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Victoria COVID-19 updates


This page will be updated with the latest information as it becomes available for GPs in Victoria. 

The information on this page was last updated: Thursday 26 November 2020, 2.00 pm AEDT.

You can also find nationally relevant information via the RACGP Coronavirus (COVID19) information for GPs webpage

For up-to-the-minute information, visit the Australian Federal Government Department of Health website and subscribe to receive the bi-weekly COVID-19 newsletter for GPs from the Chief Medical Officer.


  • Access the latest announcements and information on coronavirus in Victoria via DHHS.vic
  • Subscribe to receive alerts from the Victorian Chief Health Officer.
  • Subscribe to receive the DHHS Coronavirus update newsletter.
  • Follow the Chief Health Officer on Twitter.


Three existing Public Health Emergency Orders relating to medicine access in Victoria have been extended until 27 March 2021, unless revoked earlier, to enable continued timely access of medicines during COVID-19. These include the following arrangements:

  • Emergency supply of prescription medicines for people affected by COVID-19 to enable pharmacists to supply one month supply of prescription medicines without a prescription to people who are unable to see their GP
  • Supply of prescription medicines on a digital image of the prescription to enable pharmacists to supply prescription medicines on a digital image of the paper prescription
  • Prescribers prescribing for non–drug dependent patients will not need a Schedule 8 permit as long as they check SafeScript

Further information can be found here.


A public health emergency order, pursuant to section 22D of the Drugs Poisons and Controlled Substances Act 1981, was issued to remove requirements for registered medical practitioners and nurse practitioners to obtain a Schedule 8 treatment permit for patients who are not drug-dependent persons – provided the practitioner checks the patient’s SafeScript profile before prescribing.

The PHEO will remain in effect, for the duration of the order or until revoked. The PHEO may be examined here.

Further details can be found on the Schedule 8 treatment permits advice sheet.


In response to the coronavirus disease (COVID-19) pandemic and consequent risk of transmission from face-to-face consultations, telehealth video conferencing by healthcare providers for service delivery, online meetings, continuing professional development and training has increased exponentially.

To ensure security and privacy when consulting or meeting online please refer to the DHHS COVID-19 Telehealth consulting and conferencing: Privacy and security document for guidance on how to do this safely.

Please note that the DHHS is currently investigating options to expand Healthdirect Video Call services where possible to community based health services and further advice will be provided once available.

If you have any queries, please direct them to:  COVID19PrimaryCommunityCare@dhhs.vic.gov.au


Victoria has issued a public health emergency order to enable pharmacists to supply a Schedule 4 medicine (excluding drugs of dependence) using a digital image (eg via email) of an original paper prescription transmitted by the prescriber.

The public health emergency order is in place until 6 October 2020, unless revoked earlier.

Drugs of dependence may NOT be supplied under this public health emergency order. Drugs of dependence include all opioids, benzodiazepines and anabolic steroids.

There has been an amendment to the Public Health Emergency Order (PHEO) that enables pharmacists to sell and supply a Schedule 4 poison (Prescription Only Medicine), excluding drugs of dependence, on a digital image of an original paper prescription transmitted from a prescriber. The amendment has been made to support telehealth initiatives.

The amended PHEO allows use of a digital image of a signature where it is not possible for the prescription to include the handwritten signature due to operation of telehealth. The prescriber may include a digital image of their handwritten signature or give access to the digital image of their handwritten signature to an employee, where the employee acts in accordance with the instruction of the prescriber to apply the digital image of the prescriber’s signature to the original paper prescription.

Refer to the updated advice sheet for prescribers and the flyer specific to digital images of prescriptions.


If referring your patients for COVID-19 testing, a list of testing locations can be found on the Getting tested for coronavirus (COVID-19) page.


As MATOD/ORT prescribers we are in a position to help reduce community spread by the way we work.

A group from RACGP, PHNs, PABNs, PAMS, Pharmacy Guild, VAADA and other experts in the field have been working with DHHS to provide some urgent guidelines for prescribers and pharmacies. Please find these below or on the Victorian Alcohol and Drug Association (VAADA) website.

