COVID-19

Victoria’s Chief Health Officer released a COVID-19 Daily Update at 6:07pm on Thursday, 4 March 2021.

 Read the full update
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Purpose

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

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

What’s new?

• Victoria has recorded no new cases of COVID-19 since yesterday.
• The total number of COVID-19 cases reported in Victoria is now 20,481.
• There were no new deaths and the state’s death toll stands at 820.
• The number of active cases in Victoria is 7. This includes seven locally acquired cases and no overseas-acquired case.
• A total of 5,018,897 test results have been received. This is an increase of 19,133 since yesterday.
• You can find further details in today’s coronavirus (COVID-19) media release.
• The DH website has full details in the interactive daily report.

Easing of restrictions 

• At 11:59pm Friday 26 February, Victoria returned to the previous COVIDSafe Settings that were in place prior to the Black Rock outbreak.
• Victorians are now able to host up to 30 people in their home per day and outdoor gatherings can increase to 100.
• Meanwhile, public and private sector office workers can return to work at up to 75 per cent a day.
• Face masks will be only be required on public transport, in rideshare vehicles and taxis, in sensitive settings such as aged care facilities – and in some larger retail settings including indoor shopping centres, supermarkets, department stores and indoor markets.
• Density limits remain for pubs, restaurants and cafes, beauty services, retail business, gyms, funerals and wedding and nightclubs and community facilities, such as libraries, RSLs and community halls.
• For more information on the new COVIDSafe Settings visit Coronavirus (COVID-19) Victoria.

COVID-19 vaccination program

• A total of 1,969 COVID-19 vaccination doses were administered yesterday at hospital vaccination hubs across Victoria.
• This brings the total number of vaccine doses administered in Victoria since the program started on Monday 22 February to 8,645.
• From Monday 1 March vaccinations have commenced from the Bendigo and Ballarat hubs. These hubs will focus on public sector residential aged care residents throughout this week.
• Victorians with the highest risk of exposure to COVID-19 are being prioritised for the vaccine, including: Hotel Quarantine and Health Hotel workers, airport and port workers, and frontline health staff in COVID-19 screening clinics, specialist COVID-19 wards, Intensive Care Units, Emergency Departments, and more.
• The vaccines are being administered through hospital vaccination hubs managed by public health services. Hubs also manage several special outreach sites including at Melbourne Airport and the Port of Portland.
• Hubs will also deliver the vaccine to public sector residential aged care patients and workers, with the Commonwealth responsible for providing the vaccine to the private sector aged care and disability sectors.
• All nine hospital vaccination hubs will commence operations over the coming weeks.
• The Victorian Government is working closely with the Commonwealth on the rollout of its vaccination program.

Update: Viral fragments detected in Werribee area

• Residents and recent visitors to Tarneit, Werribee and Hoppers Crossing with even mild COVID-19 symptoms are urged to get tested after viral fragments were detected in the inlet to the Western Treatment Plant at Werribee.
• Viral fragments were found in a wastewater sample collected on 25 February, with no known people in the area who have recently had COVID-19.
• Anyone who has any symptoms of COVID-19 is urged to get tested, especially if you live in or have visited these areas from 23 February 2021. 
• Residents of and recent visitors to Lilydale, Chirnside Park, Coldstream, Kalorama, Olinda, Montrose, Mt Dandenong, Mt Evelyn, Yarra Glen and Yering with even the mildest of COVID-19 symptoms are urged to get tested after viral fragments were detected in the inlet to the Lilydale wastewater treatment plant.
• Viral fragments were found in a wastewater sample collected on 25 February with no known people in the area who have recently had COVID-19.
• Anyone who has any symptoms of COVID-19 is urged to get tested, especially if you live in or have visited these areas from 23 February 2021.
• Residents of and recent visitors to Melbourne’s outer west who have even mild COVID-19 symptoms are urged to get tested after viral fragments were detected in the local wastewater catchment.
• A weak detection of viral fragments in a wastewater sample collected on 22 February has been confirmed by further laboratory testing.
• The catchment includes some or all of Taylors Hill, Plumpton, Hillside, Sydenham, Delahey, Caroline Springs, Burnside Heights, Kings Park, Albanvale, Burnside and Deer Park.
• Anyone who has been in these suburbs and has any symptoms of COVID-19 from 20 to 22 February is urged to get tested.
• Fragments of the virus detected in wastewater may be due to a person with COVID-19 being in the early active infectious phase or it could be because someone is continuing to shed the virus after the early infectious period.
• Further information can be found at Wastewater monitoring.

Testing sites and expanded testing

• Demand for testing is stable across the system, with no waiting times longer than 30 minutes.
• The department is publishing expected wait times at testing sites as well as updated information about locations and hours of operation at Where to get tested.

