COVID-19

Victoria’s Chief Health Officer released a COVID-19 Daily Update at 6:28pm on Wednesday, 22 September 2021.

 Read the full update
 Subscribe to receive CHO alerts

Purpose

This Chief Health Officer update is intended to provide clinicians and the Victorian public with information about the number of confirmed cases of COVID-19 in Victoria as well as relevant public health response activities in Victoria.

Chief Health Officer Alerts will continue to be issued when there are changes to the public health advice related to COVID-19.

What’s new?

• Victoria was notified of 603 new cases of COVID-19 yesterday. All were locally acquired.
• There are 6,000 active cases in Victoria – 5,999 locally acquired and one overseas-acquired case.
• There are 241 COVID-19 cases in hospital in Victoria. 60 of those cases are in intensive care, with 39 cases on a ventilator.
• Sadly, the Department was notified yesterday of the death of a woman from Hume aged in her 70s.
• The total number of confirmed cases in Victoria since the beginning of the pandemic is 29,596.

Restrictions

• From 11.59pm yesterday, the construction industry has shut down for two weeks. For details visit Construction Industry To Shut Down For Two Weeks.
• The City of Ballarat, City of Greater Geelong, Surf Coast Shire and Mitchell Shire are in lockdown. For more information, see Seven day lockdown: Geelong, Surf Coast and Mitchell Shire.
• Details on Victoria’s Roadmap can be found at Victoria’s roadmap.
• Changes to Extreme Risk Zones in New South Wales means the border bubble permit exemption is again in effect (excluding Albury, which remains an Extreme Risk Zone.
• For more information, see Information for cross border communities.
• The New South Wales Local Government Area of Edward River Council has been re-added to the cross-border community.

Update: Vaccines

• Yesterday, a record 40,811 vaccine doses were administered by Victoria’s state-commissioned services. The total number of doses administered through state-run services is 3,200,720.
• More than 72 per cent of Victorians aged 16 and over 44 per cent have now had at least one dose of a COVID-19 vaccine.
• There are currently around 2,800 Pfizer appointments and 4,800 AstraZeneca appointments available over the next seven days.

Update: Wastewater testing

COVID-19 viral fragments have been detected in wastewater samples taken from the following regional areas:

• Macedon, Mt Macedon, New Gisborne (along Hamilton Road), Riddells Creek. Period of interest is 15 to 20 September.
• Bendigo. Period of interest is 16 to 20 September.
• Aireys Inlet and Fairhaven – there has been a third unexpected detection. The period of interest is 7 to 17 September.
• Moe area – there have been four unexpected detections in an area that includes Moe, Newborough, Trafalgar, Yallourn and Yarragon. The period of interest is 13 to 17 September.
• The detections could be an undiscovered new case or cases or could be the result of one or more people in these areas who have recovered from COVID-19 but are still shedding the virus.
• Anyone who lives in, works in or has visited the areas above is urged to watch for the mildest of COVID-19 symptoms and get tested as soon as possible if symptoms develop.
• For more information on wastewater testing, visit Wastewater testing.

Update: Testing

• 48,829 tests were processed in Victoria yesterday.
• Getting tested as soon as you have symptoms will help health authorities identify new positive cases and provide proper care for your family.
• If you are concerned about losing money from missing work, support is available – including the $450 test isolation payment. For more information, go to Financial support.
• To see new and extended testing sites, where to get tested and expected wait times, visit Where to get tested.

Update: Advice for household contacts of a primary close contact 

Information is available online for people who are household contacts of a primary close contact.

View more at What to do if you are a close contact.

General advice

COVID-19 symptoms include fever, sore throat, cough, shortness of breath and loss or change in sense of smell or taste. If you are experiencing symptoms, wear a fitted face mask when you get tested.

The Department publishes expected wait times at testing sites as well as updated information about locations and hours of operation at Where to get tested.

For more information call the 24-hour Coronavirus Hotline at 1800 675 398or visit Coronavirus (COVID-19) Victoria.

Current advice to clinicians

Notifications to the department of a confirmed diagnosis of COVID-19 can be done online. You can submit an online form to our public health team, rather than calling us, saving you time and resolving your case load more efficiently.

