Advice for Health Professionals

Novel Coronavirus​
(COVID-19 also known as 2019-nCoV)

Novel coronavirus (COVID-19 also known as 2019-nCoV) is a new strain of coronavirus affecting humans. This is an evolving situation and we will endeavour to keep this page updated with new information as it becomes available.

Updated 22 May 2020.

If you can’t find the information you are looking for below, you can request additional assistance

Get Regular COVID-19 email updates 

Clinical Information

Mid & North Coast NSW HealthPathways has up-to-date clinical information for GP point-of-care

Watch this two-minute video to learn how the HealthPathways COVID-19 response package helps general practice teams manage patients, prepare the practice, and keep up-to-date with rapid change in the health system. See how to send feedback on the content.

National COVID-19 Evidence Taskforce

The National COVID-19 Clinical Evidence Taskforce has launched a new website to provide:

  • weekly updates of evidence-based clinical guidelines updated with the latest research
  • taskforce endorsed flowcharts
  • evidence under review

Clinicians are invited to post questions about the clinical care of people with COVID-19 to help prioritise topics for the taskforce.

Dr Dan Ewald, North Coast PHN Lead Clinical Adviser, is a member of the expert guideline panel for mild disease.

Please see links below for latest versions of Australian Guidelines for the Clinical Care of People with COVID-19:

Practice Operations

Financial Assistance for General Practice

We know the COVID-19 situation has been a financial shock for general practices.

There are a variety of support measures in place for general practices affected by the impact of COVID-19. These include support measures from the Australian Government, the NSW Government, tax relief initiatives via the Australian Taxation Office and support packages from Australian banks.

A summary of available supports can be downloaded here.

Please also see an updated communique from the Department of Health on changes to the Practice Incentives Program (PIP) and Workforce Incentive Program (WIP).

You can download a COVID-19 and Employment Law summary here. This short document from Price Waterhouse Cooper summarises the issue of stand down and other employment considerations flowing from COVID-19.

To access free NBN connection upgrades (to 50 Mbps download and 20 Mbps upload), please contact your internet provider. Better connectivity will support your move to telehealth.

North Coast PHN would like to thank our generous colleagues from the Murrumbidgee PHN along with Medical Business Services, Riwka Hagen and Kim Poyner of Medicoach, for agreeing to share this segment of a longer webinar they held with GPs in Murrumbidgee last week. Riwka, an experienced practice manager and practice coach, goes through each of the forms of financial support and discusses how you might apply them. It’s just under 25 minutes and we hope it helps. Please let us know if you need further assistance.

Personal protective equipment (PPE)

Download masks information flyer

Personal protective equipment (PPE) is vital for protecting frontline workers and vulnerable community members from infection. It includes masks, gloves, goggles and gowns.

Currently, there is a worldwide shortage of PPE due to the COVID-19 pandemic. However, the Australian Government has secured significant stocks of additional masks scheduled to arrive by the end of April. At present, masks are only available to workers at the highest risk of exposure. Other forms of PPE will be made available once additional stocks are received.

North Coast PHN has a limited supply of masks available for distribution to general practitioners (GPs), Aboriginal Community Controlled Health Services (ACCHS), community pharmacists and allied health service providers.

Surgical masks are available for GPs, ACCHS and community pharmacists who have no local supply available, an unusual number of patients with respiratory symptoms, or are in high risk locations.

Allied health professionals are able to access a limited supply of masks for use of their staff when there is no available commercial supply and they are working in higher risk clinical areas, and with higher risk vulnerable patients. Please also note advice regarding aerosol generating respiratory therapies here.

P2 masks are only available to GPs and ACCHS who need to assess suspected COVID-19 cases because they do not have a dedicated respiratory clinic or emergency department nearby. P2 masks are only required for aerosol generating procedures or where there is uncontrolled coughing and must be used with other appropriate PPE and isolation facilities. If your practice requires P2 masks, please email: qi@ncphn.org.au

Two boxes of surgical masks (100 masks) are available per practice in each delivery period for general practices and AMSs. One box (50 masks) is available for pharmacy and allied health.

To request surgical masks from NCPHN, please click here.

Further information on mask usage and distribution is available here.

Due to high demand, a number of businesses are sourcing or producing additional supplies of hand sanitiser. NCPHN is sharing the details of these businesses but does not guarantee, and accepts no legal liability for, the accuracy, reliability, currency or completeness of any services provided by the businesses.

