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COVID-19 Anglesea Community Update – 12 July

Anglesea Community Update on COVID-19
– current as of 12th July 2020
– information continues to change rapidly
– previous updates can be found on our website:
http://angleseamedical.com.au/blog/

The events of the last week, while appearing drastic and causing a lot of distress, have not been unexpected. There has been modelling done that predicted further outbreaks and the process of containing, isolating and protecting has meant the return to Stage 3 restrictions in metropolitan Melbourne and Mitchell Shire, with associated travel restrictions, are necessary.

This is a chance to remind ourselves that this virus is not only virulent but also easily transmissible. The Victorian Government has implemented a number of changes that, when read didactically, appear to contain contradiction and ambiguity. This has led to a lot of animosity online and in person, which many people would be aware of. Divisiveness in small communities has the potential to cause harm as well, and we would encourage everyone to be kind in all interactions – take time to think about what is causing your own anger or distress. For some people it will be guilt about their choices, for others it will be fear about their health, or concern for others – of course there are many other reasons as well. People, in general, struggle with considering they may be in the wrong, and rarely does abuse or anger enable careful reflection or assist with change.

It is worthwhile remembering the the virus does not care where you are from and what justifications you make about your actions. The behaviour of many people has enabled community transmission of SARS-CoV-2 to increase, and we are all responsible for our own actions and now working harder than ever to reduce transmission.

Utilising the following basic strategies will help reduce transmission:

  • physical distancing
  • regular hand hygiene
  • not touching your face
  • staying home when unwell
  • avoiding large gatherings
  • allowing people space and time when you are shopping or near others

Please refer to the following website for offical information around the Stage 3 Stay at Home restrictions – which apply to all people if their principal place of residence is in metropolitan Melbourne or Mitchell Shire.
https://www.dhhs.vic.gov.au/travel-metropolitan-melbourne-and-mitchell-shire-covid-19

Let’s all use common sense, and consideration for others, as we move into this new phase of the pandemic as it is vital to have cohesion and work together. It falls to all of us to act responsibly and to keep our community safe and the spread of coronavirus under control.

We also need to keep testing, so even if you have the mildest symptoms, it is important to get tested. Contact us for a telehealth appointment if you are unwell or uncertain, or contact a local testing clinic directly if you have any of the following symptoms however mild:

  • fever
  • chills or night sweats
  • cough
  • sore throat
  • tiredness
  • difficulty breathing
  • headache
  • muscle pain (myalgia)
  • joint pain
  • loss of appetite
  • loss of sense of smell (anosmia)
  • distortion of sense of taste (dysgeusia)
  • vomiting
  • diarrhoea

For our area the two main options are:

Torquay
Barwon Health – Torquay Community Health Centre testing clinic
100 Surf Coast Hwy, Torquay 3228
Daily: 9am-5.30pm
Appointment only, book via (03) 4215 7815

Lorne
Great Ocean Road Health Lorne Community Hospital testing clinic
1 Albert St, Lorne 3232
Daily: 9am-4pm
Appointment only, book via (03) 5289 4300

COVID-19 Anglesea Community Update 17 April

This is a brief update. Firstly congratulations to everyone for being part of the global effort to reduce the incidence of new cases. In Australia we are in a unique position compared to the rest of the world with a significant reduction in the doubling rate. The coming weeks and months will be telling about where things go.
 
Our influenza vaccination clinics have been trialled and are running well.  We were fortunate to receive a new batch of vaccinations today and have opened up more clinics next week. Please rest assured that we will ultimately have enough of the funded immunisations for everyone, but they will continue to be sent to us in batches. Local pharmacies have also received stock, so if you require a script please get in touch. Due to new advice from the Department of Health we may be adjusting our process for the clinics, so please bear with us if we make late changes.
 
We would also like to remind people to try and remain calm and polite when interacting in the community. We recognise that there are high levels of distress and anxiety, which has been impacting on how people are behaving at times. Please remain calm and remember that we are all working hard to do our best in these extremely trying times.
 
We would also like to ask people to please remain calm when speaking with our receptionists – they, as does everyone, deserve to work in a safe and respectful environment. There is much out of all of our control, but we can support each other and manage how we behave. If you are finding that your interactions with others are creating further distress and that you are unable to manage your responses, please book in with one of our doctors or find some support through other organisations or community groups. Remember that we are all in this together.
 
Here are some resources we have previously shared around mental health and COVID-19 for easy access:
 
 
Be Kind, Stay Safe, Stay Home.

