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 7 July 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
  • Subscribe to receive alerts from the Victorian Chief Health Officer.
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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.

 

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 22 July 2020, 6–7pm
  • Wednesday 5 August 2020, 6–7pm
  • Wednesday 19 August 2020, 6–7pm
  • Wednesday 2 September 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:

PHN

Phone

Email

Website

North Western Melbourne

(03) 9347 1188

nwmphn@nwmphn.org.au

http://www.nwmphn.org.au

Eastern Melbourne

(03) 9046 0300

info@emphn.org.au

http://www.emphn.org.au

South Eastern Melbourne

1300 331 981

info@semphn.org.au

http://www.semphn.org.au/

Murray

(03) 5441 7806

info@murrayphn.org.au

http://www.murrayphn.org.au/

Western Victoria

(03) 5222 0800

info@westvicphn.com.au

http://westvicphn.com.au/

Gippsland

(03) 5175 5444

info@gphn.org.au

http://www.gphn.org.au/


We know many of you may be anxious and unsure about coronavirus (COVID-19) in the community. If you live in an identified hot spot, don't be alarmed when you see an increase of visitors in your neighbourhood. They are there to help you.

Community engagement teams will be doing outreach with door to door visits providing the latest health advice on coronavirus (COVID-19). Don't be worried when they come to your door.

A team of 800 testers will visit your neighbourhood with a fleet of mobile testing vans, allowing residents to get free testing close to home.

All residents in hot spots will be eligible for testing, with or without symptoms. We are trying to test 10,000 residents a day to get a better sense of how the virus is spreading in these communities. So, if you live in any of the suburbs below, go and get tested:

Keilor Downs
Maidstone
Albanvale
Sunshine West
Hallam
Broadmeadows
Brunswick West
Fawkner
Reservoir
Pakenham

If you feel more comfortable being tested in an Aboriginal community controlled health service, please contact:

Bunurong Health Services, Dandenong (03) 8902 9700

First Peoples Health and Wellbeing, Thomastown (03) 9070 8181

Victorian Aboriginal Health Service, Fitzroy 0478 767 140

Read Minister Mikakos' media release on the 10-day Suburban Testing Blitz

Access the COVID-19 suburban testing blitz Hotspot intervention plan 


Aboriginal and Torres Strait Islander people are considered at higher risk for COVID-19, making it even more important to get tested – even if there are only mild symptoms.

Testing for COVID-19 is important to monitor the progress of the pandemic response.

We encourage you to click on the links to check out the messages encouraging COVID-19 testing for the Victorian Aboriginal community:

Please watch then share with your networks and local community.

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.

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.


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