COVID-19 testing criteria

Practitioners should test any patients who meet the clinical criteria below:

• Fever OR chills in the absence of an alternative diagnosis that explains the clinical presentation* OR
• Acute respiratory infection (e.g., cough, sore throat, shortness of breath, runny nose, or loss or changes in sense of smell or taste)
• Note: testing is also recommended for people with new onset of other clinical symptoms consistent with COVID-19** AND who are from the following cohorts: close contacts of a confirmed case of COVID-19; those who have returned from overseas in the past 14 days; or those who are healthcare or aged care workers. Testing is recommended for those cohorts with onset of other clinical symptoms**. Asymptomatic testing is not recommended at this stage except for targeted programs.
• *Clinical discretion applies including consideration of the potential for co-infection (e.g. concurrent infection with SARS-CoV-2 and influenza)
• **headache, myalgia, stuffy nose, nausea, vomiting, diarrhoea.

If a symptomatic patient that presents for testing, confirms exposure to a known COVID-19 case within the past 14 days, and the outbreak definition is met, the test sample is to be treated as an ‘outbreak sample’.

Read the full update: Coronavirus COVID-19 daily update for information.

Key messages for primary care providers

 Visit our COVID-19 vaccines page for the latest information for vaccine providers in our region.

Key messages for the community

The COVID-19 vaccine rollout in Australia started in late February 2021.

 Download Australia’s Epidemiology and COVID-19 Vaccine Roadmap.

• Everyone in Australia will be offered a safe and effective COVID-19 vaccine.
• At first doses will be limited so high priority groups will get their vaccines first.
• The Australian Technical Advisory Group on Immunisation (ATAGI) gave advice to the Government on prioritising groups for COVID-19 vaccination.
• The COVID-19 vaccine is voluntary and free. As safe and effective vaccines become available the Government will vaccinate as many Australians as possible for COVID-19.
• If you choose not to have a COVID-19 vaccine your eligibility for Government payments won’t be affected.

Quick links

Find out more about how COVID-19 vaccines are developed, tested and approved.

 More information about how COVID-19 vaccines are being delivered in Australia.

New and updated exposure sites are listed on the Victorian Department of Health and Human Services website.

Anyone who has visited Tier 1 exposure sites during the times listed must immediately isolate, get a COVID-19 test, and remain isolated for 14 days.

• There are coronavirus exposure sites across Melbourne. If you, or your friends or family, went to any of the exposure sites listed here at the times indicated, please follow the advice given for that particular site.  
  
• If you have cold or flu like symptoms, such as a cough, fever, sore throat, shortness of breath or runny nose, even if these are mild, you should get tested for COVID-19. 
• From 11:59pm Thursday 27 May new changes have been introduced to slow the spread of COVID-19 by reducing the number of people leaving their homes and moving around Victoria. This means that you cannot leave your home unless you are doing so for one of the five following reasons:
  • shopping for necessary goods and services
  • care and caregiving, including medical care, or to get a COVID-19 test
  • exercise
  • authorised work and permitted study
  • to get a COVID-19 vaccination.
  • Victorians may also leave home to visit their intimate partner, their single social bubble buddy, or in an emergency – including those at risk of family violence. 
• Visit the DHHS website for the latest information on restrictions levels.
• Checking in at venues and facilities helps with contact tracing and keeps Victoria safe and open. When you check-in, you create a record of the time and date you visited a venue. This means that if there is a COVID-19 outbreak, contact tracers can quickly access your contact information and get in touch with you, if you’ve visited a public exposure site. This will help to contain a COVID-19 outbreak. 
• COVID-19 vaccines are now available to many Australians. Use the Eligibility Checker to find out when you can book your vaccine appointment. By getting vaccinated you’re helping protect yourself, those you provide care to, and the whole community.

Victorian COVID-19 testing criteria

Generally, only people with symptoms should be tested. However, people without symptoms can be tested in special circumstances as directed by DHHS. Refer to the guidelines for health services and general practitioners for more information on asymptomatic testing.

Practitioners should test any patients who meet the clinical criteria below:

• Fever OR chills in the absence of an alternative diagnosis that explains the clinical presentation* OR
• Acute respiratory infection (e.g., cough, sore throat, shortness of breath, runny nose, or loss or changes in sense of smell or taste)
• Note: testing is also recommended for people with new onset of other clinical symptoms consistent with COVID-19** AND who are from the following cohorts: close contacts of a confirmed case of COVID-19; those who have returned from overseas in the past 14 days; or those who are healthcare or aged care workers. Testing is recommended for those cohorts with onset of other clinical symptoms**. Asymptomatic testing is not recommended at this stage except for targeted programs.
• *Clinical discretion applies including consideration of the potential for co-infection (e.g. concurrent infection with SARS-CoV-2 and influenza)
• **headache, myalgia, stuffy nose, nausea, vomiting, diarrhoea.

