COVID-19 Care Preparation and Pathways
This webpage outlines the supports available for COVID-19 positive patients and referral pathways.
Clinicians are encouraged to:
- keep up to date with the latest PPE advice for your area
- exercise good hand and respiratory hygiene, regularly wipe down phones, ID and swipe cards, and other commonly used equipment at work
- remind patients to get vaccinated for influenza and COVID-19 and encourage boosters
- subscribe to the Frontline Advice for the latest email updates
- follow guidelines from reputable sources such as Queensland Health and the Australian Department of Health
- ask for help from your line manager when you need it.
Most people who get COVID-19 will be able to recover at home while isolating, without the need for medical intervention. This website has tips and advice for consumers isolating with COVID-19.
The primary healthcare sector will manage most patients who require clinical support. General practitioners can refer to the Information for primary care webpage or this Primary Health Network website for information on managing COVID-19 positive patients.
Queensland Health is currently continuing to use an expanded triage system to stream COVID-19 positive patients to an appropriate care option when a higher level of care is required. Under the model, consumers may be cared for virtually by a GP or other primary healthcare provider, admitted to a Queensland Health virtual ward and monitored remotely, or admitted to a ward in hospital.
- COVID-19 Virtual Care Admission (PDF 188 kB)
This form has been developed to capture clinical admission information for all patients admitted for COVID-19 management to Virtual care, Hospital-in-the-Home (HITH) care, or Inpatient care
- COVID-19 Virtual Care Review (PDF 525 kB)
This form has been developed to capture clinical review information for patients admitted for COVID-19 management in the Virtual care setting
- COVID-19 Virtual Care Discharge (PDF 186 kB)
This form has been developed to capture discharge from care information for patients that were admitted for COVID-19 management to a Virtual care setting
- COVID-19 Ward Round (PDF 175 kB)
This form has been developed to capture clinical information for patients currently admitted for COVID-19 management to Virtual care, Hospital-in-the-Home (HITH) care, or Inpatient care
Registering a positive Rapid Antigen Test (RAT)
Patients who think they may have COVID-19 based on their symptoms and/or contact history, are encouraged to have a RAT.
If the RAT is positive, please strongly encourage your patients to register this result with Queensland Health.
Registering a positive RAT will assist Queensland Health in providing consumers with further information on what to do to manage their health and to keep their family, friends and work colleagues safe.
Consumers can also access the healthdirect Australia’s COVID-19 Symptom and Antiviral Eligibility Checker, a simple online questionnaire that calculates their risk of developing more severe disease and provide information on accessing medical care, if required.
Frequently asked questions
Risk stratification is the process where the consumer supplies information about themselves and their condition to find the best care pathway for them.
The healthdirect Australia’s COVID-19 Symptom and Antiviral Eligibility Checker and the National Coronavirus Helpline are all designed to screen consumers and risk stratify their symptoms to determine the most appropriate care pathway for them.
The risk stratification process follows the national guidance developed by the COVID-19 Clinical Evidence Taskforce (Pathways to care). The adult pathway to care incorporates the consumer’s symptoms, evidence of lower respiratory tract disease and other clinical indicators and risk factors for poor outcomes. Risk factors include age, their location (i.e., remoteness/proximity to hospital), co-morbidities, vaccination status, whether they are pregnant, whether they are of Aboriginal or Torres Strait Islander heritage, and their living situation.
Consistent with the national definition from the National COVID-19 Clinical Evidence Taskforce:
An individual is considered at low risk of deterioration when they have no clinical features suggestive of moderate or more severe disease:
- no or mild symptoms and signs (fever, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhoea, loss of taste and smell)
- minimal shortness of breath or difficulty breathing on exertion
- no evidence of lower respiratory tract disease during clinical assessment or on imaging (if performed)
- absence of significant co-morbidities and risk factors that confer risk of greater disease severity.
It is appropriate for these individuals to manage their care at home as they would with other viruses, with support from their general practitioner when appropriate.
Individuals considered at moderate risk of deterioration include:
- people experiencing moderate clinical symptoms such as breathlessness on mild exertion or saturations 92-94%
- people with complex social, public health or special care needs
- at risk populations
- pregnant women
- children with unwell parents
- parent/carer or child with severe mental health illness
- high density households / other environmental concerns
- geographical isolation
- presence of significant co-morbidities and/or risk factors for higher disease severity e.g. diabetes, cardiovascular disease, immunocompromised, chronic renal failure.
These consumers need to be considered more carefully by a healthcare professional and monitored regularly. The consumer will be advised to contact their GP or other healthcare provider who can monitor their condition. Most of these patients will still be able to self-care at home, but some may be eligible for anti-viral therapies or other medicines to help shorten the duration of illness or reduce the risk of the infection getting worse.
Primary healthcare providers will be notified by Healthdirect Australia if their patient has been triaged as ‘medium risk’. If a COVID-19-positive person does not have a regular GP, they will be referred to the Healthdirect Service Finder or encouraged to find a GP or local respiratory clinic which are specifically designed for COVID-19 positive patients.