Updated criteria:
In Victoria the revised testing criteria include:
Fever OR chills in the absence of an alternative diagnosis that explains the clinical presentation
OR
Acute respiratory infection that is characterised by cough, sore throat or shortness of breath.

Note: In addition, testing is recommended for people with new onset of other clinical symptoms consistent with COVID-19* AND who are close contacts of a confirmed case of COVID-19 or who have returned from overseas in the past 14 days.
*headache, myalgia, runny or stuffy nose, anosmia, nausea, vomiting, diarrhoea

Taking the temperature of general practice during COVID-19

The past month has seen unprecedented changes occur in healthcare, and society in general, and this week we’ve finally had a moment to lift our head above the water and take a breath. Most healthcare workers and organisations have had to adapt quickly and develop new processes and protocols on the fly. This is particularly true in General Practice, the majority of which are small businesses and are the foundation stone of Primary Care.

Our clinic in Anglesea is co-located with Barwon Health allied health services and it has been interesting to note the differences between a large state based health organisation and our small GP clinic in terms of adaptability. It is certainly much easier for a small organisation to be agile and responsive, and much easier to develop a plan and implement it without the requirements of going through committees or multiple approval processes. It is also due to the fact that the bread and butter of General Practice is managing uncertainty by developing a plan, which has been key in this current environment.

What we do

As GPs we are trained to work across a number of levels that encompass some of the following;

  • direct clinical care with diagnosing, treating, and managing disease
  • continual learning with ongoing knowledge and skills development
  • awareness of public health priorities, including screening and preventative care
  • financial considerations on a patient, clinic and population level.

Another way of looking at this is that while we are working with the patient in front of us, we are always considering the context of the broader community – both locally, regionally, nationally and even internationally. To this extent, we are applying national guidelines and evidence to a regional community and the patients we are seeing. There is value in following the expert advice available and implementing it appropriately for the community we work with.

Adaptation and community

In the span of a few short weeks our clinic has moved to protect our staff, patients and community by early implementation of distancing and hygiene processes, as well as embracing providing care via Telehealth. We have developed our own processes for triaging patients, safe swabbing to test people for Coronavirus, providing a safe and innovative Influenza Vaccination clinic, and monitoring and looking after the health of our staff – all while continuing to provide face to face services where these are needed. We have had to adapt these processes almost continuously, as governmental guidelines and legislation change rapidly – at times this has occurred on a daily basis.

Throughout this time we have attempted to provide information to our local community and patients. This has involved liaising with local community based groups, the local residential aged care facility, our pharmacies, and other nearby clinics. And it has been heartwarming to see how engaged and supportive the Anglesea and surrounding community has been in embracing these rapid changes. Without this community support there are many people who would struggle to manage the day to day changes that have occurred. We can’t thank you all enough.

So where to now?

As things sit, we feel we have a moment’s reprieve and that the coming weeks will determine the outcome of the next few months. With the majority of people adhering to guidelines by staying home there has been an effect on slowing the rate of infections. However, at this pivotal time it is vital to maintain that strong commitment, and not shrug off the responsibility we all have to work together at preventing further spread of this novel coronavirus.

We also need to be planning for less positive outcomes and the potential impact that increased spread of this disease could have. There are many people who are at risk, particularly most of our older population, but also those with medical conditions that put them at higher risk of significant illness if they acquire the virus. For those who are older, we know that the spread of disease is likely to cause deaths, and we must be prepared for how we manage this if it does occur.

General health

But it is not just the impact of Coronavirus that we must plan for, it is also for all the ongoing health needs of our community. If people are not accessing GP services throughout the coming weeks and months, through fear, or not wanting to impact on services, or feeling it’s not important enough, there will also be a higher burden on our health system. We want to keep hearing from you and will continue to encourage people to manage their ongoing chronic conditions and do so in a safe environment.

It is also vital that we stay connected to each other, and watch carefully for the potential impact on our mental health. There are a number of good online resources for support, but we would also encourage you to get in touch if you are finding your mood or worries or thoughts are becoming too difficult to manage.

Here are some reliable and useful resources around mental health and COVID-19:

Please continue to check our website, Facebook page and Instagram for day-to-day updates and information:

Facebook: @angleseamedical  Instagram: @angleseamedical

COVID-19 Anglesea Community Update 9 April

Anglesea Medical Community Update on COVID-19
– current as of 9th April 2020
– information continues to change rapidly
– previous updates can be found on our website:
http://angleseamedical.com.au/blog/

There has been some good news, with an observable reduction in the doubling rate of COVID-19 cases over the last week. This however, is far from saying things will be back to usual soon, and it is more important than ever that people adhere to the Government guidelines and health authority advice in the coming weeks.

