Doctors say they have been thrown under the bus with last-minute changes and mixed messaging creating an avalanche of patients looking to them for isolation clearance.
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In a matter of days and without consultation, general practitioners say they've been asked to support and manage patients in the community with COVID.
However, those patients are also now turning to them for "medical clearance" or "de-isolation certificates" before they come out of isolation.
GPs say they are already struggling to keep up with their usual patient case load with many staff in isolation themselves due to COVID, and others on annual leave.
NSW Health has said that confirmed cases of COVID-19 must self-isolate at home "until cleared by a medical practitioner or registered nurse" regardless of vaccination status. That has prompted some people nearing the end of their isolation period to turn to their GPs.
Dr Milton Sales of Brunker Road Medical Practice in Newcastle said between Wednesday and Sunday last week they were notified of 50 people with COVID.
"So we're in a low doctor supply week with half of our admin staff off as close contacts of COVID and no free appointments and suddenly we are getting 10-15 people a day wanting a de-isolation certificate while the whole system we are working in is under stress," Dr Sales said.
"They have just thrown this to us in the last few days. We can't cope with sick people at the moment so we are not going to be able to cope with an administrative task.
"One of the practices just down the road have their doors are closed at the moment due to positive staff."
The Omicron variant has changed the landscape totally in an environment where the government was reducing protections for the community, Dr Sales said.
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"It is all very well to say don't worry about the number of positive cases and just worry about hospital admissions, but some people are getting very sick ... vomiting for three days with a high fever, cough, and aches and pains. That's what some people are getting now, even some who are young, fit and healthy, and double-vaccinated.
"So we have got to care for those people, definitely ... they need to be managed properly by their GP, and we are very keen to do that."
But the system needed to function as advertised, he said.
Hunter GP Dr Lee Fong said another issue creating confusion was that some people did not understand that swab day was day zero, not day one. He encouraged people to go to HealthDirect for the best information on specific isolation timeframes.
NSW confirmed late Tuesday that people diagnosed with COVID-19 who are assessed as low-risk will receive an automatic text message advising them that they can cease isolation on day 10, as long as they have had no symptoms for the past 72 hours, and on day 14 for those who have not been vaccinated.
"Patients who still have symptoms are advised in the text message to contact their GP for advice about their ongoing management," a NSW Health spokeswoman said.
"A relatively small number of patients being cared for by NSW Health who have a protracted illness ... may be advised by their clinical team to extend their isolation period and will be released from isolation when it is deemed safe to do so."
President of the NSW Australian Medical Association, Dr Danielle McMullen, said people flagged as low risk will be sent an SMS message encouraging them to self-care at home but need to contact their GP if they have lasting symptoms. "Clinically, that is what GPs are there for, we are highly skilled at managing viral respiratory illness," Dr McMullen said.
"But we know even people with a mild illness are going to be stressed worried and want to talk to their doctor and we want to be able to be there for people but it's just an avalanche of people coming towards us, coupled with the NSW state government easing all of our public health measures and mask-wearing... asking GPs to tidy up their mess with huge numbers, coupled with an inadequate funding model from the Commonwealth."
A more flexible model of funding was needed, Dr McMullen said.
"There is no funding for new and different ways of thinking - the GP has to be the one on the phone and if we have tens of thousands of cases we just don't have enough hours in the day," she said.
"It's a statewide issue. The more we see COVID in the community the more health care workers and other critical industry workers will be exposed and won't be at work, especially if they are positive.
"If we let it go out of control who is there to run our GP clinics, our transport, our supermarkets ? We do need to slow the spread of Omicron - we are not going to stop it but we need to slow it down."
National AMA president Dr Omar Khorshid had called on the nation's leaders who will come together at National Cabinet on Wednesday to make a national plan for dealing with Omicron.
"It is a no brainer in the view of the AMA, and in fact, in the view of many experts that have been coming out over the last few days, that sensible measures, sensible measures that do not have significant impacts on people's lives, like wearing masks, like some simple social distancing requirements, density limits in indoor venues are all measures that are absolutely essential to manage Omicron," Dr Khorshid said.
"They will not destroy the economy, they will not destroy people's Christmas, and they can keep a little bit of a handbrake on Omicron while we learn more about it, and whilst we get our booster program underway.
"You can require masks to be worn in indoor venues. You can keep some sensible limits on people getting together in indoor venues to try and minimise the impact of Omicron while we wait for that extra data."
The current advice from NSW Health for those with symptoms is to get tested, and for close contacts to stay home for seven days.
"For the next seven days, close contacts should exercise caution and not enter a high-risk setting, should avoid large indoor gatherings, use a rapid antigen test if coming into contact with vulnerable people," NSW Health says.