Coronavirus disease (COVID-19)
information for primary health care providers.

Page last updated: 8:30am, 27 November 2020

Urgent updates

Chief Health Officer Daily Update 26 November 2020

Victoria’s Chief Health Officer released a COVID-19 Daily Update at 6:16pm on Thursday, 26 November 2020.

 Read the full update
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Key messages

What's new?

  • As of 26 November 2020, no new cases have been diagnosed since yesterday with the total number of coronavirus (COVID-19) cases in Victoria at 20,345. This is Victoria’s twenty-seventh consecutive day with no new cases.
  • Today’s 14-day average case number for metropolitan Melbourne and regional Victoria is zero.
  • There have been no new deaths from COVID-19 reported since yesterday. To date, 819 people have died from coronavirus (COVID-19) in Victoria (no change since yesterday’s report).
  • The total number of cases from an unknown source in the last 14 days is zero for metropolitan Melbourne and zero for regional Victoria. 3,762 cases may indicate community transmission (no change since yesterday’s report).
  • There are no active cases in Victoria. 19,525 people have recovered.
  • A total of 3,544,104 test results have been received. This is an increase of 12,862 since yesterday.
  • You can find further details in today’s coronavirus (COVID-19) media release.
  • The DHHS website has full details in the interactive daily report.
  • Last Step restrictions wills apply throughout Victoria. Visit the summary of changes to restrictions for Victoria.

Face masks

  • Face masks are mandatory indoors, unless an exemption applies.
  • Face masks are not required outdoors except where physical distancing cannot be maintained, such as farmers’ markets and other outdoor retail. There is a requirement to carry a mask at all times.

Temporary border controls with South Australia

  • The Victorian Government will continue to monitor the situation in South Australia and will continue to be guided by the health advice.
  • A permit is now required to enter Victoria from South Australia unless an exemption applies. For more information visit the Victorian Border Crossing Permit page.
  • People who live in the previously established 70km cross-border bubble between Victoria and South Australia will not require a new permit, but they will be required to use existing permits from the South Australian Government, or their drivers licence to cross the border.
  • Those receiving or providing emergency medical care, providing or receiving emergency services or residing on a property that extends across both South Australia and Victoria will be exempt from the requirement for a permit.

Coronavirus (COVID-19) fragments found in Corio wastewater

  • Coronavirus fragments have been detected in a wastewater sample collected from the Oyster Cove wastewater treatment plant in Corio.
  • Residents and visitors to Geelong’s northern suburbs and Lara from Saturday 21 to Tuesday 23 November are urged to get tested if they have any symptoms, no matter how mild.
  • The result is unexpected given that there are no residents in the area known to have recently had a coronavirus (COVID-19) illness or diagnosis.
  • Samples of untreated wastewater are analysed for fragments of SARS-CoV-2 – the virus that causes coronavirus (COVID-19) – at more than 50 wastewater treatment plants across Victoria.

Benalla and Portland testing drives

  • In response to the detection of coronavirus (COVID-19) fragments in wastewater testing site have been established in Benalla and Portland. We are urging residents of Benalla and Portland and anyone who has visited those areas between 15 and 17 November to get tested and to isolate until they get their test result.

Current advice to clinicians

  • Clinicians should be asking patients if they have been in South Australia and if so, to check the areas of risk defined by the South Australian government and recommended actions.
  • Statement on Rapid Antigen Testing for SARS-CoV-2 (COVID-19) diagnosis in symptomatic persons.
  • 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.
  • The department is continuing to ask commercial passenger vehicle drivers and food delivery drivers to get tested for coronavirus (COVID-19). If commercial passenger vehicle drivers and food delivery drivers do not have any of the symptoms of COVID-19, they will not have to stay home to wait for their test results. Commercial passenger vehicle drivers and food delivery drivers will need to tell staff at the testing centre/site that they work in the industry.

Testing advice for clinicians in an outbreak setting

  • 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 on:

  • COVID-19 testing criteria
  • Victoria’s restriction levels
  • Key messages for the community
  • Clinical information (links)
  • Consumer information (links)

Current key messages

  • Stay home and get tested if you have 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.
  • You must wear a face covering in Victoria whenever you leave your home, unless an exception applies. You must wear a fitted face covering that covers the nose and mouth. This means that face shields, bandanas, or scarves or loose snoods, loose Buffs® or loose neck gaiters on their own will no longer be considered a sufficient face covering.
  • Everyone in Victoria must stay safe by maintaining good hygiene, keeping your distance from others and if you feel unwell stay home.
  • Visit the DHHS website for the latest information on restrictions levels.
  • 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.

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Current testing criteria and case definition

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:

Outbreak management and high priority COVID-19 tests

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.

Clinical guidelines and key documents

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

The Case and contact management guidelines were last updated on 31 August 2020 (version 24).

HealthPathways Melbourne

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

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

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 drug use and risk of family violence during the pandemic. There are many mental health, alcohol and other drugs, and family violence pathways that are being regularly updated to reflect service options for your patients.

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

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