Some suggestions

Script duration

  • Give up to 6 month duration scripts (in the event you become unwell and to give time for a replacement to be found)

Take aways

  • After conducting a risk assessment, consider increasing take-away for stable patients:
    • up to 1 month for Suboxone
    • up to 1–2 weeks for Methadone
  • Above 2 measures taken in conjunction with discussion with pharmacists about risk and suitability
  • Take away dose guidance

Long Acting Injectable Buprenorphine

  • Move patients over to this as much as possible (if you are able to prescribe and administer this)
  • Refer to brief clinic guidelines and further information (below)

Buddy / Delegate

  • This is particularly important for solo practitioners to have a colleague who can cover them in the event that they become unwell. Please speak to your Pharmacotherapy Are-Based Network (PABN) co-ordinator, to share your contingency plan.

Naloxone

  • Provide all patients scripts for take-home naloxone (Nyxiod or Prenoxad) along with educational material regarding overdose identification, first aid and naloxone administration.

Telehealth

  • Try to conduct as many consultations via Telehealth as possible to reduce the occurrence of face-to-face presentations and lessen foot traffic in our clinics. (We are fortunate that RACGP, AMA and others got this off the ground so quickly).

MATOD refresher

  • MATOD module 2 part A is available online if you wish to refresh your knowledge about opioid use disorder and the pharmacology of buprenorphine and methadone

Third party arrangements

These actions can reduce patients congregating at clinics and pharmacies which in turn helps to protect:

  • patients and their families / friends
  • yourself and clinic staff
  • pharmacists and their staff


The TGA and PBS has recently approved Long Acting Injectable Buprenorphine (LAIB) for release outside of the Restricted Access Period. Buvidal® will be available from 3 April; and Sublocade® from 21 April, 2020.

Across Victoria many pharmacotherapy prescribers and dispensers have been engaged in the TGA’s restricted access period/product familiarisation process for LAIB products.

Attached is a discussion paper outlining key considerations in accessing and administering LAIB, including interactions with SafeScript, how to order and store LAIB, and other practical considerations. The discussion paper was informed by – and developed with the advice of – the Expert Advisory Committee on medical issues related to drugs of dependence, including representation from RACGP Victoria.

To support clinicians to administer LAIB, DHHS interviewed Dr David Jacka, Addiction Medicine Specialist at Monash Health, about his key pieces of practical tips:

1. Advise your patients in advance of the possibility of stinging pain; that it will settle and that it is nothing abnormal.

Read the adverse effects information provided by the pharmaceutical companies about each of the products. Many patients have noted some pain after the injection, usually soon after the needle has been removed; a distinctive stinging sensation occasionally reported for up to 24 hours afterwards.

2. Note that the different Long Acting Injectable Buprenorphine products have different recommended injection sites.

The target fat should be gripped, after thorough alcohol cleansing, between forefinger and thumb, and held firmly while the depot is administered, to avoid the depot being placed too deeply or too superficially. Swift (vs slow) injection appears to be more comfortable.

3. Have a cotton swab ready to put pressure on the injection site as soon as the needle has been removed.

There may be some bleeding or product ooze following injection. Be prepared to quickly staunch the venous bleeding, it can be significant; this will also prevent the product leaking out of the injection site. Ask the patient to apply pressure to the injection site to minimise bruising; a small plaster over the injection site may be necessary to prevent ooze onto clothes.

4. Advise your patients that there may be a small palpable lump in the fat.

In some patients the drug crystalline matrix may be palpable for a number of months after the injection; this reportedly resolves over weeks to months.

5. Refer to the product information if the initial dose is inadequate.

Many patients have reported a distinctive ‘wearing-off’ experience, with the onset of subtle withdrawal symptoms as the next dose approaches. Patients report after weeks of great ‘cover’, there is a subjective experience of the declining levels, resolved with an earlier or larger repeat dose. The pharmaceutical companies give guidance about subsequent doses being administered early. 

Following from Dr Jacka’s reminder that the different products have different injection sites, clinicians are reminded to review the information provided on injection sites and angles.

Additional information is provided in the updated clinical guidelines available at the health.vic website.

