COVID-19 weekly update – 10 August 2022

COVID-19 cases in the region

Over the last four weeks there were 59,648 cases of COVID in the region, and over the last week there has been an decrease of 10,940 cases and it appears that we may be over the peak of the recent COVID surge – however we continue to urge vigilance as number of COVID cases are still high. 

Please note that the actual number of cases is likely to be much more. For further information please go to the latest NSW COVID statistics.

Infection control and wearing masks (staff and patients) is critically important. Practices are asked to ensure that their most vulnerable populations are fully vaccinated and where possible to ensure children with respiratory illnesses get access to care. If you would like an infectious control consultation or any other support, email coronvirus@cesphn.com.au

HealthPathways – upcoming changes to the COVID suite of pathways

HealthPathways is regularly updated with the latest information on COVID.  Please note that the following pathways have been updated on HealthPathways  for both South Eastern Sydney and Sydney)

• COVID-19 Shared Care: retired
• COVID-19 Self-care Patient Triage and Support: retired
• COVID-19 Active Case Management – title will change to COVID-19 Management.

Please be assured that all the information from the pathways that were retired is retained on the COVID-19 Management (SES & Sydney) pathway.

Update: use of antivirals in residential aged care

With influenza continuing to circulate in the community alongside COVID-19 it is important to protect our most vulnerable, including residents of residential aged care facilities (RACF).

The Commonwealth Department of Health has distributed oseltamivir and molnupiravir to RACF for use in residents. To assist with this, NSW Health has enacted legislation to permit RACF’s to hold and store both these medications. Note that:

• Molnupiravir and nirmatrelvir/ritonavir are now also available on the Pharmaceutical Benefits Scheme (PBS) for residents of RACF through community pharmacies.
• Oseltamivir(Tamiflu®) can be used in residents with confirmed influenza or for prophylactic use in exposed residents during influenza outbreaks in RACFs. Use of this medicine may shorten the duration and severity of the illness.
• Molnupiravir(Lagevrio®) and Nirmatrelvir/ritonavir (Paxlovid™) can be used in people with confirmed COVID-19 in the community (including in RACF) with mild to moderate symptoms who are immunosuppressed or who are aged over 50 and at risk of severe disease OR people who are aged 70 and over whether they have symptoms or not. The drug should be commenced as early as possible but no later than day 5 after symptom onset.

The administration of antiviral treatments soon after symptom onset for people with COVID-19 or influenza can reduce disease severity. Additionally, the administration of influenza antivirals to residents of RACF after exposure improves clinical outcomes and assists in controlling the outbreak.

CESPHN and NSW Health are working with general practitioners and providers of RACF to make sure residents are aware of these medications and can receive them as soon as they need them.

Vaccination for children aged 6 months to under 5 years

Following the Therapeutic Goods Administration’s (TGA) approval of the Moderna vaccine for children aged 6 months to 5 years, the Australian Technical Advisory Group on Immunisation (ATAGI) recommends COVID-19 vaccination for children aged 6 months to under 5 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19.

The recommendation is for 2 primary doses, except for those children with severe immunocompromise who will require 3 primary doses. The recommended interval between each dose is 8 weeks.  At this stage, ATAGI does not recommend vaccination for children aged 6 months to under 5 years who are not in the risk categories for severe COVID-19. These children have a very low likelihood of severe illness from COVID-19.

Advice: Paxlovid post labelled expiry date

The Therapeutic Goods Administration (TGA) is advising that nirmatrelvir + ritonavir (PAXLOVID) tablet blister packs for the batch numbers below, can be used up to the revised (‘new’) expiry date, provided that approved storage conditions of storage below 25 °C have been maintained.

Fourth dose eligibility and COVID boosters

ATAGI has updated its recommendations for an additional booster dose (fourth dose) for selected population groups who are at greatest risk of severe illness from COVID-19. This quick reference guide can be used by vaccine providers to assist in identifying patients eligible for a 4th dose of a COVID-19 vaccine.

