We thank you for your question – challenging times for all of us!
In response to your specific questions, our local practice is to defer transfer set changes during this pandemic or change if required if the patient on PD presents in an emergency situation. This is also the recommendation of the recently published online ISPD guideline: “Strategies regarding COVID-19 in PD patients: Adapted from Peking University First Hospital” available at: https://ispd.org/wp-content/uploads/ISPD-PD-management-in-COVID-19_ENG.pdf “non-essential procedures e.g. PET, clearance measurement etc. should be avoided during the pandemic to minimise unnecessary patient contact”. This document is also available in other languages: https://ispd.org/strategies-covid19/
 
For training, our local practice is to continue training; but with appropriate Personal Protective Equipment (PPE). Note also at this time, our local practice is that we have suspended or only rarely make home visits. For example, we now have patients submit photos of the home environment – before home training starts to ensure it is suitable. With “social distancing” “shelter in place” and “stay at home” orders by our local governments, we really can’t comment on extended home visits to rural areas that you ask about. Take note of the guidelines cited above which recommend “home visits by healthcare professionals should be minimized or stopped”.
 
For our routine PD clinic visits – all are virtual clinic visits now, also as recommended by the ISPD guidelines cited above “Remote patient management (RPM) should be strongly recommended as the major way to manage patients on PD”. We usually use phone calls, while a video calling option is available for physicians in our province of Ontario, Canada. This video calling option extends to all areas of the province including rural areas. Is this an option for you in Australia to connect virtually with rural patients?
 
Similar to the situation in many parts of the world affected by COVID-19, we are learning to adapt very fast. For example, with hand sanitizer and masks currently in short supply, we are also requesting that our home PD patients conserve hand sanitizer – wash their hands with soap and water, plus conserve masks – reuse for two days if not soiled, make their own, and be careful not to cough or sneeze on the connection.