Triage
Background to the COVID-19 Pandemic
The newly identified severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2), caused by the novel coronavirus 2019 disease (COVID-19), is of precedence due to the declaration of a pandemic by the World Health Organisation on 11th March 2020 (Lai et al., 2020; Ghebreyesus, 2020). It is currently understood that SARS-CoV-2 spreads mainly through the respiratory tract in the form of droplets (Guo et al., 2020; Sohrabi et al., 2020). Though most commonly spread through human-to-human contact, the virus has also been detected on surfaces for up to 72 hours after administration, particularly on plastic and stainless steel. In addition, SARS-CoV-2 showed an aerosol durability of at least three hours (van Doremalen et al., 2020). Both factors increase transmission. An individual may become infected by touching an object that contains SARS-CoV-2, then coming into contact with their respiratory tract (touching mouth, nose or eyes), or through the inhalation of SARS-CoV-2 particles in the air (Thomas et al., 2020). Patients that test positive for COVID-19 present with a variety of symptoms; the majority experience ‘mild to moderate respiratory illness’ (WHO, 2020). The most prevalent symptom is fever, present in 88.7% of hospitalised patients, followed by a cough (67.8% of patients) (Guan et al., 2020). Other reported symptoms include fatigue (38%), sputum production (34%), shortness of breath (19%), and a sore throat (14%) (Ellison III et al., 2020; WHO, 2020). One study showed that 1.2% of individuals presented as asymptomatic (Liu Xing Bing Xue Za Zhi et al., 2020). It has been stated that 81% of cases are mild (patients do not present with pneumonia or mild pneumonia), 15% are severe (with pulmonary infiltrates in over 50% of patients within 24-48 hours, and requiring oxygen), and 5% of cases are critical (showing respiratory failure with requirements for ventilation). Fatality rate has been estimated as 2.3%, with an increase to 14% in patients aged 80 or above, increasing further to 49% in critical patients and in patients with pre-existing comorbid conditions (Wu and McGoogan, 2020; Chang et al., 2020).
Blackrock Osteopaths appointment guidance
At Blackrock Osteopaths, we have been shut down for the last nine weeks (since Wed 18/3/2020) in compliance with the Government’s guidelines. However, we are experiencing a huge demand for osteopathic treatment, and are certain that osteopathy’s benefit to the general health of the population would be critical at this time. Therefore, we have decided to re-open the practice on a limited schedule –with the application of extraordinary measures to safeguard our patients, and ourselves, for as long as this epidemic poses a real threat.
Before making an appointment, we are suggesting that patients ask themselves these Pre Appointment Screening Questions
1. Do you have symptoms of cough, fever, high temperature, sore throat, runny nose, breathlessness, and fatigue, loss of smell and taste or flu like symptoms now or in the past 14 days?
Yes/No
2. Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?
Yes/No
3. Are you a close contact of a person who is a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2m for more than 15 minutes accumulative in 1 day)?
Yes/No
4. Have you been advised by a doctor to self-isolate at this time?
Yes/No
5. Have you been advised by a doctor to cocoon at this time?
Yes/No
Please note: if patients answer yes to any of these questions, they should NOT attend for osteopathic treatment.
COVID-19 Clinic Policy
If - to the best of your knowledge - you are not suffering from or have been exposed to any COVID-19 infections we are willing to offer appointments for osteopathic treatment. However, we are suggesting some procedures to our patient appointments to keep everyone safe
• We are scheduling patients at least 15 minutes apart to allow time for cleaning and to prevent crossover with other patients
• We are asking patients to arrive on time and wait in their car until called
• We are asking patients to come alone to appointments, if possible
• For adults bringing their children for treatment, we are asking only one parent to attend
• We are asking patients to bring minimal items with them to appointments
• We are trying to put in place the facility for patients to pay online in advance, and this would be the best arrangement
• We are asking patients to complete a Pre-Appointment Screening
• We are asking patients to call the clinic if they develop any symptoms after answering the screening questions
• We have followed Osteopathic Council of Ireland guidelines and prepared a consent form –which can be downloaded as a pdf via the link below. If you could print out and bring along a completed form with you on your visit that would be most helpful, or we will provide a form for you to complete at the start of your consultation.
• We have a limited supply of masks which we can give to patients, however, it would be optimal if you could bring with you your own mask, to reduce the use of clinic supplies.
