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 11 May 2021, 2.40 pm 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.


  • Update on booking changes

    In actively responding to the confusion and practice disruption experienced by members yesterday, the College has been in contact with the federal Department of Health to outline members concerns. The premature launch of the booking system without appropriate online capabilities, the short fall in information available to the practices, and the messages in the media to “phone your GP”, have cause a great deal of confusion and frustration to GPs and to their patients. This was compounded by the fact that, in most cases, vaccines had not been received.

     The Department have listened to the RACGP advice and have changed their messaging. We continue to advocate for clearer and more constructive and collaborative communications between the Department and GPs. Any collaboration must include precise in multiple media channels for GPs, their staff and patients.

     Our constant advocacy is for better, clearer and more collaborative communication with GPs who will be the ones delivering this program. In particular, that must include advice on precise delivery information.

    The Commonwealth’s eligibility vaccine checker now links to available GP clinics for eligible people to make bookings People can also access these services using the national hotline by calling 1800 020 080.
    Vaccine eligibility checker

  • Find details and FAQs relating to the Victorian Travel Permit System
  • 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 DoH 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 DoH COVID-19 Telehealth consulting and conferencing: Privacy and security document for guidance on how to do this safely.

Please note that the DoH 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 DoH 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, DoH 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.


Latest public health advice and Q&A presented by Department of Health Victoria representatives in conjunction with RACGP Victoria Faculty Chair Dr Anita Munoz and Co-Deputy Chairs Dr Marina Malcolm and Dr Bernard Shiu. Please register here for the series.

Upcoming webinar dates:

  • Wednesday 19 May 2021, 6pm
  • Wednesday 16 June 2021, 6pm
  • Wednesday 21 July 2021, 6pm
  • Wednesday 18 August 2021, 6pm
  • Wednesday 15 September 2021, 6pm
  • Wednesday 20 October 2021, 6pm
  • Wednesday 17 November 2021, 6pm
  • Wednesday 15 December 2021, 6pm

Previous webinar recordings & related resources:


Victorian DoH responses – on notice webinar questions

 

Question/request Webinar date Response Resources / links

Can a GP practice decline (covid) vaccinate to local patients just because they are patients of another practice? These patient's practice does not vaccinate?

21-Apr

The Commonwealth has stated general practice clinics should not restrict vaccinations to their own patients. If your clinic is providing vaccinations and you do not have capacity for extra patients, please see the coronavirus website for other COVID-19 vaccination clinics.

Book your vaccine appointment

Will the mass vaccination centres stop GP's getting more than 50 doses a week?

21-Apr

The Victorian Department of Health has sought zero Astra Zeneca doses from the Commonwealth for two weeks so they can be redistributed to general practice.

 

Few patients are asking if they can choose Pfizer although they had AstraZeneca few weeks back?

21-Apr

No, if your patients have safely had the first dose of AstraZeneca it is recommended to proceed with the second dose. The latest advice from The Australian Technical Advisory Group on Immunisation states that blood clotting is almost always seen with the first dose. For more information, please refer to the website referenced.

AstraZeneca COVID-19 vaccine

Past stroke patient in 70s-can have AstraZeneca vaccine or not (Cerebral vein thrombosis risk)?

21-Apr

Medical contraindications to the AstraZeneca vaccine include: 1) anaphylaxis after previous dose of AstraZeneca vaccine or 2) anaphylaxis to polysorbate 80 (a component of AstraZeneca vaccine). The recent statement of ATAGI states that Pfizer vaccine be used in people with a past history of 1) heparin induced thrombocytopenia or central venous sinus thrombosis.

 

How long should I wait for second dose of AstraZeneca?

21-Apr

From a regulatory standpoint, the TGA has reviewed evidence and concluded that the vaccine can be safely administered 4-12 weeks apart. That is 12 weeks being optimal period between doses and 4 weeks being the minimum.

AstraZeneca COVID-19 vaccine

If under 50 years and have had first AZ vaccine, can we still switch and ask for Pfizer vaccine? Is there a restriction against this?

21-Apr

The Australian Technical Advisory Group on Immunisation have recommended that the second dose of COVID-19 AstraZeneca vaccine can be used in adults aged under 50 where the first dose has been successfully administered with no adverse reaction.

