CPD Article

Primary care management of the coronavirus (COVID-19)

Bob Mash
South African Family Practice | Vol 62, No 1 | a5115 | DOI: https://doi.org/10.4102/safp.v62i1.5115 | © 2020 Bob Mash | This work is licensed under CC Attribution 4.0
Submitted: 19 March 2020 | Published: 31 March 2020

About the author(s)

Bob Mash, Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa


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Abstract

South Africa is in the grip of a novel coronavirus pandemic (COVID-19). Primary care providers are in the frontline. COVID-19 is spread primarily by respiratory droplets contaminating surfaces and hands that then transmit the virus to another person’s respiratory system. The incubation period is 2–9 days and the majority of cases are mild. The most common symptoms are fever, cough and shortness of breath. Older people and those with cardiopulmonary co-morbidities or immunological deficiency will be more at risk of severe disease. If people meet the case definition, the primary care provider should immediately adopt infection prevention and control measures. Diagnosis is made by a RT-PCR test using respiratory secretions, usually nasopharyngeal and oropharyngeal swabs. Mild cases can be managed at home with self-isolation, symptomatic treatment and follow-up if the disease worsens. Contact tracing is very important. Observed case fatality is between 0.5% and 4%, but may be overestimated as mild cases are not always counted. Primary care providers must give clear, accurate and consistent messages on infection prevention and control in communities and homes.

Keywords

coronavirus; COVID-19; SARS-CoV-2; primary care; continuing medical education; clinical management

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