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: Tuesday 22 September 2020, 11.00 am AEST.

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
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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 30 September 2020, 6–7pm
  • Wednesday 14 October 2020, 6–7pm
  • Wednesday 28 October 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

Previous webinar recordings

DHHS responses – on notice webinar questions

Question/request  Date Response  Page no.

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 23 September 2020, 6–7pm
    COVID-positive patients in the community – Emergency departments and general practice: When to refer, what we can do to minimise.
    Hosted by Dr Sally Cockburn and expert panelists:
    Dr Simon Judkins
    • Immediate Past President Australasian College for Emergency Medicine and
    • Clinical Director of Emergency Medicine Austin Health
    Assoc Prof Lou Irving
    • Director of Respiratory & Sleep Medicine and Director of Clinical Training at the Royal Melbourne Hospital and
    • Respiratory Physician at the Peter MacCallum Cancer Centre
    Co-hosted by RACGP Victoria Deputy Co-Chair Dr Anita Munoz.
  • Wednesday 7 October 2020, 6–7pm
    This session will cover ‘Long COVID syndrome’ – what are we going to be looking after for the next few years? 
  • Wednesday 21 October 2020, 6–7pm
    This session will cover COVID and haematology – what’s going on with clotting and blood vessels? 


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