AS AUSTRALIA attempts to 'flatten the curve' of the COVID-19 outbreak, doctors are warning those in regional areas not to be complacent, saying it is "inevitable" more cases will occur in rural SA.
Already, cases have been confirmed in the Riverland, South East, Yorke Peninsula and Whyalla, as well as the state's largest "cluster" in the Barossa Valley.
A breakdown of cases by local government area is available here.
Clare-based GP and Rural Doctors' Association of SA treasurer Gerry Considine believes they could start to see cases in the Mid North within the next few weeks.
"The problem with the virus is it's quite easily spread, compared to influenza," he said. "We know it will spread but we want to reduce the speed so rather than four or five new cases every day, we would be happier to see four or five a week."
Dr Considine said the main concern at this time for regional doctors was the availability of personal protective equipment, such as gowns and masks, worn while administering swabs for suspected coronavirus patients and treating confirmed cases.
"At the moment, that is the main limiting factor with testing," he said.
RDASA South East representative and Naracoorte GP anaesthetist Sophie Rymill said PPE availability was a concern, although there was good news with the state government signing a contract to have supplies manufactured locally.
"We have to assume any patient we see is a potential coronavirus patient so in our daily functions, we're using a lot more PPE than normal," she said.
We will stabilise patients and send them to city hospitals, but that's if the beds and transport are available.
There has been an increase in testing clinics, including a new one a Tanunda, which opened on Monday. Of the 38 testing clinics across SA, 32 are in regional areas.
Dr Considine, who works at the Clare Medical Centre in Clare and Burra, as well as Clare and Burra hospitals, estimated they had administered about 30 or 40 tests in the past two weeks, under strict SA Health guidelines.
These are limited to those who have travelled overseas, interstate or on cruise ships, have been in contact with a confirmed case, and have symptoms.
It also recently included those who had spent time in the Barossa Valley since March 14, with symptoms.
He said any expansion of this criteria would put more pressure on PPE supplies.
SA deputy chief public health officer Evan Everest said the state's health system had 325 intensive care unit beds available and 384 ventilators, with more ventilators ordered.
While there have been no locations specified for these, a spokesperson for Health SA said, as with any serious illness, a regionally-based patient requiring critical care would be transferred to Adelaide.
SA Health chief public health officer Nicola Spurrier said there was an emphasis on having patients with COVID-19 in particular hospitals, as it would allow them to have access to staff with expertise in the illness, as well as minimise the risk of the infection spreading.
Dr Considine said most COVID-19 cases would involve mild to moderate symptoms but there would be critical cases.
"We will stabilise patients and send them to city hospitals, but that's if the beds and transport are available," he said.
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Dr Rymill said this outbreak was "a completely new situation" but the workforce had been making preparations to train staff to face "the unknown".
"There are definitely concerns about the added pressure this will put on our health system," she said.
"Given the health system is already tracking at near capacity, coronavirus is added stress to that.
"People will still have regular medical incidents and illnesses that need to be attended to - there will still be heart attacks and motor vehicle accidents and sick kids that will require us to take action."
Dr Rymill and Dr Considine said more of their work was being done through telehealth services, which enabled them to continue to provide healthcare for their patients, without face-to-face contact.
Dr Considine said this would become more necessary considering the already stretched locum services program and was hopeful it could continue even after the crisis has subsided to ensure regional areas could access good healthcare.
Dr Rymill said there were also concerns about mental health and anxiety levels of people during this time.
"We want to reassure the general public the hospitals and GPs are doing what they can to minimise the spread of coronavirus and make sure we are as prepared as we can possibly we," she said.
"It is vital people do socially distance and follow precautions - it is already demonstrated to make a difference."
At the Royal Flying Doctor Service, aeromedical staff have spent part of this week in training, but RFDS Central marketing and stakeholder relations general manager Charlie Paterson said in a letter to supporters, teams have been preparing for the entry of COVID-19 into Australia since February.
People will still have regular medical incidents and illnesses that need to be attended to.
"The RFDS routinely treats patients with infectious diseases, and we have already safely transported COVID-19 patients by air and by road and will continue to do so over the weeks and months ahead," he said.
A national RFDS COVID-19 working group has been formed, with RFDS Central chief executive Tony Vaughan named team leader.
Mr Paterson said this outbreak would put pressure on the organisation, given the forecast volume of patients needing care, as well as the need for a frontline workforce, but he said they were working with state and federal health departments and would "deploy RFDS resources to outbreak areas if and when they are needed".
RFDS has wound down its fundraising until at least June 30 but Mr Paterson said they were "developing a number of strategies to help us bridge the gap in this important income stream".
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