If you have any queries about regulatory requirements concerning LAIB or Pharmacotherapy, please contact aod.enquiries@dhhs.vic.gov.au. If you have clinical queries, please contact the Drug and Alcohol Clinical Advisory Service (DACAS) on 1800 812 804.


Dates and registration links

RACGP Victoria, together with the Department of Health and Human Services (DHHS) Victoria are hosting a number of Coronavirus update webinars. Please register for the upcoming webinar series – now being held fortnightly on Wednesdays over the following dates and times:

  • Wednesday 9 December 2020, 6–7pm

These webinars are presented by:

  • DHHS Deputy Chief Health Officer or Public Health Commander
  • RACGP Victoria Council Chair, Dr Cameron Loy
  • RACGP Victoria Council Co-Deputy Chair, Dr Karen Price
  • RACGP Victoria Council Co-Deputy Chair, Dr Anita Munoz
  • RACGP Victoria Council Member, Dr Bernard Shiu

Previous webinar recordings

DHHS responses – on notice webinar questions

Question/request  Date Response  Page no./links

Please clarify – with the lifting of the restrictions – what are the current guidelines re face shields during clinical GP consultations?

28-Oct

The Guide to Conventional use of PPE has been updated as of 21 October 2020;

Tier 0 is currently not applicable.

Tier 1 – No change.

Tier 2 – The definition of Tier 2 has been redefined. It is now only applicable to health care workers providing care to a person who is suspected to have coronavirus (COVID-19) (excluding suspected patients where an aerosol generating procedure is performed and/or there is a risk of aerosol generating behaviours).

Tier 3 – The definition of Tier 3 has been expanded to include all scenarios where care is provided to probable and confirmed coronavirus (COVID-19) patients, regardless of the amount of time in contact.

Find more

With retail business and hospitality to re-open, what is the protocol for testing employees before starting work? Are they getting tested or not? Is there a protocol to have test in a timely manner, like in meat industry?

28-Oct

Hospitality

Third step: Restricted. Predominantly outdoor dining with patron cap. Density quotient applies.

Ensure physical distancing:

  • staff should work from home wherever possible
  • apply density quotient
  • some sectors allowed to lessen the reduction in staff levels
  • some sectors allowed to lessen the reduction in patrons
  • no carpooling to work

Practise good hygiene:

  • auditing of cleaning schedules

Keep records and act quickly if staff become unwell:

  • ask staff to declare verbally before each shift that are free of symptoms.

Create workforce bubbles:

  • limit number of staff members working across other work sites

Find more

Is it necessary to swab posterior pharynx and both nostrils always? Is the sensitivity significantly affected by swabbing one nostril +/- pharynx? Is it different in symptomatic vs asymptomatic patients? Is there any data on this?

28-Oct

Unfortunately, at this stage, there is no existing evidence that suggests an advantage to swabbing posterior pharynx and both nostrils or any difference in symptomatic vs asymptomatic patients. The Series of National Guidelines (SoNG), along with the Public Health Laboratory Network (PHLN), recommend sampling both nostrils and throat to maximise chance of viral detection. The Department has based their recommendations on this.

Find more

Are you testing sewage?

28-Oct

Wastewater samples are taken from more than 40 sites including the large Melbourne Eastern and Western wastewater treatment plants, regional wastewater treatment plants and locations throughout the metropolitan sewerage system.

To see where wastewater samples are collected from wastewater treatment plants across Victoria visit the wastewater monitoring page.

Find more

Can DHHS please clarify the notion that businesses are now required/expected to contact trace positive employees/customers?

28-Oct

Employer obligations

If your worker is unwell, send them home and direct them to be tested. They must stay home until they have their result. Financial support is available for workers who need to self-isolate or quarantine.

Report any positive cases of coronavirus (COVID-19) to the Department of Health and Human Services (DHHS), WorkSafe, Health and Safety Representatives, and notify your workforce.

Find more

In the event of a school outbreak can the local GPs in the area be informed along with Principals, as we know families well? I am still not receiving automated results from DHHS testing sites where patients gave my name as their GP.