VicSIS network

Is the roll-out of phase 2A happing soon as per recent media reports?

21-Apr

From May 3 2021: people 50 years and older can receive AstraZeneca vaccine at general practice respiratory clinics and state and territory vaccinating clinics. From May 17: people 50 years and over can receive the AstraZeneca vaccine at a participating general practice. State vaccination clinics will prioritise the Pfizer vaccine for people under 50 years of age, currently in phase 1a and phase 1b (priority 1) priority groups.

See resource

How do GPs access the extra doses that state is giving back?

21-Apr

Currently waiting on the Commonwealth to advise.

 

Does having had the first AZ vaccine without any clotting complications means the second dose will not give rise to clotting problems?

21-Apr

The Australian Technical Advisory group reported onset between 4 and 20 days after vaccination with the first dose of the AstraZeneca vaccine. There are no reports of the syndrome after the second dose of the vaccine.

See resource

Does 75 years old patient with recurrent DVT eligible for a Pfizer vaccine? Or she can have the AZ vaccine?

21-Apr

No, DVT is not a medical contraindication to AstraZeneca.

VicSIS network

What about patient with previous history of thrombocytopenia has had AstraZeneca first dose, can request for Pfizer?

21-Apr

Anyone presenting with a medical contraindication to receiving COVID-19 vaccine must be referred to the Victorian Specialist Immunisation Services (VicSIS) to determine patient vaccine eligibility. See links under "resources".

VicSIS network

Is there a direct contact pathway and medicolegal protection for sharing this information?

21-Apr

There is no direct contact pathway for the Information Sharing Schemes. All organisations and services prescribed as information sharing entities (ISEs) can access the online ISE list. If you don’t know whether an organisation requesting information from you is an ISE, you can verify where they are from by asking them to send an email from their work address or by calling their organisation’s reception.

In terms of professional liability, offences may apply where information is shared unlawfully under the Schemes. However, a person who is authorised to share information under the schemes, who acts in good faith and with reasonable care when sharing information will:

  • not be held liable for any criminal, civil or disciplinary action for providing the information
  • not be in breach of any code of professional ethics or considered to have departed from any accepted standards of professional conduct.

This protection from liability applies only to individuals, not organisations.

 

If patient realises that information can be shared, will they likely to not speak candidly?

21-Apr

Research has indicated that 1 in 3 family violence victim survivors disclose to GPs. GPs already share under Victorian privacy laws such as with a patient's consent or to lessen or prevent a serious threat to life, health, safety, or welfare. The Child and Family Violence Information Sharing Schemes expands information sharing obligations. GPs will be able to use these Schemes to assess and manage family violence risk and to promote child wellbeing or safety. Even where consent is not required under the schemes, the views of patients who are not perpetrators should be sought, where it is safe, appropriate and reasonable to do so.

We know that 80% of victim survivors seek help from health services (mainly their GPs) – the ability for GPs to be able to proactively share risk relevant information about family violence to assess and manage risk, and information to promote a child’s wellbeing and safety will be a significant benefit.

A 2 year review of the Family Violence Information Sharing Scheme did not find that perpetrators (people who use family violence), disengaged from services, despite the Scheme being in existence. The 2 year review of the Child Information Sharing Scheme produced a similar finding. Further, GPs are already mandatory reporters for child abuse.

 

Will there be a way of being paid for this time (information sharing)?

21-Apr

There is no funding for information sharing.

 

Is this there an answer to the pre-drawing of the Astra Zeneca vaccination yet?

31-Mar

There is limited information available in relation to the storage of the vaccine in syringes. For practical reasons, if the contents of the vial are to be used within a short period of time, drawing up the content in multiple syringes at once may be considered. Vaccine in syringes may be kept for up to 6 hours when stored at room temperature (up to 30˚C). However, ensure that the cumulative storage time at room temperature from the first vial puncture to last dose administration does not exceed 6 hours. After this time, the syringe must be discarded. For more details in relation to administration, please refer to Department of Health Guidance Documents.

ATAGI clinical guidance

What was the adverse events responsible to take time off after vaccination?