New Zealand Travel Bubble

• From 11:59 pm Wednesday 24 February all flights arriving from Auckland into Victoria will be regarded as ‘red zone’ arrivals and anyone arriving will be required to enter mandatory hotel quarantine for 14 days.
• Those who arrived in Melbourne from Auckland yesterday, Tuesday 23 February, are asked to get a COVID-19 test immediately and quarantine until they receive a negative test result.
• All flights into Victoria from New Zealand have been cancelled until after 6 March. 

Interstate border restrictions 

• All travel into Victoria from other states and territories requires a travel permit. You can apply for a permit via the Service Victoria website.

Current advice to clinicians

• Statement on Rapid Antigen Testing for SARS-CoV-2 (COVID-19) diagnosis in symptomatic persons (Word).
• Notifications to the department of a confirmed diagnosis of coronavirus (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:

1. Fever OR chills in the absence of an alternative diagnosis that explains the clinical presentation* OR
2. Acute respiratory infection (e.g. cough, sore throat, shortness of breath, runny nose, or loss or changes in sense of smell or taste)
3. Note: testing is also recommended for people with new onset of other clinical symptoms consistent with coronavirus (COVID-19)** AND who are from the following cohorts: close contacts of a confirmed case of coronavirus (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.
4. *Clinical discretion applies including consideration of the potential for co-infection (e.g. concurrent infection with SARS-CoV-2 and influenza)
5. **headache, myalgia, stuffy nose, nausea, vomiting, diarrhoea.

• If a symptomatic patient that presents for testing, confirms exposure to a known coronavirus (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’.

Victoria’s restriction levels

• The State of Emergency has been extended until 11:59pm, 15 March 2021 to allow the Chief Health Officer’s directions to remain in force.

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.

• Testing is critical to keeping numbers down, so get tested if you have any symptoms of coronavirus (COVID-19) no matter how mild. Go straight home after your test and self-isolate while you wait for the results. You must not go out until you get your results. Go to the DHHS testing map  for locations.
• Public exposure sites are listed on the DHHS website. If you have visited any of the locations listed during the dates indicated, you should watch for coronavirus symptoms. If symptoms occur immediately get tested and stay at home while you wait for results.
• Notification is required for all confirmed cases. Clinicians can send notifications of confirmed cases to DHHS by submitting an online form to the public health team, or by calling 1300 651 160, immediately, 24 hours a day.
• COVIDSafe principles apply across Victoria:
  1. You must carry a face mask with you when you leave home. Rules on when you must wear a mask can change frequently. Check the Victorian Government website for the current advice.
  2. Wearing a face mask is strongly recommended in all situations when you can’t keep 1.5 metres distance from other people. Don’t go to work if you feel unwell.
  3. Maintain a physical distance of 1.5 metres.
  4. Cough and sneeze into a tissue or your elbow.
  5. Wash hands with soap or use hand sanitiser regularly.
• Visit the DHHS website for the latest information on restrictions levels.

From 11:59pm 26 February 2021 Victoria returned to its previous COVIDSafe settings, allowing for more visitors in the home, reduced mask wearing and increasing the number of workers heading back to the office.

Masks are now only required on public transport, in rideshare vehicles and taxis, in sensitive settings such as aged care facilities – and in some larger retail settings including indoor shopping centres, supermarkets, department stores, indoor markets.

While masks are no longer mandated in most circumstances, the evidence is clear wearing a face covering makes a real difference in slowing the spread of the virus – so masks continue to be recommended indoors or outdoors when distancing can’t be maintained.

For more information visit the Victorian Government website and read a summary of the settings (.pdf).

Reminders

Visit the Victorian Department of Health website for more information on case locations and outbreaks, and where to get tested.

If you have any COVID-19 symptoms, no matter how mild, get tested and isolate until you receive a negative result.

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.

Patients who meet the following clinical criteria should be tested:

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, loss or change in sense of smell or taste).**

*Clinical discretion applies; consider potential for co-infection (e.g. SARS-CoV-2 and influenza).

** Older people may present with other atypical symptoms including functional decline, delirium, exacerbation of underlying chronic condition, falls, loss of appetite, malaise, nausea, diarrhoea and myalgia.

Additional testing note:

People who are at higher risk of infection due to their environmental exposure or higher risk of severe illness should also be tested if they have new onset of other clinical symptoms associated with coronavirus (COVID-19) (e.g. headache, myalgia, stuffy nose, nausea, vomiting, diarrhoea) AND meet the following epidemiological criteria:

• Close contacts of a confirmed case of coronavirus (COVID-19).
• Returned overseas travel in the past 14 days.
• Health care or aged care workers.
• Residents of an aged care facility or older people in the community

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