HealthCert Blog

Important coronavirus (COVID-19) update for GPs from Professor Michael Kidd, Deputy Chief Medical Officer, Department of Health

Australia’s general practitioners have been an essential component of supporting our nation’s response and helping everyone adhere to the measures needed to ensure the safety and wellbeing of our population.

The significant fall in the daily number of new COVID-19 cases across the nation is a testament to the rapid action by Australia’s governments and the willingness of all Australians to do their bit to contain the virus.

I understand the news of reduced infection rates will bring increased questions from your patients on how much longer the measures will be required. For now, the Prime Minister has said social restrictions will remain in place at least for the coming month.

As respected members of the community, I ask that you continue to emphasise with each of your patients about the need to continue to practise hand hygiene, physical distancing, self-isolation if feeling unwell, and adherence to social restrictions. I know there will be particular challenges for our patients who will be observing Ramadan over the coming month and who may seek your advice. Please encourage them to practise their faith within their household or participate in streamed services.

It’s likely that some of you will also receive questions from parents in regards to sending their children back to school. The latest advice from the AHPPC is available here.

Professor Michael Kidd AM
Deputy Chief Medical Officer & Principal Medical Advisor
Department of Health

1. Category 2 and certain Category 3 elective surgeries to resume

The Prime Minister has announced that as a result of Australia’s success in flattening the curve, our low rates of COVID related hospitalisation and new data on stocks of PPE, National Cabinet agreed that from 27 April 2020, Category 2 elective surgery and some important Category 3 procedures can recommence across the public and private hospital sectors.

National Cabinet confirmed that the following procedures can recommence from 27 April 2020:

• IVF
• Screening programs (cancer and other diseases
• Post cancer reconstruction procedures (such as breast reconstruction)
• Procedures for children under 18 years of age
• Joint replacements (incl knees, hips, shoulders)
• Cataracts and eye procedures
• Endoscopy and colonoscopy procedures

PPE stocks for these elective surgeries and procedures will not be taken from the National Medical Stockpile. These arrangements will be reviewed by 11 May 2020, to determine if other elective surgeries and procedures can recommence and volumes increased.

National Cabinet further agreed to the Australian Dental Association recommendation that dentists move to level 2 restrictions (such as fitting dentures, braces, non-high speed drill fillings and basic fillings), allowing a broader range of dental interventions to occur where the risk of transmission can be managed and PPE stocks procured by the private sector.

2. Update on telehealth

The COVID-19 pandemic has significantly altered the way health care is delivered in our country, with more than 4.9 million health and medical services delivered to more than three million patients through the temporary telehealth items introduced by the Australian Government.

Thank you to all GPs who have embraced the expansion of telehealth. The telehealth arrangements have been put in place to ensure safety for patients and practitioners during the COVID-19 pandemic.

Some conditions and consultations are not appropriate for telehealth. GP clinics need to remain open to allow attendance by patients who need face-to-face consultations and assistance.

The Government is supporting general practices to keep their doors open by doubling the bulk billing incentive and Practice Incentive Payment. GPs and Other Medical Practitioners must continue to bulk bill the COVID-19 telehealth and telephone consultation services where the service is provided to a concessional or vulnerable patient or a child under 16. For all other patients, normal billing practices may be applied.

Vulnerable means a patient at risk of COVID-19, so a person who:

• is required to self-isolate or self-quarantine in accordance with guidance issued by the Australian Health Protection Principal Committee in relation to COVID-19; or
• is at least 70 years old; or
• if the person identifies as being of Aboriginal or Torres Strait Islander descent—is at least 50 years old; or
• is pregnant; or
• is the parent of a child aged under 12 months; or
• is being treated for a chronic health condition; or
• is immune compromised; or
• meets the current national triage protocol criteria for suspected COVID-19 infection

The Government will continue to review and refine telehealth policies throughout this period. Details of the additional telehealth items implemented since March 13 are available on the MBS website.

3. New telehealth guidance for practitioners

AHPRA and the National Boards have released telehealth guidance for health practitioners. The guidance outlines expectations as to how registered health practitioners will use telehealth in the context of the COVID-19 pandemic and discusses how the Code of Conduct is applied to consultations carried out via phone or video conferencing.

4. Personal Protective Equipment (PPE) update

The Australian Government has now received 58 million protective face masks that will help provide essential protection for frontline health workers at risk of COVID-19. The protective face masks have arrived ahead of the scheduled delivery date of the end of April, and in greater numbers than the 54 million previously predicted. They will allow for additional allocations to be released from the National Medical Stockpile to healthcare workers.