Please encourage COVID booster doses as many people in our region are not receiving maximal protection from COVID-19 see the ATAGI Latest Update . Adults aged 65 years or older who have not yet received a winter dose of COVID-19 vaccine should get this as soon as possible.  Booster doses in older adults, will help reduce the number of COVID-19 related hospitalisations over the coming months.

Please consider the use of antiviral treatment in people diagnosed with COVID-19, including in people aged 50 years and above and reinforce messages on mask wearing.

The interval between the first booster and the winter booster (4^th dose) has been reduced to 3 months (from 4 months) to provide earlier protection from the additional vaccine during winter.

COVID at Home visiting service

We encourage GPs to refer to the COVID@Home Service which provides an ‘in-home’ assessment service delivered by a Registered Nurse with the support of a GP.

This service is for COVID positive patients whose regular GP is not able to undertake home visits but where such a visit is required for medical and other support reasons while the patient is isolating. Referrals will only be accepted from GPs. Find out more about the service and how to refer. If you have any enquiries, contact coronavirus@cesphn.com.au.

Free infection control advice on Zoom

We are offering specialised one-on-one Zoom consultations with an experienced primary care infection control educator to assist with infection control procedures.

GPs should consider facilitating either telehealth or in person consultation for patients with respiratory symptoms. When in person consultation is indicated, the patient should be given a surgical mask and hand sanitiser and practice staff should wear eye protection and a mask.

To book a session, email your interest to coronavirus@cesphn.com.au with the subject line: “Yes I would like infection control advice”.

CESPHN Vax at Home service

The CESPHN Vax at Home Service is for those people who are housebound and not able to leave their house to receive a COVID-19 vaccination or booster. The service will accept referrals for people 16 years and over. Referrals will be accepted from GPs and from Local Health Districts. Patient self-referrals will not be accepted.

All Vax at Home Service referrals must be sent through this Vax at Home Service Online Form. Please also indicate if an influenza vaccine is also required. Please note, a referral will need to be attached to the online form. For further information on the program, please contact us.

Ordering process for PPE

Access to PPE is now via Living with COVID PPE Bundles ordered nationally through PHNs using an online order form and delivered directly by a national distributor (rather than via PHNs). Access to PPE from the National Medical Stockpile is dependent on eligibility, and PPE volumes will be monitored by the Commonwealth Department of Health.

General Practice, ACCHS and GPRCs ordering information

Living with COVID PPE Bundles are available for:

GP, ACCHS and GPRCs willing to manage COVID positive patients face-to-face, until 30 September 2022.

ACCHSs and rural and remote GPs willing to treat COVID positive patients virtually and respiratory patients face-to-face, where workforce capacity is limited AND the GP is serving the community for most of all health needs, until 30 September 2022.

GPs and GPRCs willing to support COVID positive people virtually, and respiratory patients face to face, until 30 September 2022.

Orders can only be placed once per month and be submitted to the PHN via the online form.

Please read the guidance document before placing your first order:

GP, ACCHS and GPRC: Completing New PPE Order Form Guide

GP, ACCHA and GPRC online ordering form

PPE for the health workforce during COVID-19

PPE for COVID-19 includes surgical masks, particulate filter respirators (such as P2 or N95), gloves, goggles, glasses, face shields, gowns and aprons. For more information go to COVID PPE Information for Health Professionals.

Accessing pulse oximeters for your patients

Individual patients – we have access to a small supply of oximeters. GPs with patients they believe require a pulse oximeter urgently are asked to complete this CESPHN Pulse Oximeter online form with the patients details and we will arrange delivery of an oximeter.

General practices – practices actively seeing moderate risk COVID positive patients can also be sent up to 10 pulse oximeters per practice via the new PPE online ordering form. If your practice has already received 10 pulse oximeters via the previous process, you will need to access future stock through your local suppliers.

Webinar

COVID-19 response update

• About: primary care update on the COVID-19 response and the vaccine rollout – key updates and Q&A
• Thursday 11 August 2022 at 11:30am (AEST) – Click link to join

•  %MCEPASTEBIN%