and Approved Training Facility compliance – see full statement below.

Personal protective equipment

  • MoH announced more PPE to be released to DHBs, for distribution to vital services workers such as home and community workers, NGO workers and pharmacy staff.
  • Re-stated that existing PPE guidelines were sound, but those wanting to ‘feel safe’ as well as be safe could wear PPE (eg masks) for interactions outside those in the guideline.
  • Some clinics are already having frontline staff wear masks for all consults; members wanting to ‘feel safe’ may wish to heed the Ministry’s advice as above.
  • See also forum topic https://rnzcuc.org.nz/covid-19-forum/topic/masks-reduced-transmission-of-sars-by-70-cochrane-analysis/

Case definition

MoH widened this today “respiratory symptoms consistent with Covid-19”; overseas travel no longer a requirement. To be published shortly.

Testing

  • Operating at half capacity (1,800/day). Current full capacity is 3,700/day. Capacity being increased to c 5,000 per day.
  • MoH is actively considering point-of-care testing including immunoassay, eg by fingerprick testing.
  • Immunoassay is cheap, accurate and quick; shows presence of acute infection and immune status.
  • Asymptomatic new arrivals not being tested, and only sometimes quarantined.
See also forum topic.

New forum topics

Testing the entire population of a town for Covid-19 - results
  • Whole Italian town of Vo, pop 3600, was tested; 3% positive
  • 45% of positive cases completely asymptomatic
  • Cases of transmission by asymptomatic patients noted.
  • 90% fall in infection rate achieved in 9 days, by mass testing and quarantine
  • Positives quarantined; one death only.
  • Mass testing very effective in controlling outbreak in this town.
Summary of testing methods – RTPCR, IgG/IgM; genomic analysis

RNZCUC Facility Audit Subcommittee statement on urgent care opening hours; COVID19 pandemic response 1 April 2020

“Urgent Care clinics are contractually obliged under UC2015 standard to be open 8am to 8pm 7 days a week.
RNZCUC understands with the lockdown there has been a dramatic reduction in need which has placed significant financial stress on clinics.
Reduction of hours is acceptable on a temporary basis as long as the needs of the community are met.
If medically demand increases with or without a lockdown then clinics have a duty of care to increase clinic hours.
Negotiations are ongoing to secure additional funding for Urgent Care Clinics.
  1. Where ever possible maintain normal working hours or minimum 8am to 8pm
  2. If necessary can consider small reduction in hours eg to 7pm or 6pm in evening
  3. Any reduction to finish before 6pm requires serious consideration. Are you meeting the needs of the community?
If you close the clinic earlier than 8pm consider a phone diversion service that you can provide phone consultation/ advise from home for your population.”
With best wishes,
David Gollogly, Jasmine Mackay, Richard Chen
Pandemic Response Committee
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