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‘Advise patients travelling from northern Italy to self isolate’, says PHE

Practices should advise patients who have recently travelled from parts of Italy to self isolate, even if they do not have symptoms of the coronavirus (Covid-19)

Practices should advise patients who have recently travelled from parts of Italy to self isolate, even if they do not have symptoms of the coronavirus (Covid-19).

This comes as Public Health England has updated the list of countries most affected by the virus.

Category 1 countries and areas such as northern Italy mean that travellers should immediately self isolate, even if asymptomatic, and call NHS 111 to inform of recent travel.

These are now: any Italian town under containment measures; Daegu or Cheongdo (Republic of Korea); Iran and, as before, Wuhan city and Hubei Province in China.

The guidance said: ‘If you have returned from these specific areas since February 19, you should call NHS 111 and stay indoors and avoid contact with other people even if you do not have symptoms.’

PHE has also updated Category 2 countries and areas. These are now Cambodia; China; Hong Kong;; Japan; Laos; Macau; Malaysia; Myanmar; Singapore; Republic of Korea and northern Italy. The latter two excludes the areas specifically referred to in Category 1.

Travellers from Category 2 regions are not required to undertake special measures, but are requested to self isolate and call 111 should they develop symptoms.

As of yesterday, 6,536 people have been tested in the UK, of which nine were confirmed positive. This figure doesn’t include the four confirmed cases from the Diamond Princess cruise ship, who arrived in the UK and received test results from Japan.

Italy has seen a sudden surge in diagnoses – now totalling 219, with seven deaths – subsequently placing 50,000 people in a dozen towns into lockdown and cancelling Venice Carnival.

It comes as GPs around the country voiced concerns yesterday that advice on Covid-19 did not reflect the escalating outbreak, including developments from Italy.

Since the coronavirus outbreak worldwide, PHE and NHS 111 have provided limited updates to their guidance for primary care practitioners.There have now been 13 confirmed cases in the UK.

The Royal College of Nursing also launched a webpage earlier this month with resources to support nurses in their understanding and management of Covid-19.

Prior to the update, PHE’s  advice to GPs was that at-risk patients were those who have travelled to China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan, or Thailand within 14 days, or been in contact with confirmed cases of Covid-19.

This left some GPs in limbo yesterday, while awaiting updates to guidance.

Kent GP Dr Stephanie deGiorgio told GP magazine Pulse: ‘GPs are suffering from lack of information as time goes on. The Government doesn’t list Italy as a source country, but many GPs being contacted by people returning from northern Italy, with and without symptoms today.

‘They don’t meet the criteria for swabbing, so what on earth do we do? And if we have seen a symptomatic patient without personal protective equipment (PPE), which no one has supplied to GP surgeries, should be we off work?

‘We all know this is an evolving situation, but it feels like an information vacuum from those who should be coordinating the response, is causing uncertainty and potentially increasing risk.’

The Department of Health and Social Care have been contacted for comment.

This article was first published on our sister site, Pulse Today