31-Mar

The recommendations for "testing and isolation after the COVID-19 vaccination" by the Department of Health apply to the symptoms within the first 48 hours following the COVID-19 vaccination. If symptoms such as respiratory, fever, headache and chills last longer than 48 hours, further assessment and consideration of isolation should be undertaken. With consideration of these guidelines, 1 to 2 days is an appropriate time to take off before returning to work. Please note these recommendations are continually being updated.

See resource

Any specific precautions for a patient who had a bone marrow transplant recently or on chemotherapy?

31-Mar

Many (but not all) people affected by cancer are eligible to receive a COVID-19 vaccine in the second phase (phase 1b) of the Australian Government’s COVID-19 vaccine national roll-out strategy. At this time, the people affected by cancer or have had bone marrow transplant fit into the priority group. At this stage, people with cancer were not included in most clinical trials for the COVID-19 vaccines. The immune response to the vaccine may be lower compared to people without cancer. Continuing to practice physical distancing, hand hygiene and wearing a mask remain important even after vaccination.

 

Is there any evidence of thrombocytopenia after AZ vaccine?

17-Mar

There are ongoing investigations in Europe regarding reports of a specific type of thrombosis (cerebral venous sinus thrombosis; CVST and low platelets) following AstraZeneca vaccine. No cases of CVST associated with vaccination have been recorded in Australia to date. For more information about side effects please visit COVID-19 vaccines.

As a precaution all clinicians are being advised to refer patients who report significant headaches 72 hours or more after receiving an AstraZeneca COVID-19 vaccine to their nearest emergency department, with a referral letter.
Hospitals will further assess the patient and may perform tests to rule out thrombosis as a precaution.

For more information view the ATAGI statement.

COVID-19 vaccines

There are new versions of the training modules for COVID vaccination. Do we have to redo them again?

17-Mar

No. Doctors do not have to complete the updated COVID-19 Vaccination training modules again if they have already completed the previous version.

COVID-19 vaccination login
"Sometimes when there are updates to the module you do not have to complete them if the previous version was completed"

What about mast cell disorders and associated anaphylaxis

17-Mar

A study conducted by Rama, Moreira & Castells (2021) published in Elsevier Public Health Emergency Collection suggested that mRNA COVID-19 vaccine is well tolerated in patients with cutaneous and systemic mastocytsis with mast cell activation symptoms and anaphylaxis. The article concluded that although patients with MC activation and anaphylaxis when exposed to certain drugs and procedures, there is no evidence of increased sensitization or reactivity to PEG. Patients with MC activation disorders may be good candidates for the COVID-19 vaccinations whenever indicated, with premedication and in an appropriate setting (eg: hospital with available intensive care unit) and under medical surveillance.

See resource

My patient is in a Nursing Home is allergic to pneumonia vaccination. What is your advice re - covid immunisation for her?

17-Mar

Serious side effects like allergic reactions or anaphylaxis are extremely rare. However if this occurs, vaccination providers have medicines available to effectively and immediately treat the reaction. If your patient has had serious allergic reactions to a vaccine, it is important that she consults with the doctor on site before receiving the vaccine.

 

A doctor friend in phase 1a has been advised they cannot work the day after her vaccination. Is this the recommended protocol for both vaccines?

3-Mar

No, currently this is not the recommended protocol. Like many other vaccinations, COVID-19 vaccines can have side effects, these include; pain at the injection site, tiredness, headache, muscle pain, joint pain, chills or fever. These symptoms are generally mild and resolve within a day or two. Some symptoms of COVID-19 are similar to the side effects of the vaccination but others are quite different. It is however recommended to stay home if you are experiencing symptoms of COVID-19 infection. Symptoms such as coughing, sore throat, shortness of breath, runny nose and loss of or change in sense of smell or taste. These are not normal vaccine reactions, and if you have these symptoms it is important to get tested and isolate until you get your result. For more information about side effects please visit COVID-19 vaccines.

COVID-19 vaccines

Has there been further evidence about tranverse myelitisfor AZ vaccine?

3-Mar

At this stage, there is no further evidence for tranverse myelitisfor, however information has been released by Melbourne Vaccine Education Centre earlier this year that may be of interest: AstraZeneca COVID-19 vaccine

AstraZeneca COVID-19 vaccine

Is there a "magic number" for population vaccination beyond which the department will no longer recommend strict lockdown measures and rather accept low levels of community transmission?