There has been modelling that suggests the risk of resurgence of cases is increased if the current mitigation measures, including social and physical distancing strategies, are lifted too early. Now is not the time to be complacent.

The State Government has been clear in their direction around the Easter break – this is not a time to go on holidays. We are hopeful that people will take this seriously and not make a journey down to Anglesea or the Surf Coast this weekend. However, if you do see people around town who look like they are on holidays, please do not engage in arguments with them.

We must all remain kind, calm and courteous at all times. There may be entirely valid and important reasons for people that are not permanent residents to be in our community.

Our advice is to stay home and keep yourself and your family unit / housemates safe by avoiding everyone! Enjoy your time together and celebrate that we’ve got through the last few weeks.

Anglesea Medical will be closed for the Easter Weekend including Friday and Monday to give our hard working staff a chance to rest and recuperate. If you are unwell during this time you can call the On Call service on 1300 606 024 for advice. We will be back in action on Tuesday morning and back to our Saturday morning clinics the following weekend.

Finally, we’d also like to update you all on the latest change in the testing criteria for COVID-19, which still remains the same for the clinical picture with a fever or acute respiratory infection, but has expanded epidemiological criteria.

Of note is that anyone over the age of 65 who has a fever or symptoms meets the criteria for testing, and we are continuing to provide testing in Anglesea while our PPE (Personal Protective Equipment) and swab stocks remain available. You can utilise this self assessment tool if you are concerned you may meet the criteria for testing:
https://www.dhhs.vic.gov.au/coronavirus-self-assessment

Clinical criteria:
Fever (≥38°C) or history of fever (for example night sweats, chills)
OR
Acute respiratory infection (for example, shortness of breath, cough, sore throat).

Epidemiological criteria:
Close contacts of confirmed COVID-19 cases with onset of symptoms within 14 days of last contact
OR
Travellers from overseas with onset of symptoms within 14 days of return
OR
Cruise ship passengers or crew with onset of symptoms within 14 days of disembarkation
OR
Paid or unpaid workers in healthcare, residential care, and disability care settings
OR
People who have worked in public facing roles in the following settings within the last 14 days:

• Homelessness support
• Child protection
• The police force
• Firefighters who undertake emergency medical response
• Childcare and early childhood education
• Primary or secondary schools

OR
Any person aged 65 years or older
OR
Aboriginal or Torres Strait Islander peoples
OR
Patients admitted to hospital where no other cause is identified
OR
Any person in other high-risk settings, including:

• Aged care, disability and other residential care facilities
• Military operational settings
• Boarding schools
• Correctional facilities
• Detention centres
• Settings where COVID-19 outbreaks have occurred, in consultation with the department.

All patients being tested for COVID-19 should be isolated (at home or in hospital) until test results are available. All patients should attend an emergency department if clinical deterioration occurs.

COVID-19 Anglesea Community Update 31 March

Anglesea Community Update on COVID-19
– current as of 31st March 2020
– please note, information will be changing rapidly
– previous updates can be found on our blog.

From 30th of March the Government has announced further  Telehealth medicare rebates for all Australians.

Included in these changes are rebates for Mental Health Care Plans, and also for allied health professionals to provide focused psychological services – counselling and psychology. We are also able to continue to provided Chronic Disease Management Plans and will continue to do so regularly.

There are high levels of anxiety and distress around this pandemic and this in turn can cause people to behave in unsocial ways. We’d encourage everyone to remain calm and act with kindness at all times. There is a lot that is out of our control, but we all have the opportunity to support each other and manage how we behave and adapt to this new situation. If you are finding that your responses to day to day situations are becoming more difficult to manage, please get in touch.

Here are some reliable and useful resources around mental health and COVID-19:
https://headtohealth.gov.au/covid-19-support/covid-19
https://mindspot.org.au/coronavirus
https://thiswayup.org.au/coping-with-anxiety-during-the-covid-19-outbreak/

Mindspot and This Way Up provide online courses for managing many different mental health conditions and are currently free to use. We also have many highly experienced psychologists and mental health trained professional on the Surfcoast and in Geelong that are available to access via a GP Mental Health Care Plan.

We’d also like to remind everyone that it is important that people attend for usual medical and nursing care as they would prior to this situation – we do not want people to avoid seeing their GP out of concern for not wanting to overload the system.