Hand Hygiene Australia recommends that alcohol solutions containing 60-80% alcohol are most effective. Information is available here.

Medical services in need are invited to contact:

Infection Control

Contact and droplet transmission precautions are recommended for patients who:

  • have isolated, or
  • with suspected or confirmed nCoV infection.

Visit the HealthPathways COVID-19 Assessment and Management link for recommended infection control measures.

Click here to enlarge image

You can also:

Medico-legal concerns

If you have medico-legal concerns speak to your insurer. The RACGP has a range of links to advice from insurers – see the section on Medico-legal concerns.

Patient triage example flowchart

This example flowchart has been developed following the Australian Government’s universal telehealth announcement. This resource will continue to be developed as the COVID-19 situation develops.

You can also download Prof. Trisha Greenhalgh BMJ article on assessing COVID-19 remotely.

Click to enlarge | download here

Models of Care

MBS item numbers and making the move to telehealth

With the Australian Government announcement of a universal telehealth model, North Coast primary health care providers are now able to deliver essential Medicare-funded services remotely to ensure continued access to primary care during the COVID-19 (coronavirus) pandemic.

For more information on telehealth item numbers, please see this Commonwealth Department of Health Fact Sheet (last updated 06 April).

Visit MBS Online for a full list of telehealth item numbers.

Enquiries on the Medicare Benefits Schedule, including using and interpreting items numbers, should be directed to: AskMBS@health.gov.au

Bulk Billing Criteria (summarised):

Telehealth services may be bulk billed for Commonwealth concession card holders, children under 16 years old and patients who are more vulnerable to COVID-19 – that is, 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.

Health providers may apply their usual billing practices to the telehealth items for patients who do not fit the above criteria.

Resources and webinars

The move to telehealth is twofold – it means using new technologies and, importantly, developing new workflows for your patient consultations. Both are needed for success.

Here are some resources that could assist.

Webinars are also a way of working through the changes to your usual consulting practice.

Recorded 24 March 6 pm – 7:30 pm

Hosted by the Digital Health Cooperative Research Centre, chaired by Norman Swan.

Guests included:

  • Prof Trish Greenhalgh (UK)
  • Dr Amandeep Hansra (GP, NSW)

Click here to view the webinar.

Thursday 9 April, 6 pm- 7:30 pm

Hosted by the Digital Health Cooperative Research Centre, La Trobe University and Curtin University.

Australian GP Dr Amandeep Hansra and UK GP Dr David Triska, will share their experiences of implementing telehealth (phone, online and video consultations) and provide practical tips and advice based on their first-hand experiences

Click here to register.

healthdirect Video Call access now available

North Coast healthdirect Video Call is now available for our health workforce to be able to use this purpose-built suite of services, tools and resources. Download healthdirect’s Video Call factsheet here.

COVID-19 MBS telehealth items are now available for GPs, specialists, consultant physicians, obstetricians, consultant psychiatrists, nurse practitioners, allied mental health workers and midwives.

Get started today!

We will be creating individual clinic accounts for Mid and North Coast general practices, AMSs, mental health care professionals and other primary care providers that wish to use video calls. This is part of our COVID-19 response, but can also be used for standard service video calls/consultations.

Our Digital Health Team will create your logins and support you to start using this great platform.

Influenza Immunisation

Influenza immunisation has never been more important than in 2020.

This year’s flu vaccinations will take more planning to work around the limitations imposed by COVID-19.

To help, Carolyn Lloyd, Immunisation Coordinator at NNSWLHD, has recorded a 15-minute webinar on vaccinating during COVID-19. Her presentation is packed with useful tips and information to help you.

Carolyn herself is happy for you to contact her directly if you would like specific advice about vaccinating at your practice:

Dr Brett Lynam has kindly shared the approach he will use at his practice:

Download Dr Lynam’s flu vaccination policy and procedures due to COVID-19 pandemic.

Brett would like to point out that his clinic allows an ‘outside’ waiting room and they have sufficient nurses to run it as set out – this will not necessarily work everywhere. Thanks Brett, great to be able to learn from a colleague!

Click here for more assistance, resources and to follow our progress in a region-wide QI goal to maintain our level of influenza vaccination in 2020.

Vaccines are expected to be available from early April.

Mental health support - patients and health workers

Webinar for Mental Health and Allied Health Providers

On Friday 27 March 2020, North Coast PHN held an information session for local mental health and allied health service providers.