3-Mar

When enough people in the community are vaccinated, it slows down the spread of disease. Achieving herd immunity is a long-term goal, and this usually requires a large amount of the population to be vaccinated. The government is working hard to ensure that vaccines are accessible and equitible. Studies will monitor the impact of COVID-19 vaccines and whether herd immunity is developing over time. For this reason, public health practices will stay in place until the evidence shows us that 1) vaccination prevents transmission and 2) herd immunity has been achieved in Australia. Latest available data from the United Kingdom shows a substantial reduction in transmission of the virus, after over 10 million people were vaccinated.

 

What, if any, are the legislative requirements for recording ALL AEFI (adverse events following immunisation) no matter how minor (ie localised pain)? Or is this only required for significant side effects (ie fever and chills, anaphylaxis)?

17-Feb

Any event felt to be significant following immunisation should be reported to Safer Care Victoria, regardless of whether you think the side effect was related to the vaccine or not.

Reporting is strongly encouraged via the SAFEVAC Reporting website.

You do not need to report common/minor/expected reactions, however any vaccine reaction which has affected the vaccinee’s/family’s confidence in future immunisation should be reported.

You should discuss history of anaphylaxis or allergic reactions before the immunisation process begins. After receiving the vaccination, regular patients should be monitored for 15 minutes before leaving the premises so they can be monitored for any reaction or adverse affects. Patients with a history of allergic reactions to vaccination or of anaphylaxis to any exposure should wait 30 minutes after vaccination to be observed. Those who are suspected to have had an allergic reaction to the first dose of COVID-19 vaccine should see a specialist vaccination centre or an allergy specialist.

COVID-19 vaccines

SAFEVIC

Can DoHV please provide us with the website you mentioned is being created when this is available – a repository of information to discuss patient hesitancy to vaccine

17-Feb

The Melbourne Vaccine Education Centre provides reliable resources. Further information will be added to the Victorian Government's COVID-19 vaccination webpages shortly.

Vaccine hesitancy

What to do if a patient refuses their info going on AIR? Do Medical Defence Authorities have an opinion on this?

17-Feb

The legislation includes an exemption from reporting where a provider reasonably believes that reporting a vaccination would pose a risk to the health or safety of the individual. This is for circumstances where reporting a vaccination may put the individual at risk of domestic violence, or where a certain vaccination may indicate they have a specific medical condition etc. In these cases there is an onus on the provider to be able to provide supporting evidence should it be requested. Individuals will not be able to request their/their child’s vaccination is not reported, unless they fit the category above.

  • Individuals can opt out of having their/their child’s information shared with third parties, meaning no-one can view their immunisation details. Individuals can also opt out from receiving certain information from the register, meaning they won’t get correspondence from the AIR (ie reminder letters).
  • It is important to note that if individuals withdraw their consent for their information to be shared with third parties:
    • this applies to all their immunisation data (not just COVID-19)
    • the definition of ‘third parties’ includes all vaccination providers

General practices can consult their MDA for individual advice if they wish.

 

Can you provide the website for individual GPs to put in EOI to be part of the surge workforce? Annaliese discussed this live – what was the site for this?

17-Feb

The website to put in an expression of interest to be part of the surge workforce is: Torrens Health

Torrens Health

Any considerations for vulnerable GPs to receive the Pfizer rather than the AZ? Eg more senior GPs with underlying co-morbidities?

17-Feb

Under the federal government's rollout program, the vaccine available at the time will be provided. Some early priority groups will receive the Pfizer vaccine because that is the first vaccine to be approved and available in Australia. Most Australians will receive AstraZeneca vaccine. Both vaccines need to be dispensed in two doses, and seperated by at least 21 days for the Pfizer vaccine and four to 12 weeks for the AstraZeneca vaccine. COVID-19 vaccines are not interchangable; you should see through the course of vaccination with the one you initally receive.

COVID-19 vaccines

How will housebound vulnerable patients be vaccinated, if GP's practice is not granted Covid vaccine accreditation?

17-Feb

The Victorian Government is considering a range of ways to immunise Victorians including mobile immunisation and outreach services.

