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Table 1 Roles of general practitioners in preparing for and responding to pandemics

From: Facing the threat of influenza pandemic - roles of and implications to general practitioners

  Phase 4 Phase 5 - 6
Running and Co-ordination Co-ordination of triage system for suspected cases. Liaison with national/local health authority for prioritisation of primary health care during pandemic.
  Standardisation of procedures in handling suspected cases and cautious cases. Chair of GP network participates and gives advice in national/sub-national crisis committee.
  Action plan to avoid cross infection of suspected cases and other patients. Co-ordination of care at primary care level for large influx of influenza patients and patients with other illness.
  Co-ordination of other sectors to care for large number of ill patients. Provide local leadership in rational use of multi-sectoral resources in meeting the local health needs and demand.
  Identify the vulnerable and at risk groups for necessary health protection. Care for those under medical surveillance.
  Co-ordination of care for close contacts and family members of suspected or cautious cases. Protocol for home management for those with minor illnesses
Situation monitoring and Assessment Collect specimens from suspected cases for rapid diagnosis. Cases reporting
  Collect more clinical and epidemiological data from suspected cases. Assess the capacity to manage larger number of ill patients.
  Monitoring of symptoms and signs of flu - like illness of close contacts. Monitoring of caution cases.
  Close monitoring of 'suspected' or 'cautious' cases. Assess the uptake and impact of mitigation measures at community level.
   Monitor resources in primary health care to meet the surge of demands as alternative health care for hospital setting in management of non-infectious diseases.
  Phase 4 Phase 5 - 6
Reducing the spread of disease Clinical management of those fever cases or suspected cases according to national guidelines to avoid cross infection Re-designation of clinics within the local catchment area to designated clinics for management of fever cases and those with flu-like illness, and other clinics to manage illness of non-infectious nature
  Working closely with local health authority for management of those suspected cases isolated at home and their households and close contacts Home visits for patients with chronic illnesses rather than coming to clinics by those primary care doctors not involved in management of flu cases
  Health protection for at risk groups including clinic staff Special review clinics for those requiring follow up for chronic illnesses to avoid cross infection
  Re-organisation of clinic schedule to minimise cross infection with minimal disruption of usual services Prophylactic treatment for high risk groups
  To reinforce the community implementation of individual/household and societal level of disease control measures34  
  Given advice and provision of care to patients returning from high risk areas or close contact of suspected cases in accordance to national guidelines  
Continuity of Health Care and Provision To activate the system in primary health care to manage flu-like illnesses as well as non-infectious illnesses with minimum chance of cross-infection Primary care clinics as alternate source of medical care for those stabilised hospital patients with 'non-communicable diseases' to relieve the workload of hospital setting
  Self management protocol for patients with minor illnesses Provide psycho-social support to patients, communities and also health care workers
Communication Explain to local community what is known and not known about the virus, the state of outbreak, the effective preventive measures and next steps Act as resource persons for community to have update information of transmission pattern, clinical severity, treatment and prophylaxis options
  Act as resource persons for enquire how to obtain medicines, essential services Feedback of community concerns to national authority