Check out the video to gain information about:

  • The emerging COVID-19 situation within the North Coast region.
  • Measures that providers can undertake to minimise the risk of spreading infection while continuing to deliver services.
  • The likely impact (from a mental health perspective) of COVID-10 on our community, primary care and hospital services.
  • Suitable platforms for use when delivering services via telehealth.

There is much information available on how to best support your patients’ mental health during the COVID-19 outbreak.

Click here for a comprehensive and up-to-date list of mental health and psychosocial considerations from the World Health Organisation’s (WHO).

The WHO information includes the importance of empathy towards those affected by COVID-19; ways to refer to people with the virus to reduce stigma; and suggestions on how to lessen people’s anxiety.

Other excellent material regarding mental health and the coronavirus can be found at the Life in Mind site. Life in Mind has collaborated with the National Mental Health Commission to produce a comprehensive list of resources to support those affected.

Some of these resources are listed below:

The World Health Organisation (WHO) says feeling under pressure at the current time is normal. Stress and the feelings associated with it are not a reflection on you or your work.

Be aware that managing your mental health and psychosocial wellbeing during this time is as important as managing your physical health.

Click here for the WHO recommendations, which include:

  • Ensuring sufficient rest and respite during work and between shifts
  • Eating sufficient and healthy food
  • Engaging in physical activity
  • Staying in contact with family and friends
  • Using coping strategies that have worked for you in the past
  • Turning to your colleagues, your manager or other trusted persons for social support

The Royal Australian College of General Practitioners recognises that GPs’ work is often challenging and stressful. Click here for self-care and mental health resources and services to support RACGP members.

GPs and support for older Australians

  • Get set up with telehealth and online scripts so you can keep delivering care to residential patients. Click here for more information on telehealth, including access to the healthdirect Video Call service. Don’t forget that:
    • You can team up with an onsite registered nurse or physiotherapist to support physical examinations.
    • Home care providers can support clients to teleconference.
  • Update advance care directives with patients and their families. Consider how COVID-19 changes the end of life directives for the resident and risks for the family visiting. More information is available from the HealthPathways [Username: manchealth  Password: conn3ct3d]
  • Engage with residential care facility management and become familiar with their infection prevention and control practices and outbreak management.
  • Consider regular ear wax checks now that audiology services are limited or do not have access to facilities.
  • Refresh your knowledge of end-stage palliative respiratory symptom management. More information is available from HealthPathways [Username: manchealth  Password: conn3ct3d]
  • Older people at home can be very lonely. It is important for older people to maintain contact with their community aged care providers and not refuse services. The aged care sector is working differently to meet the safety requirements of COVID-19, e.g. a house cleaning visit may become a gardening visit and chat while maintaining physical distancing. Welfare checks are occurring regularly through a range of approaches, including waving at the front gate.
  • TESTING – know which pathology services are providing mobile testing into RACFs and into private homes. The mobile services are targeting vulnerable people, not the general population. You will have one in your area!
  • Update advance care directives with patients and their families. Consider how COVID-19 changes the end of life directives for the resident, the risks for the family visiting and the risks of abnormal bereavement, particularly in light of recent changes to funerals (viewing the body, public gatherings, etc). Click here to learn more here. Additional information on advance care directives is available here.
    • Advance Care Planning Australia webinars are available here.
  • Oxygen – encourage older people at home to order earlier than normal, supplies are tight.
  • Know when staff go to work in the aged care sector. Click here to learn more.
    • They need to receive their flu vaccinations by 1 May with a certificate or evidence that they have had it.

If you work predominately in RACFs:

  • Keep up to date through the cross sector aged care Basecamps. Check the ‘Looking for more information’ section below to be added to the network email list.
  • Support the staff to understand that testing without symptoms gives a false reading. This is often requested when the hospitals transfer residents back.
  • Support the staff to understand the significance of staff flu vaccinations. If we had a vaccine for COVID-19, would you have it?
  • If you need support with infection protection and control practices with older people, check the ‘Looking for more information’ section below.

Detailed information on COVID-19 for the health and aged care sector is available from the Department of Health website.