 

Do we advise patients they will receive a SmartVax survey SMS post vaccine? 17-Feb Over 300 general practices and health clinics in Australia use SmartVax to monitor vaccine safety. Visit the SmartVax website to register your clinic's interest to participate. A few days after the patient receives a vaccine at a participating clinic, the clinic will send out an SMS asking if the person had any reactions after the vaccination. SmartVax

Are we getting a handout sheet for the patients as we have for all other vaccinations?

17-Feb

The Australian Government provides information for COVID-19 vaccine providers including a fact sheet for health professionals to assist in answering patient queries. You can access consent forms if you wish to use them too.

Round one data collection

Most of the patients I have who are vaccine hesitant are worried about the lack of long term data, and would be happy to have it a few years down the track instead. How would you approach this?

17-Feb

Vaccines are tested to ensure they are safe before they are approved for use.

Before vaccines are made available in Australia, they must pass strict Australian safety standards set by the Australian Therapeutic Goods Administration (TGA).

All vaccines are thoroughly tested for safety before they are approved for use in Australia. This includes careful analysis of clinical research, ingredients, chemistry, manufacturing and other factors.

These vaccines have been shown to prevent disease, serious illness and death.

COVID-19 vaccines

When will we be informed if we are successful with the EOI?

17-Feb

The Commonwealth Government is running the EOI process for general practices to administer vaccines. It is understood the Commonwealth will advise all general practices of the EOI outcome through PHNs approx. first week of March.

 

 


RACGP Victoria, together with the Department of Health (DoH) Victoria, hosted a number of Coronavirus update webinars throughout 2020. You can view the recordings of these webinars from the links provided below. We are currently looking into running ongoing webinars in conjunction with DoH next year on public health, so please keep an eye out in the newsletters and on the faculty Facebook page.

These webinars are presented by:

  • DoH Deputy Chief Health Officer or Public Health Commander
  • DoH speciality representatives and staff
  • RACGP Victoria Council Members:
    • Dr Cameron Loy, Immediate Past Chair
    • Dr Karen Price, President-Elect
    • Dr Anita Munoz, Chair
    • Dr Bernard Shiu, Co-Deputy Chair
    • Dr Marina Malcolm, Co-Deputy Chair

Previous webinar recordings

DoH responses – on notice webinar questions

Question/request  Date Response  Page no./links

What is the status of the Government QR app?

25-Nov

Victorian business owners across the state can now access a free QR Code Service. The Victorian Government’s QR Code Service can be used by businesses and venues to keep records of visitors to help them stay safe and stay open.

Find more

Why when you choose ‘clinician advice’ on the DoH phone line do you get put through to the Australian Government site? Nobody from either source could answer my question about serology.

25-Nov

For advice, health professionals can call the dedicated Coronavirus (COVID-19) advice and case notification hotline – phone 1800 675 398, 24 hours a day.

Find more

Re contact tracing: What was the outcome of the DoH visit to NSW Health contact tracing? Has DoH improved and streamlined online systems and moved to an online platform similar to NSW Health?

25-Nov

The Government is working with SalesForce to deliver their case and contact management system. The digital online system covers the whole program of contact tracing – from notification of positive result, interviews, follow-up phone calls and coordination of Operation Vestige to the clearance of cases and contacts to be managed all within the one system.

Find more

What are the arrangements likely to be for HCWs (including GP staff) to be vaccinated once it’s available – and what role will GPs be taking in vaccinating the population?

25-Nov

There are three priority groups identified by ATAGI. These are:

  1. Those who are at increased risk of exposure
  2. Those who are at increased risk, relative to others, of developing severe disease or outcomes and
  3. Those working in services critical to societal functioning.

Vaccination locations may over time include: general practice clinics, GP respiratory clinics, dedicated vaccination clinics and workplace vaccinations, appropriate locations identified by the Aboriginal and Torres Strait Island Community Controlled Health Sector and Pharmacies.

If you would like to read up more on the Australian Covid-19 Vaccination Policy, please use the link provided.

Find more

Is Naloxone nasal spray available in the emergency doctor’s bag list?

25-Nov

Emergency drug doses – PBS doctor’s bag items:Emergency drug doses – PBS doctor’s bag items:

DRUG – Naloxone (2 mg in 5 mL injection)

INDICATION – Opioid overdose

DOSE – Adults and children: 0.4–0.8 mg IV, IM or SC repeated as necessaryNeonates born with low APGAR scores to mothers taking opioids: 0.1 mg/kg IV, IM or SC. Repeat if needed.