28-Oct

The Department is requesting all testing sites work to include general practices’ information on pathology forms, to ensure that general practitioners are kept up to date with emerging breakouts and new cases. All Coronavirus (COVID-19) testing sites are required to review their current processes and workflows to ensure it includes:

  1. asking each patient presenting for testing for the name of their GP and or/ GP practice name
  2. recording the information on the pathology form as a 'copy to' so that pathology labs can forward results to nominated GP/practice
  3. recommend to all presenting for testing to contact their GP to let them know they have had a coronavirus (COVID-19) test and to continue to seek expert health advice and care.

However, unfortunately less than 20% of pathology forms currently contain forward to general practitioner information.

Another initiative the department has launched is a rapid activation pilot which commenced on 22 October with two senior client coordinators. For the two weeks, these roles will coordinate up to three households each to test the function, and help ensure there is appropriate level of responsiveness across all sectors as well as consistency of messaging. One strategy within this pilot that has been highlighted is aligning with the COVID-19 clinical pathway of each case and household contacts and contacting the GP pre and post interview to discuss insights.

 

What will the GP role be in your strategy to enhance existing services? And to enhance the coordination of information and communication?

28-Oct

Under the new Client Service Coordination function, the intention is that GPs will be contacted before (where possible) or following initial case interview, to share contextual, medical, social or environmental considerations pertinent to subsequent management, and contact tracing activities and to optimise cultural safety. More broadly, we need to have a formal and consistent channel of communication with the sector given the central role of primary care in clients' health and wellbeing, engagement and public health communication. I would like to work with RACGP to define that formal channel.

 

Is this rapid activation model based on another state or country’s model?

28-Oct

The client services coordination (CSC) function itself is informed by cross sector and cross jurisdictional research, as well as local client sentiment survey specific to Victoria's COVID-19 response, independent review of staff feedback, performance review of steps in the journey and (ongoing) consultation with stakeholders across that journey as the full scope of the function is established. The rapid activation (through a limited scope pilot) is based on immediate need, as defined by the nature of recent cases being centred on households and families, and the real-time feedback received from those families in their experiences with DHHS.

 

In light of the recent Virology Journal article re the survival times of COVID-19 on various surfaces, are there any recommended changes to cleaning practices in households, workplaces and GP practices?

15-Oct

At Work

Workplaces need to clean and disinfect surfaces – both steps are essential.

The first step is cleaning, which means wiping dirt and germs off a surface. Businesses can use common household detergent products for cleaning which are stocked at supermarkets. Cleaning alone does not kill germs.

The next step is to disinfect the surface. Disinfection means using chemicals to kill germs on surfaces. High touch surfaces should be cleaned and disinfected regularly, at least twice daily.

At home

Good hygiene and cleaning should be practiced in the home.

Regular cleaning of frequently touched objects and surfaces like door handles, light switches, tables, bench tops, phones, keyboards, toilets and taps.

The first step is wiping dirt and germs off surfaces using common household detergent products stocked at supermarkets.

The second step is to disinfect surfaces. Supermarkets stock common household disinfection products. It is important to use products that are labelled ‘disinfectant’ – and to follow the instructions on the label.

Where possible, use a disinfectant that has antiviral ability (that means it can kill viruses). Chlorine-based (bleach) disinfectants are one product that is commonly used. Other options include common household disinfectants or alcohol solutions with at least 70% alcohol (for example, methylated spirits).

Preventing infection

Home safety plan

HCW are not allowed to cross to different places of work. What about other workers in other industries? Like the cleaner who worked in multiple sites?

15-Oct

On 27 October 2020 some restrictions in metropolitan Melbourne and regional Victoria eased.

Six principles for COVIDSafe workplaces are encouraged.

All businesses must ensure:

  1. physical distancing
  2. wearing a face mask
  3. practicing good hygiene
  4. keeping records and acting quickly
  5. avoiding interactions in enclosed spaces 
  6. creating workforce bubbles.

To create a workforce bubble - Keep groups of workers rostered on the same shifts at a single worksite and ensure there is no overlap of workers during shift changes.

Employer obligations

  • Collect records of all workers, subcontractors, customers and clients attending the work premises for 15 minutes or longer (certain exemptions will apply).
  • Employers must ensure that workers do not work across multiple sites, unless it is not practicable to limit workers to one site only.
  • If it is not practicable to limit a worker to only one work site, or if the worker has multiple employers, then the worker must declare this to their employer(s). The employer(s) must maintain a record of all workers who work across multiple work premises.

