Time taken by individuals with respiratory symptoms to present to primary care: a descriptive study of assessments at Australian General Practitioner-led respiratory clinics.

Abstract

Effective control of coronavirus disease 2019 (COVID-19) has been challenging, in part due to significant asymptomatic and pre-symptomatic transmission of disease. Reducing the time between symptom onset and COVID-19 testing and isolation allows enhanced outbreak control. The purpose of this study is to describe the time taken by participants to present to general practitioner-led (GP) respiratory clinics for assessment following the development of symptoms, and to explore associations between demographic and geographic characteristics and the time to presentation. A total of 314,148 participants, who were assessed in GP respiratory clinics between 1 February and 31 August 2021, were included in the analysis. The median age of participants at presentation was 33 years (interquartile range, IQR: 15-49). The median time from development of symptoms to presentation for assessment at GP respiratory clinics was 2 days (IQR: 1-3). Participants were more likely to present within one day of symptom onset if they were aged between 15 and 64 years (43.4%), lived in urban areas (40.9%) or were non-Indigenous (40.2%). Participants in New South Wales and Victoria had twice the odds (OR 2.01; 95% confidence interval (CI): 1.95, 2.08) of presenting at a GP respiratory clinic within one day of symptom onset in August 2021, when there was a COVID-19 outbreak in those states, than they did in March 2021, when there was no COVID-19 outbreak in Australia. The number of days from symptom onset to presentation at a GP respiratory clinic was strongly associated with the presence of a COVID-19 outbreak. Participant age, location of the clinic, and Indigenous status of participants were also associated with the time to presentation. This study highlights the importance of recognising COVID-19 as a potential cause of symptoms, as well as the importance of providing easily accessible, and culturally appropriate, testing facilities for the population.