GPs concerned over request to arrange tests for Covid-19 close contacts

GPs have been asked to arrange tests for close contacts of positive Covid-19 cases due to continued pressure on public health teams following a significant rise in virus cases, it has emerged.

Over the weekend a backlog of close contacts of Covid-19 positive cases arose as public health teams struggled to respond to these cases quickly enough.

In a letter to GP members of the IMO on Tuesday evening (20 October), Dr Denis McCauley, IMO GP Chair, highlighted that up to now GPs were only involved in referring patients presenting with Covid-19 symptoms for testing.

Heretofore GPs have not been involved in initiating tests for or contacting close contacts of positive cases.

“However, given the very significant and rapid increase in numbers  there is extreme pressure on our public health medical colleagues and on the contact tracing systems. This has impacted on their ability to respond quickly to close contacts and our public 
health specialists are prioritising workplace, educational and residential facilities outbreaks,” said Dr McCauley in the letter.

GPs will now refer for testing a patient who contacts the practice to advise they are a close contact but have not yet been contacted by HSE public health staff.

Patients who contact their GP to say they have been directed to do so by public health will also be tested.

Whether patients are symptomatic or not, they will be referred for a test and advised to self-isolate for 14 days.

If a patient’s test is negative they will be advised to continue restricting their movement for 14 days.

If positive, a patient will be advised to continue self-isolation for 10 days or five days following “clearing up of any fever, whichever is the later”, Dr McCauley said.

“This is a short term issue that will be resolved within the next  week to 10 days. For this short time period GPs are being asked to assist in the testing referral process for a particular category of patients who are self-identifying as close contacts and who present to your practice.

“This is a significant ask of GPs who are already under pressure however we believe it is 
necessary at this time given the surges across all communities and in support of our public health colleagues for a defined period of time while additional staff are being recruited/trained and IT enhancements are put in place.

“Under no circumstances are GPs being asked to undertake any contact tracing or to identify patients who fall into this category. It is absolutely recognised that public health are experts in contact tracing and there is no role for GPs in that process.”

Close contacts of positive Covid-19 cases are usually tested twice, on day 0 and day 7, but GPs have been instructed to order one test only.

Commenting on the move, a GP warned that positive cases would go undetected, and that the change, while temporary, would, in his view, be in place for at least four weeks.

“Lots of close contacts will have negative tests at day three or four and go around spreading the virus unknown to themselves”, according to the GP.

The move is expected to result in a reduction in the number of Covid-19 tests performed and lead to a decrease in the detection of positive cases, GP sources said.

It is also feared that GP practices, which are already overwhelmed, may not be able to cope with the extra workload.