Six principles

Cleaning

If someone has symptoms which are likely/ possible to be COVID – ie are getting a test … should their immediate close contacts also isolate until their results are back?

15-Oct

There is no need for others in the house to self-isolate unless they are also waiting for a coronavirus (COVID-19) test result.

While in self-isolation, you should:

  • Stay in a different room to other people as much as possible. Sleep in a separate bedroom and use a separate bathroom if available.
  • You must not allow other people into the home if they don't live there, unless they are there to provide medical care, personal care or urgent household assistance.
  • Ensure you stay at least 1.5 metres away from others in the home, if possible.
  • You are permitted to leave your property to seek medical help or in an emergency.
  • You are not allowed to leave your home to exercise while you are in isolation or quarantine.
  • As always, we encourage anyone with symptoms, however mild, to get tested, so if anyone you live with has symptoms of coronavirus (COVID-19) they should get tested too.

If a person has had close contact with a person diagnosed with coronavirus (COVID-19) or a close contact of a contact, the Department of Health and Human Services will notify them as soon as possible. A close contact must quarantine at home (or another suitable place). If the person is not at their home when they receive the notification, they should go straight home (or to the place they will be quarantining) and remain there until they are cleared by the Department of Health and Human Services.

Read What to do if you have been in close contact with someone with coronavirus (COVID-19) factsheet (Word) for more information.

Find more

What is the current definition of a close contact? Sounds like it has been refined...

What did that “testing 14 hours post transmission“ of close contact mean? Isn’t it 11 days?

15-Oct

Generally, ‘close contact’ means:

  • having face-to-face contact for more than 15 minutes or sharing a closed space for more than two hours with a person diagnosed with coronavirus (COVID-19)
  • having close contact with a close contact of a person diagnosed with coronavirus (COVID-19) when the person was infectious (or potentially infectious).

Close contact can happen in many ways, such as:

If you have had close contact with a person diagnosed with coronavirus (COVID-19), you may become infected, this is most likely to happen within 14 days of your contact with the person diagnosed with coronavirus (COVID-19). This is why the Department of Health and Human Services will ask you to get tested on or about Day 11 of your quarantine period.

From 11:59pm 11 October 2020, if you are a close contact of a person diagnosed with coronavirus (COVID-19) and refuse to get tested on or about Day 11 (or later) of your initial quarantine period, your initial period of quarantine will be extended by 10 days (although this period can be shorter, varied or extended in certain circumstances). This is to ensure that you do not come out of quarantine while potentially infectious.

If you agree to be tested and your test is positive, you become a person diagnosed with coronavirus (COVID-19) and you will be required to isolate. The Department of Health and Human Services will regularly check on you and your symptoms and tell you when you can stop isolating.

Find more

How do we find out details of our local public health unit? I’m on the Mornington Peninsula

15-Oct

Lead health services will work closely and partner with health services and community organisations to create the cluster-wide Local Public Health Units. The local public health unit closest to the Mornington Peninsula is the South Eastern Public Health Unit (SEPHU). The lead health service is Monash Health, and the partner health services are Alfred Health and Peninsula Health.

 

Please provide some response around why children’s immunisations were moved to the RCH without consideration given to primary care and GPs’ in this and the public perception.

2-Sep

Insights Paper No.6
Statement on children's immunisations at RCH

 

Is DHHS planning to include a section on their website for employers and schools (and the like) to reconsider asking students/employees to be tested for COVID before returning if asymptomatic (ie that people must fall into the specific testing criteria) and how are the costs of such requests to be covered?

19-Aug

Feedback has been noted and under consideration . 

 

DHHS to clarify the definition of a close contact for GPs who were in a consult with someone who has been found positive but who were wearing a mask and eye protection but were in a room with that patient for longer than 15 mins. 

19-Aug

Coronavirus case and contact management guidelines health services and general practitioners

Pg 11 

Can COVID aged care patients be looked after in their home (ie palliative care)? 

