Coronavirus-Letter from Chief Medical Officer

Dear colleagues,

I am writing to update you on the Coronavirus (COVID-19) outbreak and to outline the Commonwealth’s current and future support for the central role you are playing in our national response.

I thank you for your efforts so far and encourage you to maintain your vigilance in assisting to prevent further transmission of this disease.

To protect all Australians from the COVID-19, including vulnerable groups such as the elderly, the Australian Government has announced a comprehensive $2.4 billion health package.

This package includes: ? $100 million to fund a new Medicare telehealth service; ? $25 million for vulnerable people in the community, including those in self-isolation, to order and receive their PBS/RPBS medicines; ? $50.7 million to expand the 24/7 national hotline (1800 020 080) to help triage people with respiratory symptoms and those who are concerned about contact with a possible COVID-19 case. Aged care providers should encourage and support care recipients to access this hotline as appropriate; ? $206.7 million for up to 100 private practice respiratory clinics to provide dedicated services to people with mild to moderate COVID-19 symptoms; ? $170 million to establish a bulk-billed pathology (microbiology) test for COVID-19. This includes specialist “in reach” pathology testing in aged care facilities; ? $30 million for COVID–19 research to enable Australian researchers to contribute to global efforts to control the outbreak; ? $1.1 billion to increase Australia’s supply of personal private protective equipment and pharmaceuticals held in the National Medical Stockpile; and ? $30 million for a new national communications campaign.

Importantly, the package also includes $101.2 million to educate and train aged care workers in infection control, and enable aged care providers to hire extra nurses and aged care workers for both residential and home care.

  • 2 – The Aged Care Quality and Safety Commission will receive additional funding to work with providers on improving infection control.

Situation as at 12 March 2020

As you will be aware, the international situation has changed significantly in the last few weeks. New imported cases are being seen every day, some from countries not previously identified as high risk.

On Tuesday, 3 March, New South Wales Health identified an aged care worker with COVID-19 at the Dorothy Henderson Lodge, operated by BaptistCare in Sydney. The staff member, who has worked at the facility for more than two decades, had not travelled overseas. She presented with symptoms on 24 February 2020 and is being treated at Royal North Shore Hospital and is in a stable condition.

This represents the first case of COVID-19 identified in relation to an aged care facility. Five aged care residents at the facility have since tested positive for COVID-19, and were transferred to hospital. Sadly, two of these residents have died. A further two staff, and several close contacts outside of this facility, have tested positive for COVID-19.

NSW Health is working with the facility to contact trace, and support infection control measures on the site. The Dorothy Henderson Lodge has been closed to visitors and this arrangement will remain in place until advised. The priority is the safety of all residents and staff involved.

Disease characteristics

Current information about COVID-19 shows that the majority of people with COVID-19 infection (>80 per cent) have a mild form of the disease. This mild disease contributes to the high transmissibility of the virus. However, we are also very conscious older people are at much greater risk of serious illness.

Reducing exposure in aged care settings

Isolation or cohorting of people with COVID-19 is key to containing the rate of transmission of the virus.

Our current response, under the Australian Health Sector Emergency Response Plan for COVID-19, is focused on early identification of cases, isolation, contact tracing and quarantine.

We have previously advised the community, that if they believe that they have been exposed to COVID-19, they should phone their GP or local health service before attending.

One of the important messages is the value of basic standard hygiene (hand washing, cough etiquette, social distancing) in preventing transmission. As trusted care providers in our community, I appreciate your assistance in communicating this message to your workforce, senior Australians, their families and friends.

  • 3 –

In coming days, the Communicable Diseases Network of Australia (CDNA) will release National Guidelines for the Prevention, Control and Public Health Management of COVID-19 Outbreaks in Residential Care Facilities in Australia.

Aged Care COVID-19 Preparedness Forum

Given the increased risk to senior Australians, the Minister for Aged Care and Senior Australians, Senator the Hon Richard Colbeck and I convened an Aged Care COVID-19 Preparedness Forum on 6 March 2020. The forum was convened to address priority issues for ensuring appropriate planning and preparedness is in place across the aged care sector.

In addition, the forum discussed the importance of and need for aged care providers to: ? maintain their facility’s Infection Control protocols; ? be ready to activate their facility’s COVID-19 Emergency Response Plan, including testing and updating assumptions in those plans; ? finalise arrangements for seasonal flu vaccinations for residents, staff and volunteers; and ? communicate regularly with care recipients and their families, as well as staff.

A further forum (webinar) will be held today and will focus on COVID-19 preparedness for home care providers, Community Home Support Programme (CHSP) Providers and the assessment workforce.

Personal Protective Equipment (PPE)

Generally there is no need for aged care workers (or the public) to wear masks. Health and personal care workers are advised to wear masks only when dealing with symptomatic patients or consumers.

Evidence currently suggests droplet spread is the main mode of transmission, and surgical masks are adequate and much easier to fit than P2 masks. The current PPE guidelines are available on the Department of Health’s website.

However ensuring Australia has sufficient medicines, face masks and other personal protective equipment is crucial to the COVID-19 response. The funding announced in the response package will ensure patients and critical health care staff have access to face masks, and other protective equipment.

Communication

The evolving nature of this outbreak has required public health advice to evolve rapidly. A new national communications campaign will keep the general community and the aged care sector informed, with up to date clinical guidance, information on triaging and caring for patients, development of an app and advice to workers in looking after their own safety.

  • 4 – The Department will continue to deliver information to the sector through its usual channels. Workers and providers can subscribe to the aged care sector announcements and newsletters on the Department’s website.

The Department is also working closely with the Aged Care Quality and Safety Commission in monitoring the impact of COVID-19 on the aged care sector. I am aware the Commissioner is also communicating to aged care service providers on the Commission’s regulatory response and other activities.

No one can accurately predict how the COVID-19 outbreak will develop in Australia. Our collective response has to be flexible and collaborative. The Australian Government has committed to provide the necessary resources to support the response in whatever form it needs to take.

Yours sincerely

Professor Brendan Murphy Chief Medical Officer

13 March 2020

Absolute Home Care