If a symptomatic patient that presents for testing, confirms exposure to a known COVID-19 case within the past 14 days, and the outbreak definition is met, the test sample is to be treated as an ‘outbreak sample’.

Case definition

Confirmed case

A person who tests positive to a validated SARS-CoV-2 nucleic acid test

OR

has the virus isolated in cell culture, with PCR confirmation using a validated method

OR

undergoes a seroconversion to or has a significant rise in SARS-CoV-2 neutralising or IgG antibody level (i.e. four-fold or greater rise in titre)

Probable case

• A person who has detection of SARS-CoV-2 neutralising or IgG antibody AND has had a compatible clinical illness AND meets one or more of the epidemiological criteria outlined in the additional testing note above.

Case notification

Only confirmed and probable cases need to be notified to the department.

You should notify the department of confirmed and probable cases as soon as practicable by either:

• using the online COVID-19 notification form
• calling 1300 651 160, 24 hours a day

Due to the volume of testing, DHHS is asking GPs who are performing COVID-19 tests to label samples from three priority groups as “URGENT PRIORITY” samples to speed up results.

If a symptomatic patient that presents for testing confirms there has been an exposure to a known COVID-19 case within the past 14 days, and the outbreak definition* is met, the test sample is to be treated as an ‘outbreak sample’. To ensure all outbreak samples and other urgent priority samples are prioritised for testing in laboratories please follow these instructions:

Three “at risk” groups whose samples should be labelled “URGENT PRIORITY”:

Priority 1 (P1): Outbreak

• Including Close Contacts of a confirmed case, people in quarantine hotel(s), and residents or staff of a known outbreak at a residential aged care facility or a residential disability setting. Note for priority testing a Close Contact must have been notified by DHHS that they are a Close Contact.

Priority 2 (P2): Symptomatic health care workers and residents including

• Aged care workers
• Residential disability setting workers
• Symptomatic aged care residents, disability setting residents and hospital patients.

Priority 3 (P3): Other ‘at risk settings’

• For symptomatic people identified to be from other ‘at-risk’ settings as determined by the referring clinician. This includes non-residential disability settings.

How to label urgent samples

1. Sample bag: the outside of the sample bag(s) must have a red sticker** and marked “URGENT PRIORITY”
2. Pathology slip: must have a red sticker** and be marked as “URGENT PRIORITY” with “P1/P2/P3” to identify the reason why the sample is urgent. For example: “Priority 1– Outbreak“. See above for the three priority groups.
3. Sample: the sample must be labelled clearly with the patient’s name and date of birth and marked as P1, P2 or P3 to indicate the priority group.

Samples should then be forwarded on for laboratory testing using normal processes.

*Please refer to the latest Case and contact management guidelines available on the DHHS website for the definition of “outbreak” and “close contact” in the context of urgent priority testing.

** Some GPs and pathology providers are unaware of the red sticker. We have followed up with DHHS, who have advised that GPs do not have to attach a red sticker if they do not have one. GPs can just:

As of 26 July 2020, URGENT PRIORITY 1 – OUTBREAK samples can now be processed by the receiving pathology provider or hospital laboratory. These samples no longer require referral to the Victorian Infectious Diseases Reference Laboratory for processing.

Nominate someone in your practice or service to check the COVID-19 hub on the DHHS website each day to make sure you have the latest copies of the:

• quick reference guide and checklist
• case and contact management guidelines for health services and general practitioners
• case definition and testing criteria
• health care worker PPE guidance
• infection control guidelines.

HealthPathways Melbourne is the best place to find up-to-date clinical advice plus local referral information during the COVID-19 pandemic.

Health professionals can access the following COVID-19 pathways on HealthPathways Melbourne:

• COVID-19 Practice Management
• COVID-19 Assessment and Management
• COVID-19 Assessment and Management in Aged Residential Care
• COVID-19 Child Assessment and Management
• COVID-19 Referrals and Referral Advice
• COVID-19 Information
• COVID-19 Impact on Local Services
• COVID-19 Recent Changes

These form the suite of COVID-19 pathways, which are being regularly updated with the latest risk criteria and local referral information.

Health professionals should be aware of increased mental distress, alcohol and other drugs use and risk of family violence during the pandemic. There are many mental health, alcohol and other drugs, and family violence pathways, and these are being regularly updated to reflect service options for your patients.

Need a login? Contact info@healthpathwaysmelbourne.org.au