There is a chance that people who delay seeing (via Telehealth or if necessary at the clinic) a doctor or nurse their condition may worsen and precipitate higher level care in hospital. We need to reduce the burden on the hospital system as much as possible and this is why we will continue to see people face to face where needed.

We are able to test for coronavirus in Anglesea for as long as our PPE (Personal Protective Equipment) supplies last – as many people would be aware, there is a shortage nationally and we are constantly sourcing more. We have been doing this testing already when people meet the current Clinical and Epidemiological criteria. In high risk cases or where people are not living nearby we may send them in to Geelong for further management.

At any stage, if you have questions or concerns please contact the clinic. Our receptionists will answer many questions, and if they are unable to, they will arrange for a doctor or nurse to speak with you – this may be at the end of the day if they can’t speak immediately.

COVID-19 Anglesea Community Update 27 March 2020

Anglesea Community Update on COVID-19
– current as of 27th March 2020
– please note, information will be changing rapidly
– please refer to our previous update for introductory info

Since our last update there have been many changes and new messages from the Federal and State Governments, some of which may have appeared contradictory. This remains an area of rapidly changing information and we are adjusting our systems and processes day to day to ensure that we help contain the spread of the virus, protect staff and patients, and most importantly, protect the vulnerable people in our community.

We can not iterate strongly enough how important it is for us all to play a role in managing this pandemic, and it has been heartening to see how many community groups and businesses are engaging in supporting each other and the community in general.

Quite simply, the best thing we can do is strictly adhere to physical distancing guidelines. 

This graph shows how important this can be. If just 3 out 10 people do not take this seriously there is no impact on transmission, which means a huge impact on our health system.

Our advice in pragmatic terms is:

  1. Stay at home 
  2. Only shop once a week if you can
  3. Avoid people when out – stay at least 1.5m away
  4. Wash your hands regularly and avoid touching your face
  5. Stay connected with people via phone and online
  6. Be kind and generous at all times!

Do not gather with friends or extended family – unless it’s online.
Do not go on holidays – have a Staycation instead!

This quote is from an epidemiologist and explains how quickly you can compromise your efforts in physical distancing, even when you feel you are doing the right thing.

“You should perceive your entire family (or household) to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbour, your neighbour is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with.”

We have been busily transitioning to predominantly Telehealth consultations over the last two weeks. Again, this is to protect our staff, patients and the community and prevent inadvertent transmission of the virus (or any virus!). The Government is set to provide further Medicare rebates for Telehealth in the coming week, which makes it more accessible to everyone. Currently not everyone meets the criteria for Telehealth rebates.

You may have seen that inside the clinic we have increased hygiene and distancing measures with tape on the floor that provides guidance around a 1.5m buffer between people to reduce the potential for close contact. We are trying to avoid having anyone in our waiting room at the moment where possible.

For some consultations however, we will need to see patients in the clinic. For these people, when you arrive at the clinic stay in your car (if you drove) and please call reception on 42156700 (Select option 1) to let us know you have arrived. If you do not have a mobile phone please wave from the door but do not enter.

The nurses and doctors may see you in your car, or invite you to come into the clinic.

If you are attending for blood tests, or other pathology tests, the same process applies. Dial 42156700 and select option 3 for Clinical Labs and you will be invited into the clinic when they are ready to see you.  Barwon Health allied health services have been suspended at the Anglesea Community Health Centre for the time being. Please liaise directly with Barwon Health about this if you have questions, complaints or concerns.

Stay safe and be proactive. We can work together to improve outcomes, and it is only together that we can make this work.

—-

UPDATED TESTING GUIDELINES
(please note these continue to change regularly)

Currently you only meet guidelines for testing for COVID-19 if you meet one clinical AND one epidemiological:

  1. Clinical criteria:
    • Fever > 38°C or
    • Acute respiratory infection (shortness of breath, cough, sore throat).
  1. Epidemiological criteria
    • Travellers from overseas with onset of symptoms within 14 days of return.
    • Close contacts of confirmed COVID‑19 cases with onset of symptoms within 14 days of last contact.
    • Healthcare workers and residential aged care workers.
    • Aged and residential care residents.
    • Patients who are Aboriginal and/or Torres Strait Islander.

If you feel unwell you should stay at home and call the clinic or the Coronavirus information line to discuss your risk.

