Patients presenting for hospital‐based screening for COVID‐19: risk of disease, and healthcare access preferences

Rojek, Amanda; Dutch, Martin; Peyton, Daniel; Pelly, Rachel; Putland, Mark; Hiscock, Harriet; Knott, Jonathan

OBJECTIVE: Early during the SARS‐CoV‐2 pandemic, Australian emergency departments (EDs) experienced an unprecedented surge in patients seeking screening for COVID‐19. Understanding what proportion of these patients require testing and who can be safely screened in community‐based models of care is critical for workforce and infrastructure planning across the healthcare system, as well as public messaging campaigns. METHODS: In this cross‐sectional survey, we screened patients presenting to a SARS‐CoV‐2 screening clinic in a tertiary ED. We assessed the proportion of patients who met testing criteria; self‐reported symptom severity; reasons why they came to the ED for screening; and views on community‐based care. RESULTS: We include findings from 1846 patients. Most patients (55.3%) did not meet contemporaneous criteria for testing and most (57.6%) had mild or no (13.4%) symptoms. The main reason for coming to the ED was being referred by a telephone health service (31.3%) and 136 (7.4%) said they tried to contact their GP but could not get an appointment. Only 47 (2.6%) said they thought the disease was too specialized for their GP to manage. CONCLUSIONS: While capacity building in acute care facilities is an important part of pandemic planning, it is also important that patients not needing hospital level of care can be assessed and treated elsewhere. We have identified a significant proportion of people at this early stage in the pandemic who have sought health care at hospital but who might have been assisted in the community had services been available and public health messaging structured to guide them there.