In some areas where there are minimal primary healthcare services or difficulties with accessing a GP or community service in a timely manner, Hospital and Health Services will support moderate risk consumers.
Some patients with special circumstances e.g. those who are immunocompromised, may be directed immediately to the Hospital and Health Service local hospital for further care.
High – very high risk
Very high-risk consumers have severe symptoms of COVID-19 and signs of deterioration such as respiratory distress or respiratory failure, or other specific clinical or social risk factors that place them at high risk. These consumers will be referred to a Queensland Health hospital.
Consumers identified as very high risk by any of the screening services will automatically be referred to Triple Zero (000) or advised to attend their closest hospital emergency department. High risk / severe symptoms include:
- difficulty breathing even when moving around your home
- suddenly find it hard to breathe or your breathing has gotten worse
- coughing up blood
- significant chest pain
- collapsing or fainting.
- feeling cold and sweaty, with pale or blotchy skin
- have a rash that looks like small bruises or bleeding under the skin and doesn’t fade when you roll a glass over it
- feeling agitated, confused or very drowsy
- stopping peeing or peeing much less than usual.
There are four types of medicines used to treat COVID-19 infections:
Inhaled medications (e.g. Pulmicort®)
These are simple inhalers often used by asthmatics and other patients with chronic airways disease. The inhaler can be prescribed by a GP or the local hospital and is appropriate for patients with mild symptoms.
Anti-viral medicines (e.g. Lagevrio® and Paxlovid®)
Anti-viral medicines work by stopping viruses in your body from copying. With less copies of the virus in your body, your chance of getting sick is lower. These medications must generally be started within five days of symptoms starting in patients who have some symptoms, but do not require admission to hospital. These medicines are available as tablets, intramuscular injections or intravenous infusions. Some of the tablets are available at local pharmacies and can be prescribed by any doctor. The intravenous infusions are used by hospitals.
Monoclonal Antibodies (MABs)
These medicines work by sticking to the COVID-19 virus. This stops the virus from entering human cells in the body and can prevent people from becoming very sick. MABs are given in hospital or in a clinic by intramuscular injection or intravenous infusion.
These medications are used in hospital when patients are more unwell. They assist in reducing the degree of inflammation caused by the infection and assist in reducing the time it takes for the patient to recover.
Healthdirect Australia will notify GPs if their patient has been allocated to the medium risk pathway after phoning the National Coronavirus Helpline. If the GP is not managing COVID-19 positive patients, the consumer will be encouraged to find a GP or local respiratory clinic which are specifically designed for COVID-19 positive patients.
In some areas where there are no or minimal primary healthcare services, Hospital and Health Services will support moderate risk consumers.
The COVID-19 Care Pathway doesn’t replace normal referral processes already in place between primary healthcare (i.e GP clinics) and Queensland Health.
Healthdirect Australia’s COVID-19 Symptom and Antiviral Eligibility Checker can be used for self-assessment and risk stratification. Advice will be provided via a pop-up text box based on risk.
Healthdirect Australia (or HHSs for at-risk populations) will assess and advise people who phone the National Coronavirus Helpline of the appropriate care pathway including allocation to community-based care with GPs or Aboriginal Medical Service (AMS). Some Hospital and Health Services will also be able to provide care for COVID-19 patients where there is no GP/ primary care provider available.
The National Coronavirus Helpline also has translators and accesses the National Relay Service. Carers can also access these services on behalf of someone else.
Healthdirect Australia’s COVID-19 Symptom and Antiviral Eligibility Checker is only available in English, but can be completed by anyone on behalf of an unwell individual or infant.
Mob Link is an initiative of the Institute for Urban Indigenous Health to support Aboriginal and Torres Strait Islander people living in South East Queensland by linking them with health and social services. By calling 1800 254 354 Aboriginal and Torres Strait Islander people across South East Queensland can opt in to access a variety of COVID-19 related services and support plus a wide range of other health and social services.
Note: a positive test result is not required to access the screening services.
For children experiencing COVID-19 symptoms their carers are advised to visit the Children’s Health Queensland website.
If the child’s symptoms worsen, they are advised to:
- complete Healthdirect Australia’s COVID-19 Symptom and Antiviral Eligibility Checker on behalf of the child
- phone the National Coronavirus Helpline on 1800 020 080 which is accessible 24/7 (interpreters also available).
If at any time the child they are caring for experiences severe shortness of breath, is difficult to rouse, feeling faint or if they have serious concerns, they are advised to call 000.
Children less than three months of age who have a fever of 38 degrees or more are advised to present to their local emergency department within two hours.
As a consumer’s healthcare needs change, they can be moved to a different care pathway. Patients can complete the online self-care symptom checker more than once, if, for example, their symptoms worsen or they are failing to improve. Any patient can ring their local GP practice for advice and/or to book in a telehealth appointment with a GP at their local practice. If a patient has a usual treating specialist, they can also contact them. Finally, if patients are extremely unwell, they should ring ‘000’ or present to their local hospital emergency department.