Sector support and updates:

  • Extensive funding packages are available to subsidise RACFs with outbreaks, provide staff incentives during the pandemic, etc.
  • The changes to the assessment process to enter aged care services have been placed on hold.
  • For daily newsletter updates to the industry, subscribe here.
  • The  Royal Commission into Aged Care Quality and Safety activities have been placed on hold, submissions are still be accepted with constant changing deadline.
  • PPE supplies for all aged care providers are now through the one email address ensuring equal access. Limited supplies are starting to be delivered.
  • NSW Ministry of Health will be including a respiratory status section in all discharge letters from hospitals.

Residential aged care facilities:

  • Facilities with confirmed COVID-19 cases will be able to access personal protective equipment from the national stockpile.
  • The Communicable Diseases Network Australia Coronavirus (COVID-19) Guidelines for Outbreaks in Residential Care Facilities is available here.
  • Some pathology services are establishing mobile services to cover nursing homes. LHDs are considering how to support this if pathology is not available.
  • Implementing visiting guidelines to no more than two visitors per day.
  • All staff and visitors must carry evidence of flu vaccines by 1 May to enter homes.
  • Fly-in fly-out teams are being coordinated by NSW Ministry of Health, should any RACF experience staffing issues during a COVID-19 outbreak.

Community aged care services:

  • People aged 65 years and older with confirmed COVID-19 can access urgent or immediate Commonwealth Home Support Programme services for six weeks without assessment through My Aged Care.
  • Commonwealth Home Support Programme services that are group social / transport activities have been encouraged to look at alternate models and funding has been made more flexible to support this.
  • Community providers are routinely screening clients before a visit. For all people living in community with COVID-19 a home isolation kit is sent through the LHD Public Health Unit and includes masks, hand hygiene products and directions on how to look after themselves and their families.
  • Extensive planning and preparations are underway in community aged care services. Group respite programs are cancelled and are starting to do 1:1 visits to people’s homes. Personal protective equipment is limited, particularly Commonwealth Home Support Programme services such as transport, new approaches to service are being considered.
  • The COVID-19 guide for home care providers in home care is now available.
  • Additional funding is available to providers to extend home care packages during COVID-19.
  • Older people with no services who require support with shopping, hygiene and meals can access Commonwealth Home Support Programs during COVID-19 without an assessment. Access through My Aged Care or direct to local services.

Key resources:

 

North Coast PHN is working collaboratively with the Mid North Coast and Northern NSW LHDs, residential aged care facilities and community aged care providers to ensure a coordinated response to COVID-19. Regular virtual region-wide meetings are being held and an online resource library has been created on Basecamp to support collaboration and networking across services.

NCPHN has supported both LHDs RACF planning activities through undertaking extensive planning surveys. Of note are the small number of RACFs with only RN on call coverage over night and limited GP coverage in some facilities. Other activities include supporting services that are requiring support with infection prevention and control practices. Modelling of pathways for older people during COVID-19 is in its early stages and will result in broad collaboration with LHDs and the aged care sector to provide clarity of local supports for older people during COVID-19.

Extensive planning and preparations are underway in facilities. Visitor changes with no more than two visitors at once are being enacted with many facilities stepping this up to a semi lockdown approach with only health professionals able to enter facilities. Consideration is being provided for families of residents who are terminal and/or palliative.

Families are being encouraged to communicate through telehealth and ‘window visits’ are being set up. Welfare roles have been established in some facilities to focus on maintaining family connections.

Extensive planning and preparations are underway in community aged care services. Group respite programs are cancelled and are starting to do one on one visits to people’s homes. Personal protective equipment is limited, particularly Commonwealth Home Support Programme services such as transport, new approaches to service are being considered.

Some community services are struggling to provide their standard services. Reasons are diverse, including supplies of PPE. Of note are transport services and smaller programs whose infection prevention and control understanding may need support. A toolbox of resources is currently being sourced by NCPHN to assist these programs. Transport meetings are being negotiated in NNSW with social sector support services.

Extensive planning and preparations are underway in the local health districts including a range of activities to support residential aged care facilities to keep residents at home. See ‘Secondary triage system for residential aged care‘ below.

MNCLHD has developed a listing of services and providers offering support and shopping for older people. A similar list is being built in NNSW by Social Futures. Links will be published as they become available.

Palliative Care – both LHD’s services are keen to support GPs with any complex cases during this time, in particular end stage respiratory distress with COVID-19. MNCLHD is setting up a palliative care hotline – more as this becomes available.

The NSW Ministry of Health has enacted a statewide secondary triage system of residents in nursing homes.

