Interim Guidelines for Sri Lankan Primary Care Physicians V 3.1 Live Guideline


Coronaviruses (CoV) are a large family of enveloped viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Coronavirus disease (COVID-19) is a new strain that was discovered in 2019 and has not been previously identified in humans. The World Health Organization (WHO) recently declared COVID-19 as a global pandemic.

Incubation period of the virus is 2-14 days (1).  The median incubation period is estimated to be 5.1 days and 97.5% of those who develop symptoms will do so within 11.5 days (2). During the incubation period, the virus may not be identified with the currently available Reverse Transcriptase Polymerase Chain Reaction (RT -PCR) test with a single sampling. However, people are contagious when they are most symptomatic.

The virus spreads by droplets. Direct spread occurs when a person facing a patient who talks, coughs or sneezes. The droplets can spread to a distance of 1-2 meters and directly get into another person’s airways. More importantly it can spread when the virus lands on a surface and when a person touches the contaminated surface and then the face. Its survival on that surface will be determined by the temperature, humidity and the type of the surface. The third method of spread identified is by inhalation of the aerosolized virus which can exist in the air for up to three hours.

Primary Care Physicians (PCPs) are in the frontline of patient care in any healthcare crisis as the closest healthcare professionals to the family. They have a major responsibility in looking after high-risk groups, identifying suspected cases, preventing spread and opportunistic patient education during the current pandemic of COVID-19.

This guideline is for Primary Care Physicians in (a) Private Family Practice/General Practice Clinics (b) Primary Medical Care Units (PMCU), and (c) the Divisional Hospitals (d) Doctors working in Outpatient Departments (OPDs) of secondary & tertiary care institutions and private hospitals delivering primary curative care (3).

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