Patients presenting for hospital‐based screening for the coronavirus disease 2019: Risk of disease, and healthcare access preferences

• Published in: Emergency medicine Australasia 2020-10, Vol.32 (5), p.809-813
• Main Authors: Rojek, Amanda, Dutch, Martin, Peyton, Daniel, Pelly, Rachel, Putland, Mark, Hiscock, Harriet, Knott, Jonathan
• Format: Article
• Language: English
• Subjects: Ambulatory Care Facilities - statistics & numerical data; Australia; coronavirus disease 2019; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; COVID-19; Cross-Sectional Studies; Emergency Service, Hospital - statistics & numerical data; epidemic; Female; Health Services Accessibility - statistics & numerical data; Humans; Incidence; Male; Mass Screening - organization & administration; Original Research; outbreak; pandemic; Pandemics - prevention & control; Pandemics - statistics & numerical data; Patient Preference; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Public Health; Risk Assessment; severe acute respiratory syndrome coronavirus 2; Tertiary Care Centers
• ISSN: 1742-6731; 1742-6723
• DOI: 10.1111/1742-6723.13589

Objective Early during the coronavirus disease 2019 (COVID‐19) pandemic, Australian EDs experienced an unprecedented surge in patients seeking screening. Understanding what proportion of these patients require testing and who can be safely screened in community‐based models of care is critical for workforce and infrastructure planning across the healthcare system, as well as public messaging campaigns. Methods In this cross‐sectional survey, we screened patients presenting to a COVID‐19 screening clinic in a tertiary ED. We assessed the proportion of patients who met testing criteria; self‐reported symptom severity; reasons why they came to the ED for screening and views on community‐based care. Results We include findings from 1846 patients. Most patients (55.3%) did not meet contemporaneous criteria for testing and most (57.6%) had mild or no (13.4%) symptoms. The main reason for coming to the ED was being referred by a telephone health service (31.3%) and 136 (7.4%) said they tried to contact their general practitioner but could not get an appointment. Only 47 (2.6%) said they thought the disease was too specialised for their general practitioner to manage. Conclusions While capacity building in acute care facilities is an important part of pandemic planning, it is also important that patients not needing hospital level of care can be assessed and treated elsewhere. We have identified a significant proportion of people at this early stage in the pandemic who have sought healthcare at hospital but who might have been assisted in the community had services been available and public health messaging structured to guide them there. Many patients who present to EDs for COVID‐19 screening can be safely screened in community‐based settings.