The Coronavirus Health Information Line operates 24 hours a day, seven days a week 1800 020 080 or online at:
https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert

—-

“Everything we do before a pandemic will seem alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. We need to reach out to everyone with words that inform, but not inflame. We need to encourage everyone to prepare, but not panic.” — Michael O. Leavitt, 2007

—-

Influenza Immunisation Update

We are expecting the governmental supply of Influenza Vaccinations to arrive soon and will follow current guidelines that recommend immunising during the coming weeks rather than delaying until May. We do not have control over the supply we get, so please be patient as we will have enough to go around, but the supply will be staggered. Do not panic!

We will be arranging Flu Vaccination clinics and will have more information in the coming days on how this will work. We will send out an SMS to people about this and call those who do not have mobile phone numbers.

In 2020, influenza vaccines funded (free) through the National Immunisation Program are available to the following groups. This is due to their increased risk of complications from influenza.

  • Aged 6 months to less than 5 years (this cohort is newly eligible in 2020)
  • All Aboriginal and Torres Strait Islander people aged 6 months and over
  • Pregnant women (during any stage of pregnancy)
  • All people aged 65 years and over
  • People aged 6 months and over with medical conditions which increase the risk of influenza disease complications.

If you do not qualify for a funded vaccination you will need a consult with a doctor to get a script – this can be done via Telehealth and booked online or via reception.

COVID-19 Anglesea Community Announcement

Anglesea Community Update on COVID-19

– current as of 15th March 2020
– please note, information will be changing rapidly
– please read this entire update

The World Health Organisation has declared COVID-19 a global pandemic due to the highly infectious nature of the virus, it’s impact in terms of mortality, and that there is no wide spread immunity or curative treatments currently. The most common symptoms are fever and cough however it does not act like a cold and it is not the flu.

We know from global data that anyone can catch the virus and that anyone can become critically unwell and die, even young and healthy adults. However we also know that those most at risk are people over 60 years old and those with other medical problems.

It appears that people are most infectious when they have symptoms and that asymptomatic spread (passing on the virus when you don’t have symptoms) is not driving spread of the disease in the community.

At Anglesea Medical we are putting in place measures to help contain the spread of the virus, protect staff and patients, and most importantly, protect the vulnerable people in our community. Everyone has a part to play in reducing the spread of the disease.

Simple measures, including social distancing and hand washing are very important. We are asking anyone with any flu like symptoms including a fever, cough, sore throat, runny nose or shortness of breath and/or you have returned from overseas in the last 14 days to call the clinic before coming in. Inside the clinic we are enacting increased hygiene and distancing measures – you may see tape on the floor that provides guidance around a 1.5m buffer from staff and patients to reduce the potential for close contact.

Currently you only meet guidelines for testing for COVID-19 if:

  1. you have a fever or acute respiratory infection AND international travel in the 14 days before onset of illness, or close contact in the 14 days before illness onset with a confirmed case of COVID-19. Please note that casual contact is no longer a trigger for testing
  2. You have severe community-acquired pneumonia (who are critically ill) and no other cause is identified, with or without recent international travel
  3. You are is a healthcare worker with direct patient contact who has a fever (>37.5) AND an acute respiratory infection

Even if you feel you just have a cold and would like to see the doctor for something else, we ask that you let the receptionist know. We will be asking everyone with any symptoms listed above to put on a mask before entering the clinic, you will either be placed in an isolated room or be told to wait in your car to be seen. We may talk to you over the phone before seeing you. This is for the safety of other community members at the clinic as well as our staff.

On Friday last week the Government introduced new MBS item numbers that allow GPs to consult with vulnerable and isolated patients over the phone. These can be accessed by patients who;
(a) have been diagnosed with COVID-19 virus
(b) has been required to isolate themselves in
(c) is considered more susceptible to the COVID-19 virus:

  • 70 or older (50 or older and is of Aboriginal or Torres Strait Islander descent);
  • pregnant;
  • parent of a child under 12 months
  • under treatment for chronic health conditions or immune compromised;

As the disease develops in Australia information will change but currently in the community we should:

  • avoid large gatherings and limit unnecessary travel
  • practice social distancing (1.5m)
  • wash hands frequently with soap and water
  • avoid touching your face
  • avoid being in close contact with sick people

If you feel unwell you should stay at home and call the clinic or the Coronavirus information line to discuss your risk.

The Coronavirus Health Information Line operates 24 hours a day, seven days a week 1800 020 080 or online at:
https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert

ALERT:

All Travellers arriving from International destinations are now required to self-isolate for 14 days. We are able to provide Telehealth services to these people as well as those listed above.