19-Aug

COVID positive aged care residents can be looked after in their residential aged care facility, which is considered to be their home. This should be in collaboration with the local community palliative care service if there are any challenging circumstances, for example symptoms are difficult to manage or family decision-making is challenging.

 

If GPs have patients in an aged care facility who are either positive or negative for COVID, can the GP visit the facility – and what if there is an outbreak in that facility? Can a GP attend to visit patients? Please clarify 

19-Aug

The Care Facilities Directions restrict who may visit a care facility. Among the permitted ‘workers’ who may visit are those who’s presence is for the purpose of providing ‘health, medical or pharmaceutical goods’. The Directions do not distinguish between facilities that have residents who have tested positive to COVID-19 and those that do not. Aged care consumers’ right to appropriate clinical care are contained in the Aged Care Quality Standards. Accordingly, there is an obligation on providers to ensure that residents receive ‘safe and effective personal care, clinical care, or both personal care and clinical care, in accordance with the consumer’s needs, goals and preferences to optimise health and well-being’ (Standard 3).

 

PHNs have provided some masks to GP clinics that have an expiry date from a few months back – are these safe to use or should they be discarded? What should GP clinics do in this case? 

19-Aug

GPs may seek guidance from the PHNs that supplied the PPE of concern, and action as per PHN advice. 

 

Is COVID-19 associated with chilblains?

19-Aug

There is no convincing evidence that COVID-19 causes chilblains. Chilblains are not an indication to test for COVID-19 unless COVID-19 symptoms are present.

 

1. A resource/flow chart for GPs around ‘what advice do I give to someone…’

  1. Who has been tested and is awaiting a result -
  2. A close contact (and what is this definition now)
  3. Someone who is positive with symptoms
  4. Someone who was positive but whose symptoms have now resolved etc

So that GPs can be involved in giving patients in the community the right advice

5-Aug

Coronavirus disease 2019 COVID-19 general practice quick reference guide

Coronavirus case and contact management guidelines health services and general practitioners

 

Videos created by DHHS in multiple languages covering multiple scenarios (ie those listed above) – Louise was going to look at what resources they already have in this vein and what may still be needed 

5-Aug

Translated resources Coronavirus disease COVID-19

 

Can you provide data on the Health Care Workers infected and whether they contracted this through their work?  

6-Jul

Healthcare worker infections are acknowledged and provided to the department and contact tracing provides information about where they most likely contracted the virus. Unfortunately we aren’t able to provide this information to you in a timely manner. 

 


Dates and registration links

Well known media commentator and regular RACGP webinar attendee Dr Sally Cockburn will be deep diving into various GP-relevant clinical topics with guest panellists to address clinical issues arising from the COVID-19 pandemic.

Hosted by RACGP Victoria Faculty and Dr Sally Cockburn, these will be interactive panel discussions and promise to be entertaining and educational events! Please register for the series that will be held on the ‘alternate Wednesdays’ to our DHHS & RACGP Victoria webinar series:

  • Wednesday 2 December 2020, 6–7pm
    Topic:  What will the new COVID-normal general practice look like?
    Host Dr Sally Cockburn will be joined by:
    • Prof Michael Kidd AM FAHMS
    • Deputy Chief Medical Officer and Principal Medical Advisor
    • Australian Government Department of Health


Previous webinar recordings


For Coronavirus (COVID-19) updates and information to support healthcare teams in prevention and management of COVID-19 for Aboriginal and Torres Strait Islander peoples please visit the NACCHO website: COVID-19 Primary Healthcare Guidance

To subscribe to the COVID-19 information update for the Victorian Aboriginal Community produced by the Aboriginal Strategy and Oversight unit of the Strategic Policy and Projects Branch, Department of Health and Human Services, Victorian Government, please click here.

Other resources

For more information about COVID-19 for Aboriginal communities, please visit the DHHS website Coronavirus (COVID-19) information for Aboriginal communities.

Victorian Aboriginal Community Controlled Health Organisation Inc. (VACCHO) provides daily and weekly updates on their website.


RACGP Victoria

Phone: (03) 8699 0488  

Email: vic.faculty@racgp.org.au

Join the RACGP Victoria Facebook group to chat with your colleagues and stay up to date