Discharge from a care stream will occur when the person has met the criteria for release from home isolation directions as per the national COVID-19 guidelines and are determined to have no further acute care needs. Please refer to the isolation and quarantine information below for information on leaving isolation. It is recommended that patients make contact with their usual general practitioner, if they have one, when recovering from COVID-19 so they can be monitored for post-COVID syndrome and other care requirements.
For the most up-to-date information about isolation, visit the Queensland Government website.
Consumers with COVID-19 should follow the instructions on how to isolate safely. The below FAQs may also assist patients with COVID-19 or living with a diagnosed person.
Close contacts should follow the advice on this page.
Only those living with the person with COVID-19 or those who have been with a person that has COVID-19 for more than four hours in a house or other accommodation need to follow the close contacts advice.
Most people with COVID-19 can end isolation seven full days after taking a COVID-19 test and if symptoms have resolved. For the latest advice - Please see Ending isolation – coronavirus (COVID-19)
If people are worried about their mental health, they can read about when to seek help and the mental health services available.
If they need any other support while in isolation there is a guide on where to get help.
The positive PCR test result SMS and will have a link to the COVID Care website which has links to the COVID-19 Symptom and Antiviral Eligibility Checker. Consumers who register a positive Rapid Antigen Test result with Queensland Health – Rapid Antigen Test Registration will also receive this advice via the confirmation email.
By completing the Healthdirect Australia’s COVID-19 Symptom and Antiviral Eligibility Checker, depending on your symptoms and other health conditions, you'll be advised the right type of COVID care for you. You’ll be told if you need to see your GP or your contact details may be sent to a hospital so they can call you. Some people may be told to call Triple Zero (000).
Information about all screening services is also linked to from the Queensland Government COVID website.
Consumers won’t be able to choose their own care pathway. The risk stratification process will determine the most appropriate model based on the information they provide. However, it is important to reiterate that that National Coronavirus Helpline and the COVID-19 symptom checker can link a consumer to care, if required – they are not just to confirm if a patient’s symptoms are consistent with COVID-19.
Patients who do not have a regular GP will be referred to the Healthdirect Service Finder or encouraged to find a GP or local respiratory clinic which are specifically designed for COVID-19 positive patients.
It is important that patients at risk of developing more severe disease due to underlying medical problems, older age, not being vaccinated or other risk factors, are identified early and directed to care within the time allowed for anti-viral therapy tablets to be prescribe. Anti-viral tablets need to be commenced within five days of symptoms starting.
In some areas where there is no or minimal primary healthcare services, Hospital and Health Services will support moderate risk consumers.
- management of risk of infection
- determining the setting of care
- baseline assessment of clinical presentation to determine disease severity and of co-morbidities and risk factors for developing more severe disease (see above algorithm/table).
- monitoring and markers of clinical deterioration, such as rapidly progressive respiratory failure and sepsis, especially five to 10 days after onset of symptoms (see above algorithm/table)
- instituting supportive therapies
- consideration of disease modifying treatments (e.g., inhaled budesonide 800mcg BD in non-hospitalised patients with mild-moderate disease within 14 days of symptom onset who do not require oxygen and have one or more risk factor for disease progression):
- consideration of contacting local Hospital and Health Service (HHS) to apply for monoclonal therapy (see below).
Please refer to the information for primary care website for additional resources.
Every HHS has a phone number for GPs to call for COVID-19 advice and to expedite referral to the virtual ward or hospital, together with an array of written referral pathways. These access details are summarised on HealthPathways. In an emergency, call 000
Approximately 10 per cent of patients will continue to experience symptoms beyond three months, broadly falling into three groups:
- chronic fatigue
Long COVID is defined as symptoms lasting for more than three months after acute COVID symptom onset and lasting six months or perhaps longer, not otherwise explained. It is differentiated from post-COVID syndrome when patients take a month or two to fully improve and post-ICU syndrome for patients who have experienced a critical illness, potentially with a period of ventilation, with the consequent neuromyopathic effects of this serious illness. Long symptom syndromes were also observed in SARS and MERS.
There is a range of symptoms that can affect any body system. Adults and children can be affected and in general the severity of the acute illness does not reliably relate to the development of long-COVID, but there is some sense that being older (>70 years), female, having more initial symptoms and co-morbidities might confer greater risk of developing long-COVID. Serum biomarkers at 2-3 months may be helpful e.g. CRP. Assessment will be required to differentiate exacerbation of chronic disease from new pathology and to consider multi-disciplinary management options.
The possibility of long-COVID should be identified at the outset for patients and steps taken to adjust expectations of recovery, if appropriate. A home-based, self-directed rehabilitation program endorsed by the Statewide Clinical Rehabilitation Network and reflective of the WHO: Support for rehabilitation: self-management after COVID-19-related illness policy. Additional information regarding long-COVID can be accessed on HealthPathways.
Regular GP consults attract Medicare Benefits schedule rebates. From 1 January 2022, patient access to telehealth services will be supported by ongoing Medicare Benefits Schedule (MBS) arrangements.
For the latest list of MBS-supported consults, please visit the MBS Online website.