The Government’s highest priority is to ensure access to masks and other PPE for health and aged care workers – people who have a high risk of close contact with COVID-19 cases. At this time, the Government is only supplying P2 and surgical masks from the National Medical Stockpile to workers at the highest risk of exposure. Other forms of PPE will be made available once additional supplies are received.

The Government is currently prioritising distribution of supplies to places that are most in need, including:

• public hospitals (supporting the states and territories), general practices, community pharmacies and other frontline settings.
• residential aged care facilities with an outbreak of COVID-19 because of the vulnerability of residents to severe illness and death from the virus.

PPE should be worn when caring for someone with a confirmed or suspected case of COVID-19. Wear a gown, mask, protective eyewear and gloves. Remove PPE before exiting the room or the person’s home. Wash or sanitise hands immediately after removing PPE.

GPs are being urged to work with their PHNs and use available resources with caution and care.

5. Update on GP-led respiratory clinics roll-out

The number of GP-led respiratory clinics in operation continues to grow, with 34 now open around the country, 11 of which are in regional and rural communities. These respiratory clinics provide dedicated services to people with mild to moderate respiratory symptoms and/or fever.

Thanks to all GPs who have established clinics so far and those that are finalising details with the Department. The plan is to have up to 100 operational in metropolitan, regional and rural areas across Australia. These GP-led clinics complement the 253 respiratory clinics operating nationally, which includes 224 state and territory fever clinics, and 29 ADF clinics (for ADF personnel). Find the GP-led clinic near you.

6. Update on population cancer-screening programs

There has been some confusion in the community about the status of the national cancer-screening programs during the COVID-19 pandemic. The pandemic is impacting the three cancer screening programs differently.

Some states and territories have paused BreastScreening services.   This situation is being reviewed regularly by individual jurisdictions. Information for your patients about BreastScreening can be found at the BreastScreen Australia website.

The National Cervical Screening Program is encouraging healthcare providers to continue to offer routine screening and follow up. Noting that under the current circumstances, patients may feel uncomfortable to attend appointments and healthcare providers have different capacities and arrangements during this time, the following documents are now available on www.cancerscreening.gov.au/cervical:

• Overarching guidance to assist with clinician decision-making on screening appointments including deferral and rescheduling, depending on individual patient circumstances
• Guidance for the management of patients requiring further investigation and treatment during the pandemic due to the cancellation of elective surgeries.

Participants in the National Bowel Cancer Screening Program will continue to receive screening kits and results through the mail. Participants with positive home test kit (iFOBT) results will still require follow-up, and their results letter will advise them to contact their GP to seek advice.

You should continue to refer your patients to colonoscopy services for further investigation where appropriate. The availability of colonoscopy may increase over the coming weeks as private hospitals and other clinics increase available services.

Information on each of the screening programs is being regularly updated on the cancerscreening.gov.au website.

7. Flu vaccination update

The Australian Government has secured three million additional doses of seasonal influenza vaccine to protect Australians from the flu, bringing the total number of doses of flu vaccine available for Australians to 16.5 million for 2020. These three million additional doses will be available via GPs and community pharmacies across April, May and June. This includes approximately two million doses of the quadrivalent vaccine, Afluria Quad® (supplied by Seqirus).

The Government has already secured a record 8.6 million vaccines for the National Immunisation Program (NIP), including more than four million doses of Fluad Quad®, which is recommended for people aged 65 and over. This is enough to provide free vaccines through the NIP to almost 100 per cent of people aged 65 and over.

Around 7.9 million vaccines will be available through the private market through GPs, community pharmacy and other vaccine providers.

Patients are being encouraged to contact you or their community pharmacy to book an appointment to get their flu shot throughout April and May, unless they have a medical reason that would prevent them from getting a vaccine.

8. Racism is never okay

The Department has been made aware of concerning information around racist comments and attitudes directed towards health care workers of Asian backgrounds. This is very disappointing to hear, and sadly reflects the experience of a number of Asian-Australians around the country at the moment. Under no circumstances is racism ever okay.

The shock of experiencing or witnessing racism can make it hard to know what to do. For tips on how you can stand up to racism and keep yourself and others safe, visit the Human Rights Commission website.

Original source: https://mailchi.mp/health.gov.au/covid-19-update-for-gps-from-the-chief-medical-officer-xxxxxx-4404791?e=83862cc2c1

See last week’s update from Professor Michael Kidd here.

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