 

NPS website

PBS website

Any update about nasal spray for prevention of COVID-19?

25-Nov

Biomedical Translation Fund (BTF):

Brandon Capital Partners’ MRCF BTF Fund has committed $11.7 million from the fund to Ena Therapeutics to test a nasal spray treatment that targets the primary site of most respiratory virus infections, including SARS-CoV-2 (the strain of coronavirus that causes COVID-19) and influenza.

Find more

Any data out there about the incidence of COVID-19 in substance abusers?

25-Nov

Professor Nicolas Clark who spoke at the 25 November RACGP webinar stated that there are no official statistics that he is aware of. However, he did make mention, anecdotally, that the incidence of COVID-19 seemed to be lower in people who use injectable drugs, presumably as they were not well connected to those travelling overseas. Prof Clark can be contacted at Monash health; Faculty of Medicine, Nursing and Health Sciences

 

What is the latest regarding the PFIZER vaccine being 90% effective – what does this mean practically and what can we tell our patients regarding timeline of availability?

11-Nov

The Australian government has invested more than $3.2 billion on securing COVID-19 vaccine. The Prime Minister has stated that the Government's vaccine and treatment strategy has now secured access to four COVID-19 vaccines and over 134 billion doses. The Novavax and Pfizer/BioNTech vaccines are expected to be available in Australia from early to mid-2021 subject to approval from the Therapeutic Goods Administration (TGA).

Find more

Have there been any cases of prolonged shedders infecting others beyond 14 days?

11-Nov

There have been no recorded cases of people infecting others after being cleared of COVID-19 infection, but clearance often takes more than 14 days to be achieved.

After infection, the extent or duration of any acquired immunity is still unknown. Apparent re-infection has been reported in a small number of cases. However, most of these reports describe patients having tested positive within 7–14 days after apparent recovery.

The role of serology in determining immunity is currently unclear. Immunological studies indicate that people recovering from coronavirus (COVID-19) mount an antibody response. However, further studies are needed to indicate whether these antibodies are indicative of virus neutralisation, or protection from infection.

Criteria for clearance following COVID-19 include duration since symptom onset and clinical improvement, and can be found in the link.

Case and Contact Management Guidelines

When is the use of the Government QR app for businesses going to happen?

11-Nov

Currently, businesses in Victoria have taken the initiative to use QR code systems as a part of their booking and ordering systems. The Victorian government has indicated that it is developing a specific QR code check-in system that hospitality and retail stores will be asked to use so data can be easily transferred to the new contact tracing system. As yet, there has been no formal announcement of the release of the QR code.

 

Given the dynamics of indoor spread (noting the importance of aerosol transmission), how wise is it to be accelerating the numbers of people allowed indoors in the same space and in mask-off settings, at the current rate we seem to be opening up?

11-Nov

It is likely that transmission of SARS-CoV-2 involves a complex interplay between droplet sizes and the air that carries them. There is a higher risk of transmission within crowded places, close-contact settings, and confined and enclosed spaces (with poor ventilation). There is general consensus that the transmission of the virus occurs most commonly through droplets and close contact and that aerosol transmission can occur in specific settings. Coronaviruses generally tend to have low stability in the environment due to the natural action of oxidants that disrupt the viral envelope. There is increasing research suggesting that ventilation / airflow can impact droplet spread. Indoor settings are likely to have increased risk of transmission compared to outdoor settings, due to the potential for issues with ventilation.

Find more

Any advice on lung function testing safety?

11-Nov

The respiratory protection program is being rolled out across the Victorian health system. The program will assist health services in implementing structure interventions and prevention strategies (such as fit testing) which minimise the risk of health care worker exposure to respiratory hazards. This has been mandatory in public health services since 31 October 2020.

Find more

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.

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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 DoH 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 (DoH), WorkSafe, Health and Safety Representatives, and notify your workforce.

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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 DoH 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.

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 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 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 DoH 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 . 

 

DoH 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 DoH 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 are interactive panel discussions. We will look to pick these up again in 2021, so keep an eye on the faculty newsletters or join the RACGP Victoria Facebook group for updates if you have not already.


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 DoH 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