All non-urgent flu and COVID-19 related calls from residential aged care facilities to NSW Ambulance will now be secondarily triaged by a remote accredited emergency physician consultation service.

All clinically appropriate patients will be diverted to community-based models of care, keeping in line with public health recommendations.

Local health districts are responding to support the triage system.

  • NNSWLHD has developed a nurse practitioner led in-reach program of support for RACFs. It is now accepting referrals and providing advice and support to RACFs. Click here to download a fact sheet. Learn more via HealthPathways [Username: manchealth  Password: conn3ct3d].
  • MNCLHD is currently communicating the outreach pathways through COVID-19 cross sector channels to: nurse practitioners, palliative care services, community nursing services and psychogeriatric services.
  • NCPHN has provided extensive support to building these systems by updating existing RACF listings and building a profile of homes and after hours key contacts, linking the LHDs together through extensive COVID-19 communication strategies and sector knowledge. Strong, collaborative, integrated ways of working are being built.

Dementia Australia has added a range of COVID-19 fact sheets with tips for people living with dementia.

The fact sheets are available now and include:

  • Tips for people living with dementia – outlines the coronavirus/COVID-19 symptoms, hygiene tips, the importance of having a good support network, ideas to remain active and engaged while in self-isolation, and where to go for help.
  • Tips for carers, families and friends of people living with dementia – outlines the coronavirus/COVID-19 symptoms, hygiene tips, helpful tips for primary carers, as well as for family, friends or neighbours, ideas for remaining active and engaged while in self-isolation, and where to go for help.
  • Tips for residential care providers – outlines the impacts coronavirus/COVID-19 may have on residents, tips on alternative activities and how to support continued engagement with families and carers.
  • Tips for home care providers – outlines the impacts coronavirus/COVID-19 may have on a person living with dementia, tips to reduce heightened anxiety and where to go for help.

Click here to learn more.

Contact Bron McCrae, Deputy Director Healthy Living and Ageing, North Coast Primary Health Network at bmcrae@ncphn.org.au or phone 0447 113 823.

Aboriginal community resources

North Coast Primary Health Network (NCPHN) is committed to ensuring regional leadership and response to the COVID-19 (coronavirus) pandemic. This COVID-19 Response Framework for Aboriginal Communities on the North Coast has been developed to provide guidance to health care providers to best support Aboriginal communities during this time.

Due to the risk COVID-19 poses for Aboriginal communities, NCPHN’s Aboriginal Health Team has developed a coordinated approach in collaboration with Aboriginal Medical Services to reduce the impact of COVID-19 within Aboriginal communities.

The purpose of this framework is to increase preparedness and awareness around COVID-19 in Aboriginal communities on the North Coast; and to respond effectively and in a timely way when an Aboriginal person tests positive with COVID-19.

Our Aboriginal Health Team is working closely with the community and the Aboriginal Community Controlled Health (ACCH) sector to ensure we are providing support in a way that is driven by community need.

Check out these great videos with messages for our mob. You can share this on Facebook or download the MP4 file.

Click above to play
Share Facebook post | Download MP4

Click above to play
Share Facebook post | Download MP4

We have also developed this great community focussed resource with more to come in the near future.

We understand the disappointment surrounding the cancellation of celebrations such as NAIDOC week and urge our mob to look after each other and continue to be resilient and proud of being part of the oldest living culture in the world!

Click to download
Wellbeing Yarning Line

Feeling stressed or worried? Not coping so well at the moment?
The Mid North Coast Local Health District offers a Wellbeing Yarning Line. Call and have a yarn with Aboriginal mental health and
drug and alcohol staff.

Phone: 0408 985 916

Please note: this line is available from 9:00 am to 4:00 pm weekdays and is not for emergencies.

More Information

Nationally, the dedicated Aboriginal and Torres Strait Islander Advisory Group for COVID-19 is currently developing information for Aboriginal Community Controlled Health services and community members. We will be updating this section of our web page in line with these developments.

The four National Aboriginal Workforce Peaks, Australian Indigenous Doctors Association (AIDA), Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), Indigenous Allied Health Australia (IAHA) and National Aboriginal and Torres Strait Islander Health Worker Association (NATSIWHA) met on Thursday to discuss development of a co-designed, cobranded resource for our combined membership.

This resource will include information on social and emotional wellbeing support and will be made available on this page when available.

More information can also be found here:

Local resources

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