Background

Back in March 2020, Sri Lanka as a country received the first red light to be a part of the COVID-19 pandemic. Gradually novel coronavirus started to spread in Sri Lanka making us, ‘the primary care physicians’ the front line doctors responsible to deal with the situation. 

Nevertheless, there was no proper guidance to follow in primary medical care settings on patient management and protecting ourselves from the potential risk of exposure as well as preventing transmission to the public within the primary medical care facilities. Thus, the situation demanded some basic guidance for primary care physicians both in government and private sectors.  

Joining hands

This task was initiated by a team lead by Consultant Family Physician Prof. Kumara Mendis from the Faculty of Medicine, University of Kelaniya. The team consisted of family doctors from private and public sectors, a Consultant Virologist and a Consultant Physician/Geriatrician to provide the expert opinion.

Heading forward

We referred many national and international documents including circulars and guidelines of the Ministry of Health and WHO, CDC and NHS-UK. Our team met frequently via Zoom, maintaining the social distancing and worked day and night to produce the “COVID-19 Outbreak in Sri Lanka; Guidance for Sri Lankan General Practitioners”, on 17th March 2020 which was published by the College of General Practitioners of Sri Lanka in the College website.

The team focused on version 2 as the Covid19 was spreading rapidly worldwide and Sri Lanka situation was changing very fast. Due to requests from doctors working in primary care, we increased the content relevant to primary care.

A number of  Consultant Family Physicians from the Divisional Hospitals, MoH joined the group representing the MoH primary care physicians. Furthermore, the second version was named ‘COVID-19 Outbreak in Sri Lanka; Guidance for Sri Lankan Primary Care Physicians’ and released on the 25th of March 2020. This version 2 was approved by the Ministry of Health, Sri Lanka.

In both versions, we addressed the challenges encountered by the primary care physicians in ‘face to face’ consultations. However, we recommended ‘remote consultations’ which would be the ideal solution in a pandemic situation.

The team is working ion version 3 and would do the best to keep this guideline a dynamic evidence-based guideline for primary care physicians.

By adhering to these guidelines, we expect the primary care physicians to be safe, pragmatic and futuristic, while following the principles of family medicine, in an era where a Nano-sized virus has become a daunting challenge to the meticulously built human civilization.

Primary Care Physicians Guideline Team

(In alphabetical order)

Dr. Asela Anthony – Consultant Family Physician, Ministry of Health

Dr. Chandana Atapattu – Assistant Registrar, SLMC

Dr. Priyantha Halambarachchige – Consultant Family Physician, Ministry of Health

Dr. Deshan Kotugodella – PG trainee in Family Medicine

Prof. Kumara Mendis – Consultant Family Physician and Professor of Family Medicine, University of Kelaniya

Dr. Rohitha Muthugala – Consultant Virologist, Teaching Hospital Kandy

Dr. Sankha Randenikumara – PG trainee in Family Medicine

Dr. Gobith Rathnam – Family Physician

Dr. Lalantha Senaratne – Consultant Family Physician, Ministry of Health

Dr. Sindoopa Seneviratne – PG trainee in Family Medicine

Dr. A. H. W. De Silva – Consultant Family Physician and Head, Department of Family Medicine, University of Kelaniya

Dr. Shehan Silva – Consultant Physician and Geriatrician, National Institute of Mental Health

Dr. Tareen Weerasinghe – Demonstrator Department of Family Medicine

Dr. Supun Withana – Lecturer, Family Medicine, University of KelaniyaMarch