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Sunday, June 26, 2022

Health dept tips for managing influenza and COVID-19 in aged care

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Vaccines save lives. Put simply — the best way to protect yourself and fellow staff, your residents, their families from influenza (flu) and COVID is to get vaccinated.

This winter an increase in influenza cases is expected and with COVID continuing to circulate at the same time, it is important to be protected against flu and COVID.

The department of health strongly encourages facility operators and management to engage with residents and workers to discuss vaccination options and support the consent process to achieve optimum vaccination coverage.

Operators should also be assisting in-home and community care recipients and workers to understand how they can access flu and COVID vaccinations.

Having your arrangements in place early, so that you can offer vaccinations and boosters to your residents and staff, will help to minimise potential outbreaks and severity of disease.

Under the National Immunisation Program (NIP), flu vaccinations are free if you are aged 65 years or older, and is also recommended for all people aged six months and over (unless contraindicated).

For COVID, you need a booster to stay up to date with your vaccinations if you are 16 years and over.

The health department encourages facility operators to make sure eligible populations have had or will receive their additional COVID booster dose before the winter season.

Please look at the available information on accessing flu vaccinations through the NIP on the Department’s website, and the promotional materials including posters and brochures that you can use from the 2022 influenza resource collection.

Infection Protection Control (IPC) in an outbreak

Maintaining infection prevention and control measures continues to be very important in minimising the impact of flu and COVID.

While the IPC lead nurses play a core role in ensuring that IPC competency is sustained, IPC behaviours should be a core part of everyone’s role.

All staff (management, care workers and support staff) should be trained in basic infection prevention and control. You may wish to encourage staff to refresh their on-line training available on the health department’s website.

It is safe to work in a flu or COVID outbreak with good IPC practices. These include increased hand hygiene, PPE use, cleaning and waste disposal.

In addition, screening of staff, visitors and other entrants to residential facilities is a key component of early detection of possible flu or COVID.

This includes monitoring for symptoms, not attending if unwell, and wearing an appropriate mask to reduce the risk of transmission.

Influenza and COVID-19 treatments

To complement vaccination and infection prevention and control, access to oral treatments is a key tool in managing both flu and COVID infections where clinically appropriate.

To support this, the COVID oral antiviral, molnupiravir (Lagevrio) was distributed in February this year to all residential aged care facilities for resident only COVID cases.

Lagevrio is now listed on the Pharmaceutical Benefits Scheme (PBS) and can be accessed through community pharmacies with a prescription.

Further information and resources on COVID treatments are available at COVID‑19 oral treatments and Lagevrio.

Influenza treatment deployment in residential aged care

From this week, packs of the prescription-only medication, Tamiflu (oseltamivir), an oral antiviral used to treat and prevent influenza A and B infections, will be deployed to residential aged care facilities (RACF) in a one-off pre-placement. This is part of the Department of Health’s 2022 winter preparedness plan.

This stock is being pre-placed to ensure access to supplies at the commencement of this year’s flu season.

The department says this is not intended to replace standard supply chains used by providers, rather it reduces the impacts of supply shortages within the private market and the delays in shipping that may result from increased demand during the winter period.

RACFs will need to source additional supply through community pharmacies in line with normal arrangements once the pre-placed stock has been expended.

Note: Western Australia RACFs without permits to hold medications will need to access the pre-placed stock through WA Health. In the event of an influenza outbreak, they should contact their Public Health Unit to request urgent approval to have a deployment of Commonwealth Government stocks.

Additional communication will be sent out separately this week about deployment details for each jurisdiction.

Responsibilities of approved providers

Prepare residents and families

RACFs are encouraged to pre-assess residents for suitability for Tamiflu and seek resident or family consent ahead of an influenza outbreak and to ensure agreed arrangements with an authorised prescriber for timely provision of prescriptions when needed.

Ensure appropriate storage

RACFs must safely store the medicines when they arrive so they are accessible in an influenza outbreak. Tamiflu must be kept in a secure, cool dry place where the temperature stays below 25°C.

Monitor residents for symptoms and act

Given the short period of time to act (within 48 hours of symptom onset), RACFs should activate their outbreak management plan, in line with Communicable Diseases Network Australia (CDNA) Guidelines for the Prevention, Control and Public Health Management of Influenza Outbreaks in Residential Care Facilities, when symptoms are first detected, including a clinical assessment, test and treatment pathway.

Safe and effective medication administration

Tamiflu is a Schedule 4 Prescription Only medication. The pre-placed Tamiflu can only be used for residents of aged care facilities following prescription by an authorised prescriber.

Nurse practitioners may prescribe medicines as private prescriptions according to their state/territory prescribing accreditation.

The medicines which can be prescribed differ between states and territories.

Nurse practitioners should check whether they have authority to prescribe Tamiflu under their relevant state or territory medicines and poison legislation.

You can find further information in the following resources:

The health department says testing for flu and COVID is a critical step to determining appropriate treatment for both flu and COVID and ensuring the right medication is administered in a timely way. But please note that a lab-confirmed positive flu result is not required for a GP or nurse practitioner to prescribe Tamiflu.

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