Department of Health Victoria Updates & COVID-19

What is the status of the Government QR app?

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.

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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.

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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.

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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.

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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.

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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).

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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.

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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.

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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.

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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

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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.

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.

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.

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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.

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.